Difference between revisions of "Team:Oxford/Questionnaires"

(Undo revision 190017 by Duke of hildas (talk))
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    <div class="container-fluid page-heading">
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        <h3>Questionnaire Results</h3>
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    <h3>Practices</h3>
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    </div>
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    <div class="container-fluid">
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<div class="container-fluid">
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    <div class="row">
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            <div class="col-md-9">
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        <div class="col-md-9">
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                <div class="section" id="first_questionnaire">
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            <div class="section" id="introduction">
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                    <div class="slim">
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                <div class="slim">
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                        <h2>First Questionnaire</h2>
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                    <h2>Introduction</h2>
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                         <div id="q1_aim">
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                    <p>
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                             <h4>Aim:</h4>
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                         Our project relies on a three way conversation between the team, the public and experts. It touches every aspect of the project, from our choice of application to the details of our delivery system. We promoted Synthetic Biology and iGEM through outreach programs to inspire the next generation.
 +
                    </p>
 +
                    <p>
 +
                        Urinary tract infections are a huge problem globally with millions of cases reported each year. We’re producing a guide for everything you need to know about urinary tract infections, as well as a treatment to beat antibiotics, which are rapidly becoming ineffective.
 +
                    </p>
 +
                    <p>
 +
                        We want to make our website as accessible as possible to all readers, regardless of their level of expertise. Words with a <a class="definition" title="Dotted Blue Underline" data-content="Yep, just like this one.">dotted blue underline</a> will show a definition when you hover over them.
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                    </p>
 +
                </div>
 +
            </div>
 +
            <div class="section-spacer"></div>
 +
            <div class="section" id="project-choice">
 +
                <div class="slim">
 +
                    <h2>Project Choice</h2>
 +
                    <div id="project-choice-approaching-the-public">
 +
                             <h3>Approaching the Public</h3>
 
                             <p>
 
                             <p>
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                                 To find out what the public want synthetic biology to do for them.
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                                 To decide on our project idea, we sent out an initial questionnaire to the public to hear about what they thought about synthetic biology. We asked what big problems they wanted solving. We took the questionnaire to schools, to the streets and to our friends.
 
                             </p>
 
                             </p>
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                        </div>
 
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                        <div id="q1_introduction">
 
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                            <h4>Introduction</h4>
 
 
                             <p>
 
                             <p>
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                                 We conducted this survey in the Christmas vacation, with the idea that the results from this survey could inform our choice of project. The responses we got back were very varied, with some very interesting and detailed possibilities, and other, less thought-through options, such as "stop racism".
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                                 Examples of their suggestions for the applications of synthetic biology include bacteria which:
 
                             </p>
 
                             </p>
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                        </div>
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                            <ul>
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                        <div id="q1_results">
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                                <li>Remove carbon dioxide from the atmosphere</li>
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                            <h1>Results</h1>
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                                <li>Target and kill cancerous cells</li>
 +
                                <li>Help treat Alzheimer's disease</li>
 +
                                <li>Produce energy</li>
 +
                                <li>Sew up holes in clothes</li>
 +
                                <li>Produce teeth glue</li>
 +
                                <li>Indicate how long someone has been dead for</li>
 +
                                <li>Combat antibiotic resistance</li>
 +
                            </ul>
 
                             <p>
 
                             <p>
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                                 We decided to display the responses from this questionnaire as a word cloud. The size of each word in the word cloud is proportional to the frequency of its occurrence in the questionnaire responses, so that it is clear what the public consensus of useful project ideas is.
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                                 Of our responses, around 40 were related to Medicine and Health [<a href="#PRef1">1</a>]. This led us to choose that track for our project. However, it was our team member George Driscoll’s work at the UTI clinic in London which helped us to select UTIs as a specific cause. Due to the un-aesthetic nature of the infection, it often receives less attention with regard to research.
 
                             </p>
 
                             </p>
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                             <div class="image image-full">
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                             <p>
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                                <img src="https://static.igem.org/mediawiki/2015/0/04/Ox_Wordcloud-white-background.png">
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                                A large proportion of our responses expressed concern for how Synthetic Biology would be used in society, with several references to the issues of contamination and exploitation for profit. With this in mind, we constructed a second questionnaire about our project, to test whether the public would get behind it.
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                            </div>
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                            </p>
 +
                    </div>
 +
                        <div id="project-choice-approaching-the-public-initial-feedback">
 +
                              <h4>Initial Feedback</h4>
 +
                              <p>
 +
                                  We sent a second questionnaire to find out more about whether the public would use a Solution from synthetic biology to treat Urinary tract infections. We asked more about whether they had heard of genetic engineering or synthetic biology, and how much they trust a recommended treatment by a doctor. In collaboration with UCL, we also filmed some of these responses on the street. The results were overwhelmingly positive.
 +
                              </p>
 
                         </div>
 
                         </div>
 +
                    <div id="project-choice-our-inspiration">
 +
                            <h3>Our Inspiration</h3>
 +
                            <p>
 +
                            </p>
 
                     </div>
 
                     </div>
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                </div>
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                         <div id="project-choice-our-inspiration-jorge-talk">
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                <div class="section" id="second_questionnaire">
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                             <h4>Jorge Talk</h4>
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                    <div class="slim">
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                        <h2>Second Questionnaire</h2>
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                         <div id="q2_aim">
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                             <h4>Aim:</h4>
+
 
                             <p>
 
                             <p>
−
                                To find out the public's thoughts on genetic modification, and see whether they would consider a treatment involving modified bacteria if they were suffering with a UTI, as well as gauging their opinion as to whether antibiotic resistance is a problem.
 
 
                             </p>
 
                             </p>
 
                         </div>
 
                         </div>
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                         <div id="q2_introduction">
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                         <div id="project-choice-our-inspiration-churchill">
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                             <h4>Introduction</h4>
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                             <h4>Churchill Hospital, Oxford</h4>
 
                             <p>
 
                             <p>
−
                                 Throughout our project, we have been determined to engage with the public so that we can develop a project which will be as useful to as many people as possible. These questionnaires, along with interviews with medical professionals and posts on social media, comprise a dialogue that we have maintained with the public for the duration of our project.
+
                                 Our first visit to the hospital was to the outpatient clinic during which we spoke with Jan, one of the nurses on the ward. Jan told us about a case of a person getting septicaemia as a result of a urinary infection. The patient had received antibiotics for seven days and had come back for a check up. Their urine sample was clear and all seemed fine but then the patient had started to shake. The bacteria were now in their blood as it had travelled back up the ureter to the kidney. Even though this was a rare case, it was shocking to hear about such a serious case and made our project feel very relevant.
 +
                            </p>
 +
                            <p>
 +
                                Jan also made the following points:
 +
                            </p>
 +
                            <ul>
 +
                                <li>People with infections have a catheter because they need a way to empty the bladder; else the urine travels up the ureter and back into the bladder</li>
 +
                                <li>If a patient becomes septic the catheter has to be removed or can be fatal</li>
 +
                                <li>UTIs are not just contracted by the catheter and it is important to also consider community based UTIs</li>
 +
                                <li>“UTIs are very common and can be quite painful”</li>
 +
                                <li>No separate ward for UTIs – they are treated in every ward</li>
 +
                                <li>The protocol for treatment is to take a urine sample, see if there is an infection, and prescribe antibiotics that the bacteria are most sensitive to</li>
 +
                                <li>Elderly hospital wards are likely to have many cases of UTIs</li>
 +
                            </ul>
 +
                            <p>
 +
                                We took a lot from this initial conversation. We went onto investigating the pros and cons of the current methods of treating urinary infections and compared these to what Solution could offer. We realized that we needed to consider the catheter more from a hospital/medical perspective as up to this point we had confused its function, thinking it was more to do with administering medication rather than emptying the bladder. Following this meeting, the design of the catheter became an integral part of the project.
 
                             </p>
 
                             </p>
 
                         </div>
 
                         </div>
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                         <div id="q2_questions">
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                         <div id="project-choice-our-inspiration-jr">
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                             <h1>Questions</h1>
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                             <h4>John Radcliffe Hospital, Oxford</h4>
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                             <div id="q2_age">
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                             <p>
−
                                <h3>Ages of participants</h3>
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                                We still wanted to learn more about urinary infections as well as to get some feedback from nurses abourtour idea. We organized a trip to the Adams Ward (Geratology) to learn more about how urinary infections affect elderly people.
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                                 <div class="image image-right">
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                            </p>
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                                     <img src="https://static.igem.org/mediawiki/2015/3/38/Ox_Colour_scheme_age_pie_chart.png">
+
                            <h4>First interview with Laura Evans, Adams Ward</h4>
 +
                            <p>
 +
                                What is the procedure for treating UTIs?
 +
                            </p>
 +
                            <ol class="interview-response">
 +
                                <li><em>Dip urine</em></li>
 +
                                <li><em>If the test comes back as positive, treat with a wide spectrum antibiotic</em></li>
 +
                                <li><em>Whether or not the catheter is inserted with prophylactic antibiotic treatment is the doctor’s decision</em></li>
 +
                            </ol>
 +
                            <p>
 +
                                What happens when a patient tests positive for a urinary infection?
 +
                            </p>
 +
                            <p class="interview-response">
 +
                                <em>Whether or not the catheter is removed if a patient tests positive for a urinary infection depends largely on the reason that the catheter has been fitted. On the whole, the catheter remains fitted and the patient is treated with a large dose of antibiotics.</em>
 +
                            </p>
 +
                            <p>
 +
                                Is antibiotic resistance a problem?
 +
                            </p>
 +
                            <p class="interview-response">
 +
                                <em>Yes, particularly on this ward. As we treat elderly patients with recurring infections, their UTIs are frequently resistant to antibiotic treatment. We try different combinations of antibiotics but recurring infections are a significant problem.</em>
 +
                            </p>
 +
                            <p>
 +
                                Our project involves designing a catheter that prevents the formation of a biofilm on its surface. What do you think of this idea?
 +
                            </p>
 +
                            <p class="interview-response">
 +
                                <em>A catheter like that would be useful, but it depends on how long your catheter would work for. Patients can have catheters fitted for 3 months or longer. Catheters are also removed for other reasons, for example if they become blocked. Blockage is particularly an issue when the patient is suffering from a urinary infection.</em>
 +
                            </p>
 +
                            <p>
 +
                                Laura’s response regarding how long a catheter remains in place spurred us into researching how we could keep our Solution bacteria alive. This is what we found.
 +
                            </p>
 +
                        </div>
 +
                    <div id="project-choice-the-problem">
 +
                            <h3>The Problem</h3>
 +
                            <p>
 +
                                Following our inspiring visits to the Churchill and John Radcliffe hospitals, we wanted to find out the public thought about the problem of antibiotic resistance. We posed the question:
 +
                                <em>To what extent do you feel that antibiotic resistance is a problem that needs addressing in society today?</em>
 +
                                 <div class="image image-full">
 +
                                     <img src="https://static.igem.org/mediawiki/2015/d/dd/Ox_Q2_antibiotic_resistance.png">
 
                                 </div>
 
                                 </div>
 
                                 <p>
 
                                 <p>
−
                                     We included age brackets as part of the survey so that we could check that our data is roughly representative, and so that we could see to what extent people of different ages are informed about genetic modification and antibiotic resistance. We found that most older people (31+) have heard of genetic modification but not synthetic biology, and are less likely to allow genetically modified bacteria to be used as a treatment. Younger people (up to 30) tend to be more open to the new treatment ideas, and more of them have heard of synthetic biology. However, our results may be biased, due to the high proportion of our participants aged under 30. Different generations are likely to have had different educations; synthetic biology is a very new field, so it is likely not to have been taught in schools yet. Similarly, older people may be more aware, and sceptical, due to the previous GM food scare.
+
                                     Our survey clearly shows that, according to the general public, antibiotic resistance is an important problem that needs solving. Therefore we felf it was a useful area to direct our project towards. One of our team members, George, worked in a UTI clinic over the summer of 2014, so he knows first-hand that UTIs are a big problem for a lot of people and that, in severe cases, current methods of treatment are inadequate. When he brought this to our attention, we thought it was worthwile trying to find a solution to this problem.
 
                                 </p>
 
                                 </p>
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                             </div>
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                             </p>
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                            <div id="q2_awareness">
+
                    </div>
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                                <h5>Awareness</h5>
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                        <div id="project-choice-the-problem-experts">
−
                                <div id="q2_antibiotic_resistance">
+
                            <h4>Feedback from Oxford Experts</h4>
−
                                    <h3>To what extent do you feel that antibiotic resistance is a problem that needs addressing in society today?</h3>
+
                            <p>
−
                                    <p>
+
                              To gain a further insight into the feasibility of Solution, we gave two talks during the summer, one at the termly Corpus Christi College Biochemistry talks and another to a group of alumni from the Oxford Biochemistry department. Two important questions arose from these talks:
−
                                        Our survey clearly shows that the public think that antibiotic resistance is an important problem that needs solving, therefore we feel that it is an appropriate and useful area to direct our project towards. One of our team members, George, worked in a UTI clinic last summer, so he knows first-hand that UTIs are a big problem for a lot of people, with current methods of treatment still being inadequate in severe cases. When he brought this to our attention while we were trying to decide on a project, we thought it was worthwile trying to find a solution to this problem.
+
                            </p>
−
                                    </p>
+
                            <ul>
−
                                    <div class="image image-full">
+
                              <li>Have you considered whether the proteins you planning on secreting are immunogenic?</li>
−
                                        <img src="https://static.igem.org/mediawiki/2015/d/dd/Ox_Q2_antibiotic_resistance.png">
+
                              <li>If you are to kill all of the pathogenic bacteria in the urinary tract, will that make fungal infections more likely?</li>
−
                                    </div>
+
                             </ul>
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                                </div>
+
−
                                <div id="q2_hospital_infection">
+
−
                                    <h3>Which of these do you think is the most common infection acquired in hospitals?</h3>
+
−
                                    <p>
+
−
                                        Most of the public (45.5%) thought that MRSA is the most commonly acquired infection in hospitals, showing that they think that antibiotic resistance is a problem. However, with UTIs coming in quite far behind this (19.5%), it seems that the public are not aware of the risk of getting UTIs in hospital due to urinary catheterisation. This could be due to the fact that UTIs are advertised less than MRSA, but since this is an important issue, we looked into educating the public through sessions with summer schools and school students, as well as getting in touch with local media, such as BBC Radio Oxford, ad promoting our project across social media. We believe that this has helped raise awareness of problems associated with catheter-based infections, not only in the urinary tract, but also due to other catheterised parts of the body.
+
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                                    </p>
+
−
                                    <div class="image image-full">
+
−
                                        <img src="https://static.igem.org/mediawiki/2015/f/f9/Ox_Q2_hospital_infection.png">
+
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                                    </div>
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                                </div>
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                                <div id="q2_genetic_engineering">
+
−
                                    <h3>Have you heard of genetic engineering?</h3>
+
−
                                    <p>
+
−
                                        96.5% of the people we surveyed had heard of genetic engineering. However, we did not collect data for whether people thought it was a good thing or not. This would be something to pursue in further surveys.
+
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                                    </p>
+
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                                    <div class="image image-full">
+
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                                        <img src="https://static.igem.org/mediawiki/2015/f/ff/Ox_Q2_genetic_engineering.png">
+
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                                    </div>
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                                </div>
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                                <div id="q2_synthetic_biology">
+
−
                                    <h3>Have you heard of synthetic biology, before this questionnaire?</h3>
+
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                                    <p>
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                                        Compared to the question about genetic modification, the results for this question were much more evenly spread between yes and no, with 58% saying they had heard of synthetic biology. Again, it would be interesting to see whether those who have heard of synthetic biology have a good opinion of it or not, and this would be an avenue for future surveys.
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                                <h5>Treatment</h5>
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                                    <h3>If you had the option of using two treatments for an infection, where one was antibiotics and one was bacteria that were designed to cure the infection, which would you choose?</h3>
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                                        The majority (70%) of the people we surveyed said that they would take the advice of their doctor on this. This means that it is important that we talk to and get advice from doctors as to how we can improve out treatment, since if we can't convince doctors that this is a better treatment than any current treatment, the patients won't take it either. However, encouragingly, of those who wouldn't take the advice of their doctor, our treatment was favourite with just under half saying they would prefer the designed bacteria (48%), compared to 40% who would prefer antibiotics.
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                                    <h3>If your doctor recommended a treatment for an infection, which involved the use of bacteria that had been engineered to treat the infection, would you use it?</h3>
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                                        Our survey showed that if a doctor recommended our treatment, only 6% would not consider it. This is very encouraging data for our project, but again highlights the importance of gaining support from doctors, because without their backing, this project is likely never to become as common a treatment as antibiotics.
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                          <h3>Our Solution</h3>
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                        <a href="#first_questionnaire">First Questionnaire</a>
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                     <h2>Project Viability</h2>
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                            <li><a href="#q1_results">Results</a></li>
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                        <h3>Will Our Idea Work?</h3>
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                         <a href="#second_questionnaire">Second Questionnaire</a>
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                        <h3>Ethics</h3>
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                        <p>
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                             <li><a href="#q2_introduction">Introduction</a></li>
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                            To find out the public opinion on our project, we sent out a questionnaire to over 150 people, asking: <em>'If your doctor recommended a treatment for an infection, which involved the use of bacteria that had been engineered to treat the infection, would you use it?'</em>. We also asked this question to a number of medical professionals during our visits to hospitals and clinics.
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                                    <li><a href="#q2_age">Ages of Participants</a></li>
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                            Whilst the majority of feedback was very positive, we did encounter some valuable criticism, as shown in the graph below. Most medical professionals we spoke to had positive responses, though one nurse did have certain reservations about our idea.
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                                            <li><a href="#q2_antibiotic_resistance">To what extent do you feel that antibiotic resistance is aproblem that needs addressing in society today</a></li>
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                                            <li><a href="#q2_hospital_infection">Which of these do you think is the most common infection acquired in hospitals?</a></li>
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                                            <li><a href="#q2_genetic_engineering">Have you heard of genetic engineering?</a></li>
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                                            <li><a href="#q2_synthetic_biology">Have you heard of synthetic biology, before this questionnaire?</a></li>
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                             This proportion of negative feedback, although small, highlighted to us that our dialogue with the public needed to be improved. We believe that, through improving people's understanding of our project, we can convince pessimists that genetic engineering is now a force for good. This also led us onto holding talks to student groups, which you can find in the <a href="#project-viability-increasing-awareness">Increasing Awareness</a> section below.
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                                    <li><a href="#q2_treatment">Treatment</a>
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                            Nevertheless, this is very encouraging data for our project, and again highlights the importance of gaining support from doctors, because without their backing, this project is likely never to become as common a treatment as antibiotics.
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                                            <li><a href="#q2_options">If you had the option of using two treatments for an infection, where one was antibiotics and one was bacteria that were designed to cure the infection, which would you choose?</a></li>
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                                            <li><a href="#q2_doctor_recommendation">If your doctor recommended a treatment for an infection, which involved the use of bacteria that had been engineered to treat the infection, would you use it?</a></li>
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                        <h3>The UTI Clinic</h3>
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                        <h3>Delivery Method</h3>
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                    <div id="project-viability-increasing-awareness">
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                        <h3>Increasing Awareness</h3>
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                        <p>
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                            To promote Synthetic Biology and iGEM, we’ve used a variety of approaches.
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                        <div id="project-viability-increasing-awareness-uniq-workshop">
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                                <h4>UNIQ Workshop</h4>
 +
                                <p>
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                                     We met with 40 prospective Oxford students to teach them about Synthetic Biology. The students had in interest in Biochemistry but knew nothing about iGEM. We hammered home the key message of Synthetic Biology - that we achieve more progress by expanding a registry of standardised biological parts - through a 15 minute introductory presentation on BioBricks. We then split them into groups and gave each one a mentor from our iGEM team. We worked through questions to test their understanding in a tutorial style and asked them to explain the constructs of previous iGEM teams. They finished by presenting their findings to each other.
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                                <h4>UTC Oxfordshire</h4>
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                                <p>
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                                    A couple of us gave a presentation on antibiotic resistance to a class of GCSE students from UTC Oxfordshire (a local school specialising in science) at the Natural History Museum in Oxford, The Pitt Rivers Museum. Our talk covered the discovery of antibiotics, the advantages of them (including their use in laboratory work), how they work, and how bacteria can evolve to gain resistance to them, as well as concepts such as horizontal gene transfer and the consequences of antibiotic resistance on our everyday lives. It also covered our project outline, and pros and cons of Solution, showing how it should help combat antibiotic resistance. At the end, we held a discussion between the students and our team about antibiotic resistance, and their perception of the concern. We also asked how they would feel about using our engineered bacteria, and the response was positive, with most of the students saying that if their doctor recommended the treatment, they would be open to using it.
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                             <h4>BBC Radio Oxford</h4>
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                <li><a href="#introduction">Introduction</a></li>
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                <li><a href="#project-choice">Project Choice</a>
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                        <li><a href="#project-choice-approaching-the-public">Approaching the Public</a>
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                                <li><a href="#project-choice-approaching-the-public-initial-feedback">Initial Feedback</a></li>
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                        <li><a href="#project-choice-our-inspiration">Our Inspiration</a>
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                                <li><a href="#project-choice-our-inspiration-jorge-talk">Jorge Talk</a></li>
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                                <li><a href="#project-choice-our-inspiration-churchill">Churchill Hospital, Oxford</a></li>
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                                <li><a href="#project-choice-our-inspiration-jr">John Radcliffe Hospital, Oxford</a></li>
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                        <li><a href="#project-choice-the-problem">The Problem</a>
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                                <li><a href="#project-choice-the-problem-experts">Feedback from Oxford Experts</a></li>
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                        <li><a href="#project-choice-our-solution">Our Solution</a></li>
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                          <li><a href="#project-viability-will-our-idea-work">Will Our Idea Work?</a></li>
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                          <li><a href="#project-viability-ethics">Ethics</a></li>
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                          <li><a href="#project-viability-the-uti-clinic">The UTI Clinic</a></li>
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                          <li><a href="#project-viability-delivery-method">Delivery Method</a></li>
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                          <li><a href="#project-viability-increasing-awareness">Increasing Awareness</a>
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                                  <li><a href="#project-viability-increasing-awareness-uniq-workshop">UNIQ Workshop</a></li>
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                                  <li><a href="#project-viability-increasing-awareness-utc-oxfordshire">UTC Oxfordshire</a></li>
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                                  <li><a href="#project-viability-increasing-awareness-bbc-radio-oxford">BBC Radio Oxford</a></li>
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Revision as of 15:04, 9 September 2015

Practices

Introduction

Our project relies on a three way conversation between the team, the public and experts. It touches every aspect of the project, from our choice of application to the details of our delivery system. We promoted Synthetic Biology and iGEM through outreach programs to inspire the next generation.

Urinary tract infections are a huge problem globally with millions of cases reported each year. We’re producing a guide for everything you need to know about urinary tract infections, as well as a treatment to beat antibiotics, which are rapidly becoming ineffective.

We want to make our website as accessible as possible to all readers, regardless of their level of expertise. Words with a dotted blue underline will show a definition when you hover over them.

Project Choice

Approaching the Public

To decide on our project idea, we sent out an initial questionnaire to the public to hear about what they thought about synthetic biology. We asked what big problems they wanted solving. We took the questionnaire to schools, to the streets and to our friends.

Examples of their suggestions for the applications of synthetic biology include bacteria which:

  • Remove carbon dioxide from the atmosphere
  • Target and kill cancerous cells
  • Help treat Alzheimer's disease
  • Produce energy
  • Sew up holes in clothes
  • Produce teeth glue
  • Indicate how long someone has been dead for
  • Combat antibiotic resistance

Of our responses, around 40 were related to Medicine and Health [1]. This led us to choose that track for our project. However, it was our team member George Driscoll’s work at the UTI clinic in London which helped us to select UTIs as a specific cause. Due to the un-aesthetic nature of the infection, it often receives less attention with regard to research.

A large proportion of our responses expressed concern for how Synthetic Biology would be used in society, with several references to the issues of contamination and exploitation for profit. With this in mind, we constructed a second questionnaire about our project, to test whether the public would get behind it.

Initial Feedback

We sent a second questionnaire to find out more about whether the public would use a Solution from synthetic biology to treat Urinary tract infections. We asked more about whether they had heard of genetic engineering or synthetic biology, and how much they trust a recommended treatment by a doctor. In collaboration with UCL, we also filmed some of these responses on the street. The results were overwhelmingly positive.

Our Inspiration

Jorge Talk

Churchill Hospital, Oxford

Our first visit to the hospital was to the outpatient clinic during which we spoke with Jan, one of the nurses on the ward. Jan told us about a case of a person getting septicaemia as a result of a urinary infection. The patient had received antibiotics for seven days and had come back for a check up. Their urine sample was clear and all seemed fine but then the patient had started to shake. The bacteria were now in their blood as it had travelled back up the ureter to the kidney. Even though this was a rare case, it was shocking to hear about such a serious case and made our project feel very relevant.

Jan also made the following points:

  • People with infections have a catheter because they need a way to empty the bladder; else the urine travels up the ureter and back into the bladder
  • If a patient becomes septic the catheter has to be removed or can be fatal
  • UTIs are not just contracted by the catheter and it is important to also consider community based UTIs
  • “UTIs are very common and can be quite painful”
  • No separate ward for UTIs – they are treated in every ward
  • The protocol for treatment is to take a urine sample, see if there is an infection, and prescribe antibiotics that the bacteria are most sensitive to
  • Elderly hospital wards are likely to have many cases of UTIs

We took a lot from this initial conversation. We went onto investigating the pros and cons of the current methods of treating urinary infections and compared these to what Solution could offer. We realized that we needed to consider the catheter more from a hospital/medical perspective as up to this point we had confused its function, thinking it was more to do with administering medication rather than emptying the bladder. Following this meeting, the design of the catheter became an integral part of the project.

John Radcliffe Hospital, Oxford

We still wanted to learn more about urinary infections as well as to get some feedback from nurses abourtour idea. We organized a trip to the Adams Ward (Geratology) to learn more about how urinary infections affect elderly people.

First interview with Laura Evans, Adams Ward

What is the procedure for treating UTIs?

  1. Dip urine
  2. If the test comes back as positive, treat with a wide spectrum antibiotic
  3. Whether or not the catheter is inserted with prophylactic antibiotic treatment is the doctor’s decision

What happens when a patient tests positive for a urinary infection?

Whether or not the catheter is removed if a patient tests positive for a urinary infection depends largely on the reason that the catheter has been fitted. On the whole, the catheter remains fitted and the patient is treated with a large dose of antibiotics.

Is antibiotic resistance a problem?

Yes, particularly on this ward. As we treat elderly patients with recurring infections, their UTIs are frequently resistant to antibiotic treatment. We try different combinations of antibiotics but recurring infections are a significant problem.

Our project involves designing a catheter that prevents the formation of a biofilm on its surface. What do you think of this idea?

A catheter like that would be useful, but it depends on how long your catheter would work for. Patients can have catheters fitted for 3 months or longer. Catheters are also removed for other reasons, for example if they become blocked. Blockage is particularly an issue when the patient is suffering from a urinary infection.

Laura’s response regarding how long a catheter remains in place spurred us into researching how we could keep our Solution bacteria alive. This is what we found.

The Problem

Following our inspiring visits to the Churchill and John Radcliffe hospitals, we wanted to find out the public thought about the problem of antibiotic resistance. We posed the question: To what extent do you feel that antibiotic resistance is a problem that needs addressing in society today?

Our survey clearly shows that, according to the general public, antibiotic resistance is an important problem that needs solving. Therefore we felf it was a useful area to direct our project towards. One of our team members, George, worked in a UTI clinic over the summer of 2014, so he knows first-hand that UTIs are a big problem for a lot of people and that, in severe cases, current methods of treatment are inadequate. When he brought this to our attention, we thought it was worthwile trying to find a solution to this problem.

Feedback from Oxford Experts

To gain a further insight into the feasibility of Solution, we gave two talks during the summer, one at the termly Corpus Christi College Biochemistry talks and another to a group of alumni from the Oxford Biochemistry department. Two important questions arose from these talks:

  • Have you considered whether the proteins you planning on secreting are immunogenic?
  • If you are to kill all of the pathogenic bacteria in the urinary tract, will that make fungal infections more likely?

Our Solution

Project Viability

Will Our Idea Work?

Ethics

To find out the public opinion on our project, we sent out a questionnaire to over 150 people, asking: 'If your doctor recommended a treatment for an infection, which involved the use of bacteria that had been engineered to treat the infection, would you use it?'. We also asked this question to a number of medical professionals during our visits to hospitals and clinics.

Whilst the majority of feedback was very positive, we did encounter some valuable criticism, as shown in the graph below. Most medical professionals we spoke to had positive responses, though one nurse did have certain reservations about our idea.

This proportion of negative feedback, although small, highlighted to us that our dialogue with the public needed to be improved. We believe that, through improving people's understanding of our project, we can convince pessimists that genetic engineering is now a force for good. This also led us onto holding talks to student groups, which you can find in the Increasing Awareness section below.

Nevertheless, this is very encouraging data for our project, and again highlights the importance of gaining support from doctors, because without their backing, this project is likely never to become as common a treatment as antibiotics.

The UTI Clinic

Delivery Method

Increasing Awareness

To promote Synthetic Biology and iGEM, we’ve used a variety of approaches.

UNIQ Workshop

We met with 40 prospective Oxford students to teach them about Synthetic Biology. The students had in interest in Biochemistry but knew nothing about iGEM. We hammered home the key message of Synthetic Biology - that we achieve more progress by expanding a registry of standardised biological parts - through a 15 minute introductory presentation on BioBricks. We then split them into groups and gave each one a mentor from our iGEM team. We worked through questions to test their understanding in a tutorial style and asked them to explain the constructs of previous iGEM teams. They finished by presenting their findings to each other.

UTC Oxfordshire

A couple of us gave a presentation on antibiotic resistance to a class of GCSE students from UTC Oxfordshire (a local school specialising in science) at the Natural History Museum in Oxford, The Pitt Rivers Museum. Our talk covered the discovery of antibiotics, the advantages of them (including their use in laboratory work), how they work, and how bacteria can evolve to gain resistance to them, as well as concepts such as horizontal gene transfer and the consequences of antibiotic resistance on our everyday lives. It also covered our project outline, and pros and cons of Solution, showing how it should help combat antibiotic resistance. At the end, we held a discussion between the students and our team about antibiotic resistance, and their perception of the concern. We also asked how they would feel about using our engineered bacteria, and the response was positive, with most of the students saying that if their doctor recommended the treatment, they would be open to using it.

BBC Radio Oxford