Healthcare Architecture

This article presents a proposal to categorise stimuli that influence well-being in therapeutic environments following Complementary and Integrative Practices (CIPs). With the broader aim of understanding which environmental stimuli influence the well-being of CIP therapeutic environment users, this qualitative research adopted a multimethod approach: bibliographic and documentary research; walkthrough analysis; exploratory visits; environment observations; and finally, interviews. After cross-referencing a literature review and an environmental assessment of three case studies during 2017, a categorisation was drawn up, and it suggests that the stimuli which most influence well-being in CIP environments are: Artistic, Auditory, Biological, Luminous and Hygrothermal Comfort, Energetic, Spatial, Natural, Olfactory, Social and Socio-Spatial stimuli. Included in a broader debate on creating environments favourable to users’ health, and in line with an increasing demand of CIPs in Brazi...

CONF.ITECH 2022 is the 1st International Conference launched by the Laboratory of Architecture, Building Innovation and Technology, Environment and Climate Changes, Health (LAB.ITECH), Department of Architecture and Design (DIAP), Sapienza University of Rome, and by Roma Sapienza Foundation.

We invite professors, researchers, professionals, and experts around the conference themes to share interdisciplinary vision studies, plans, projects, and experiences regarding topics of strategic importance to the green and digital transition.

Conference Sessions:

- Innovation | Digital world for real cities
- Technology | “Printed” buildings for sustainable habitats
- Environment | Technological innovation for low tech environments
- Climate | Effective solutions for resilient urban habitats
- Health | Environments for healthy living

Abstract submission | 29 November 2021 extended to 10 January 2022

Abstract acceptance | 16 December 2021 extended to 24 January 2022

Full paper submission | 14 March 2022

Full paper acceptance | 14 April 2022

Final paper submission | 23 May 2022

Conference presentation | 30 June, 1-2 July 2022

Papers selected at CONF.ITECH 2022 are to be published in a Conference Proceedings volume by Springer.

Web-site: https://www.technologicalimagination.net/

Submission link: https://cmt3.research.microsoft.com/User/Login?ReturnUrl=%2FCONFITECH2022%2FSubmission%2FIndex

For any information please contact: technologicalimagination.sapienza@uniroma1.it

Date: 30 June 2022 - 2 July 2022

Hospitalised patients are faced with a brute reorientation of their normal spatial needs andpreferences and forced to adjust spatially to a new environment. Patients start to re-arrangetheir own situation according to personal needs and the site-specific circumstances. It is are-arrangement that includes furniture, private objects and spatial positioning, but also theadjustment to the presence and needs of the staff and other patients. What types of spatialand aesthetical preferences and actions emerge in this alignment with the hospital cultureand how can preferences and everyday spatial production by patients be investigated? Here,a methodological approach is suggested where patients look upon their stay at the hospitalby discussing photos that they have produced themselves while hospitalised and answers toa set of questions they have written on image cards produced by the researchers in orderto stimulate discussion. The investigation was carried out in 2012 at Helsingborg Hospita...

Research on the silver economy shows that products and services, which enhance personal autonomy and social cohesion, are common to successful enterprises that serve the needs of both older adults and their carers. Policymaking focuses on such interventions mainly from medical-pharmacological and hi-tech perspectives, such as advancements in pharmaceuticals, wearable technologies and e-health applications or robotics. Aspects of the built environment—that is, human-made surroundings—are rarely considered worth exploring. Yet, the fact that we have created buildings, as opposed to many advanced technologies that we are yet to invent, does not necessarily make them fit for purpose to the needs of our ageing population. This is the case in all forms and scales of the built environment, from houses to transportation networks. This article argues that policies and interventions for active and healthy ageing could benefit from a broader integration framework that would allow our built surroundings, of all scales and complexities, to become part of the solution. This could be achieved through new architectural and design paradigms that, contrary to prevailing architectural education and practice, operate in harmony with human perceptions and physiology, especially for vulnerable and older adults. By better understanding the consequences of the built environment on the well-being of the older population and acting on this we could first prevent the environment being disabling for vulnerable people and, second, hopefully enable increased autonomy through interventions.

In 2020, the Turkish Thoracic Society started a petition demanding the renovation and re-use of the nonoperating sanatorium in Heybeliada Istanbul, as a pandemic hospital including a medical history museum. Along with its potential role in the struggle against the Corona pandemic, the complex is a cultural heritage as well, testifying for the collaborative modernization of architecture and medicine. These two fields concurrently emerged as modern disciplines in the nation-building years of the Turkish republic, a period marked with the regime’s efforts to disintegrate the image of “the sick man of Europe”. The ruling officials, a majority of which were medical graduates influenced by Social Darwinism, identified physical weakness and sickness with moral corruption and treason, which led to a strong emphasis on the struggle against medical diseases, Tuberculosis (TB) in particular. While the architects and physicians borrowed techniques and terminology from each other, the traditional spatial elements such as caged windows and the extensive use of decorative textiles in interiors were condemned as potential causes of TB. Along with public hygiene propaganda, sanatoria and dispensary construction had been high-priority projects. This paper examines the foundation and development period of the first pandemic hospital in Turkey, Heybeliada Sanatorium as a product of modern architecture as well as a tool for socio-cultural transformation. Through periodicals and official publications, the paper further focuses on representations of sanatoria and the position of medical institutions as mediums of state-initiated modernization. Moreover, it discusses how this particular facility resonated with the biopolitical discourse of the regime and set a precedent for the subsequent medical institutions.

This research work carried out in Brazil presents a summary of the experiences of architecture and engineering in the construction of emergency hospitals, as well as other adjustment, retrofit and adaptation solutions in existing buildings to satisfy the needs of each five regions or each of the 5570 cities in all country. For these studies, the documentation and technical recommendations existing at the Ministry of Health were used, as well as the guidelines sent by the International Federation of Healthcare Engineering (IFHE) and the World Health Organization (WHO). In the Brazilian health system, it was possible to identify the different buildings for Health Assistance (EAS) dedicated specifically to the treatment of people affected by COVID-19:
1) Hospitals that care exclusively for the patient with the disease:
a. Existing units converted to service
b. Units built temporarily for assistance
2) Hospital that cares for patients with various diseases including COVID-19.
In most hospitals, a crisis committee was set up with professionals from management, assistance, and technical areas such as architecture and engineering. The main concerns were related to changes in external and internal flows, the creation of beds dedicated to COVID, the mapping and or the acquisition of new equipment and identification of the need to provide changes in the air conditioning system. The first adaptations of Brazilian hospitals that were organized to care for patients with COVID-19 were: the creation of external environments for screening potentially infected patients, separation of flows between different patients and the separation of access by the assistance team; and zoning of inpatient areas, defining exclusive areas for infected patients. Another  fundamental item was the organization of the areas of laboratory and imaging exams.

Access: https://content.yudu.com/web/1u0jl/0A1umgt/IFHE-Digest-2021/html/index.html?page=76&origin=reader

The culture that we have created requires architecture in order to live and socialise, yet the architect is driven by the urge to create aesthetically pleasing buildings, an urge which habitually neglects the need for creating an essence and compromising the usability of the building. Prevalent especially in healthcare architecture, where the usability of the building by medical professionals overshadows the functional needs of the patient, requires design-based solutions which primarily focuses on the restorative essence and properties created by holistic design in order to benefit the user. The interaction between environment and recovery is heavily documented (Ulrich 1984,1992, 2002), yet perpetually falls on deaf ears in favour of the aesthetic.
It is now that returning to our vernacular roots, which supply us with the simplest, most effective form of addressing humanitarian needs, can help us combat these detrimental effects to our planet and rekindle the utilitarian connection between humanity, architecture and nature. Reciprocating our knowledge of utilising the sun and daylight into the building, passive ventilation and energy efficiency, we can strive to create a holistic approach to the intimate connection between design and nature in order to create ‘an essence in architecture: vernacular solutions to the humanitarian issues of the design for healthcare’.
Through analysis of existing scholarship on vernacular methods of sustainable design and the creation of ‘essence’ through the manipulation of space, this essay discusses the importance of creating high quality, aesthetically pleasing sustainable healthcare architecture in order to promote healing and wellbeing.

Introducción En este trabajo discutiremos el papel del Hospital da Lagoa, en Río de Janeiro, como representante del patrimonio del Movimiento Moderno Brasileño y de la historia de las instituciones de salud. Proyectado por los arquitectos Oscar Niemeyer y Hélio Uchôa, también se configura en un modelo de atención hospitalaria a la época de su concepción, evidenciando las formas de enfermedad, tratamiento y cura, en las décadas de 1950 y 1960. El estudio del Hospital, primeramente, denominado Hospital Sulamerica, fue elegido por su valorización como patrimonio arquitectónico moderno, y por su estado de conservación y reutilización de sus espacios. Cabe observar que, además de la adecuación del proyecto a las premisas de la salud, los arquitectos brasileños se encontraban fuertemente influenciados por las características de la arquitectura moderna. Se presenció la búsqueda por mayor confort en las enfermerías, con un cuidadoso estudio de orientación del edificio y empleo de elementos que pudieran proporcionar buena ventilación e insolación, características esenciales de los espacios hospitalarios, y con la incorporación de paneles de azulejos de Athos Bulcão y jardines diseñados por Burle Marx. La preocupación por agregar a los proyectos de los hospitales jardines terapéuticos y obras de arte fue una de las características bastante exploradas por la arquitectura moderna brasileña. 1 Tipología y diseño En 1952 comienza su construcción. La obra se desarrolló por siete años, hasta 1959, y encontró dificultades para su finalización. La primera dificultad fue promover la remoción de una favela, con aproximadamente mil habitantes, que ocupaba el lugar de la construcción. Otro problema de la implantación fue la característica del suelo local, configurado como terreno pantanoso, y que exigió cuidados en la elaboración del proyecto que cuenta con piso en el subsuelo. El hospital fue concebido teniendo un bloque principal con 10 pavimentos y subsuelo, que alberga sus servicios: enfermerías y apartamentos para la internación, consultorios, el Centro Quirúrgico, servicios administrativos y áreas de apoyo al diagnóstico y terapia. El proyecto sigue premisas que posibilitaran la eficiente organización de los espacios internos como la modulación de su estructura y la independencia de paredes divisorias. Este bloque se conecta a un volumen externo, donde están escaleras y elevadores para la circulación vertical, solución recurrente en proyectos de la arquitectura moderna brasileña. 1 Estos elementos presentaban lo que se denominó, en la época, como "síntesis de las artes" o "integración de las artes." La "integración de las artes" fue discutida por el Congreso de Críticos de Arte, realizado en 1959, en Río de Janeiro, en São Paulo y en Brasilia, a punto de ser inaugurada.

Therapeutic architecture can be described as the people-centered, evidence-based discipline of the built environment, which aims to identify and support ways of incorporating those spatial elements that interact with people physiologically and psychologically into design. Architecture is an important factor in people's lives when they are well; when they experience ill-health and are less able to cope it becomes even more important.

This book explores the design of specialized residential architecture for people with mental health problems. It sets out to show how building design can support medical and health related procedures and practices, leading to better therapeutic outcomes and an enhanced quality of life. Based on almost two decades of research, it aims to understand how architectural design interacts with the therapeutic milieu, the care programs, and actually living in the spaces.

The book is divided into two main parts covering theory and research. Part one consists of three chapters: a brief introduction to old practices, current medical psychosocial and architectural thinking, and alternative thinking. Part two explores the research and conclusions derived from fieldwork.
This book provides a fascinating insight into the effect that architectural design can have on all of us, but particularly on those with mental health problems.

The present PhD thesis aims to study architecture for tuberculosis in Portugal, in particular sanatoriums, from its context and project until its decline. This health equipment, distinguished from similar types, constitute a remarkable and singular presence in the universe of architecture between 1850 and 1970, and with which one can observe the mutations during more than one hundred years of existence. On the other hand, they are a mirror of scientific and programmatic changes to combat the disease that depended, to a great extent, from its architectures.
From construction of data scattered by several archives – since the National Assistance to Tuberculosis' own file was not found, which protected the sanatorium processes in Portugal – resulted in a set of information that justifies a thorough historiographical analysis, from several research lines or visions, to the architecture for the white plague.
Based on a broad picture of its evolution, from its origins (analyzing its assertion as sanatoriums, as well as its own functionality) until its dematerialization or reformulation, three fundamental points for the approach were constituted. A first one, constituted by the historiography of the architecture to combat the disease, related to the seemingly similar types, and where architects, the protagonists, are studied in their preponderance, constituted the necessary framework to the understanding of the phenomenon. Grammars and aesthetic languages, formal architectural approximations and spatial configurations, between sanitariums and other architectures of similar scope, are analyzed in the light of cause-effect processes and, where possible, with international relations. On the other hand, the same chapter is designed to build the influence of international panoramas and the construction of vector stipulations with Portuguese systems.
Each of the key architects is associated with their works, in constant comparative and associated reading. In addition to this focus, one travels between urban readings resulting from hygienic processes (notably at the hinge of the nineteenth and twentieth centuries) and the architectural scale of the various buildings, particularly hospital buildings. The bodies with decision-making power over architects and architectures are also analyzed, in particular with the eternal paradigms of the various modernities and possible interpretative readings of the various governmental moments to which sanatoriums are transversal. Between tradition and modernity, the various models are analyzed, for the typological consolidation of the sanatorium as architecture and as therapy.
A second chapter takes parallel structure but related to the history of tuberculosis, its evolution, therapeutics and consequences for the sanatorium program. From the first scientific considerations regarding tuberculosis, its definition and consolidation as a discipline, through its transitions and ending in the structuring of its fight, are revealed the multiple phases and layers of the organization and power, by the architects, doctors and political decision-makers. Meanwhile, and before the beginning of the end, a series of premises and definitions of devices, networks and systems that marked the path of the sanatorium as a system and as a device for the disease are stipulated.
In this way, a third chapter – the body of the thesis – takes place, where the points and the questions that are placed in these architectures are carefully studied. A first concept argues about the first sanatorial architectures in Portugal, with the particular cases of Madeira and Serra da Estrela, between the international pioneering spirit and the consolidation of a propagated treatment by sea and altitude. Subsequently, through the consolidation of treatment centres, we come to the comparative analysis of sanatoriums, architectures, architects, physicians and, necessarily, the constantly changing sphere of power that has surrounded them, from financing, planning, approval and execution. There is a concern about the consolidation of modern importance – both in programs and in buildings – and its evolution, especially with the hygiene rules of transition and during the “Estado Novo”, reflected in the institutions and as a mirror of the concerns of the pandemic without effective treatment.
Its differentiating elements, such as healing galleries, gardens, equipment and spatial configurations, are correlated between different categories or parallel to other systems, along with styles and architectural grammars, by the pencil of key architects and their works.
One concludes by highlighting the main ideas, the possible responses and consequent analysis of the results, providing clues to future research considerations.
The universe of research and consolidation of information is presented in the second body (annexes), with its own structure that allows the individual understanding of all sanatoriums studied, supported with the respective textual and graphic documentation, synthesized in their individual files.

Various dementia diseases (including Alzheimer's) are associated with a significant reduction in abilities and the progressive destruction of cognitive and expressive functions. Alzheimer's per se disrupts mental abilities like memory, judgment, language, and decision-making abilities and causes negative emotions, sleep disorders, destructive behaviors such as isolation, depression, agitation, and aggression. As Alzheimer's develops, symptoms like a disturbance in testing reality, confusion, and anxiety will be added to the previous problems. There is still no definitive treatment for the disease. But the studies proved that architecture can play a significant role in the reduction of this disease. Studies on care centers for patients with Alzheimer's, analysis of its complications and conditions, and effectiveness of environmental elements for design show that proper design for their living environment is the basic principle for creating their normal lives in society. To answer what environmental and architectural features can be effective in reducing the progress of Alzheimer's, it was found through a descriptive-analytical method that these centers should have a patient-oriented and home-like architecture to create an internal and external environment proper for their lives. Presented elements, while being simple and understandable, should be based on human scales, maximum use of light, use of proper furniture, use of contrasting colors, shortening internal paths, use of signs and elements, noise control in the internal environment, as well as considering the courtyard, determining entrances and exits and non-use of sliding floorboards in the external environments. To this end, various factors have significant roles. Some of these factors are the five senses, furniture, privacy, participation in social affairs, connection with nature, and relatives. Each of these factors prompts the patients' memories and somehow helps them to keep their memories alive and creates a sense of independence in them. So, architecture can help them to keep their mind active and dynamic and slow down their disease progress. Physical exercises have a significant effect on the cognitive functions of elderlies with Alzheimer's. Results showed that endurance and combined exercises caused significant differences with those who received no exercise. But strength exercises cause no significant difference with elderlies with no exercise. So, the principles and elements for optimal design should be considered in designing care centers for patients with Alzheimer's while maintaining their independence.

Objective: To present a comprehensive review of the research literature on the effects of the architectural designs of mental health facilities upon the users.
Background: Using a team of cross disciplinary researchers, this review builds upon previous reviews on general and geriatric health care design in order to focus upon research undertaken for mental health care facility design.
Methods: Sources were gathered in 2010 and 2011. In 2010 a broad search was undertaken across health and architecture; in 2011, using keywords listed below and 13 databases, researchers conducted a systematic search of peer reviewed literature addressing mental health care and architectural design published between 2005 to 2012, as well as a systematic search for academic theses for the period 2000 to 2012.  Recurrent themes and sub themes were identified and numerical data that emerged from quantitative studies was tabulated.
Results: Key themes that emerged were:  nursing stations; light; therapeutic milieu; security; privacy; designing for the adolescent; forensic facilities; interior detail; patients’ rooms; art; dementia; model of care; gardens; post occupancy evaluation; user engagement in design process.  Of the 165 articles (including conference proceedings, books and theses), 25 contain numerical data from empirical studies and 7 are review articles.
Conclusions: Based on the review results, especially the  growing evidence of the benefits of therapeutic design upon patient and staff well-being and client length of stay, additional research questions are suggested concerning optimal design considerations, designs to be avoided, and the involvement of major stakeholders in the design process.

Medicine is a science, but the practice of medicine is an art. This is especially true in the branch of medicine called medical imaging. The art of applying medical imaging requires high-technology equipment, tremendous care and patience, and a unique sensitivity.

Identification of environmental Therapeutic Goals (TGs) has proven essential in providing useful guidance for planning and design (Cohen & Weisman 1991).  Though age-specific environmental dimensions have been suggested by several researchers during 1980’s to 1990’s, none of them focused on dying patients and their experience in hospice care environment, so the need for categorizing dimensions for hospice environment is evident. The objective of this study is to identify the Therapeutic Goals of hospice environment focusing on patients’ experience. This study employed a systematic literature review with an
approach developed by Hawker and colleagues in 2002. This study had considered a wide-ranging literature search: 7 electronic databases search (PubMed, PsycINFO, Social Science Citation Index, Science Citation Index, ProQuest Dissertations & Thesis, Avery, and Cochrane Library), reference list search, examination of literature recommended by relevant experts, and Google search for books, reports, and guidelines.  In total 48 literature included; 39 full text articles, 2 books, 5 guidelines, and 2 reports. The data has extracted from these literature onto a standard template (matrix) for comparison and analysis for coding and thematic development. The study identified eight themes as TGs which have direct influence on patients’ experience of hospice care environment: provide continuity of self, provision of access to nature, provision of privacy, facilitate social interaction, maximize safety & security, provision of autonomy, regulate stimulation, and
provision of spiritual care. These goals reflect two characteristics; each expresses a basic or derived major patient’s need, and a potential environmental facilitator for the satisfaction of the need (Lawton et al. 2000). As the physical environment of hospice has significant impact on the patients’ quality of life and the possibility of a good death (Cohen et al. 2001), these TGs have a positive effect on patients’ lives.

This chapter is intended to provide a common language to enable both medical and design professionals to improve their dialog and collaborative work processes when designing pediatric cardiac care settings. This approach will help provide knowledge that can be applied to new construction or renovation
of cardiovascular operating rooms and cardiac catherisation laboratories.

It is not uncommon during the course of healthcare facility design for numerous people to use common terms that have different meanings for each person and community, and then be surprised to later discover that their conversations were about different meanings that led to a different understanding and mindset.

Within the context of this chapter, the term “hybrid (surgical) room” is used to describe a procedure room designed and intended for either “open” or “closed” procedures, or both. They may be built for use by specific sub- specialists, or they may be shared by diverse users. This is a prime example of the necessity to clarify the operational, technological, cultural and political strategies explicitly prior to design inception and master planning.

This chapter is not only about architectural design and planning, although that is its primary focus. Its underlying message is that the design of cardiovascular surgical procedure rooms or suites – regardless of how innovative they are or how much advanced medical technology they contain – will likely only be successful if they are closely aligned with the evolving changes in models of care, medical practices, local culture, politics and a concern for safety and high reliability of care. Cardiovascular spaces must
also be designed with strategies that enable them to constantly evolve and be prepared for future changes in care models and technology requirements.

Traditional boundaries – both physical and virtual – between surgical and non-surgical specialists, as well as within surgical and interventional subspecialties are eroding with the emergence of hybrid interventionalists.
The chapter encourages the development of a new design ethos and practice to be considered: one in which the commonalities – instead of the differences – of traditional surgical and interventional environments form the building blocks of facility design for tomorrow’s cardiovascular procedures.

Sociologists of health and illness have tended to overlook the architecture and buildings used in health care. This contrasts with medical geographers who have yielded a body of work on the significance of places and spaces in the experience of health and illness. A review of sociological studies of the role of the built environment in the performance of medical practice uncovers an important vein of work, worthy of further study. Through the historically situated example of hospital architecture, this article seeks to tease out substantive and methodological issues that can inform a distinctive sociology of healthcare architecture. Contemporary healthcare buildings manifest design models developed for hotels, shopping malls and homes. These design features are congruent with neoliberal forms of subjectivity in which patients are constituted as consumers and responsibilised citizens. We conclude that an adequate sociology of healthcare architecture necessitates an appreciation of both the construction and experience of buildings, exploring the briefs and plans of their designers, and observing their everyday uses. Combining approaches and methods from the sociology of health and illness and science and technology studies offers potential for a novel research agenda that takes healthcare buildings as its substantive focus.

I testi pubblicati sono sottoposti a un processo di peer-review Dopo la fine dell'ordine cosmico su cui si reggevano le civiltà antiche, dopo il tramonto della Cristianità medievale e il naufragio del delirio prometeico della Modernità, il globo sul quale ormai sappiamo d'avere un destino comune attende con urgenza un nuovo Nomos. Diviene dunque ineludibile, di fronte alla crisi che pervade ogni aspetto della vita sul nostro pianeta, tornare a pensare il senso e le possibili forme del nostro abitare sulla Terra. Ciò può avvenire soltanto a partire da un radicale ripensamento del Luogo, in quanto spazio non meramente astratto e geometrico, ma concreto lembo di terra, ogni volta singolare, qualificato dall'incontro tra natura e cultura e dalle loro stratificazioni storiche, nel convincimento che l'odierno galoppante processo di delocalizzazione non produce unicamente spaesamento, ma impedisce anche ogni possibilità di futuro soggiorno, senza del quale l'umanità è certamente destinata alla sparizione.

Le persone con Disturbi dello Spettro Autistico (DSA) presentano una particolare sensibilità sensoriale, per la quale l’ambiente va ad incidere sensibilmente sulla qualità di vita. Si parla di ‘spettro’ poiché si ha una grande varietà di comportamenti, che non consentono di definire criteri universali di design, ma necessitano di un nuovo approccio dinamico e flessibile, che permetta di personalizzare le risposte di progetto. L’obiettivo della ricerca è quindi quello, a partire dallo studio dalle esigenze specifiche dell’utenza, delle condizioni ambientali e degli approcci progettuali, di fornire strumenti innovativi di supporto alla progettazione di ambienti ‘terapeutici’, che passino dalla riduzione del disagio e dello stress correlato all’abilitazione della persona, per un’inclusione nella comunità sociale in un progetto di vita integrato, che riguardi ‘casa’, spazi di vita di applicazione (scuola, lavoro, centri diurni…) e condizioni di emergenza rispetto alla cura.

هدف این تحقیق عرضۀ تفسیر و سامانی نو از رابطۀ انسان و محیط مصنوع است. این سامان نو برگرفته از طب
سنتی ایرانی و اساس آن، حکمت طبیعیات است. در نظام حکمت و به تبع آن در طب، هر آنچه در عالم ماده ظهور
یافته، ازجمله انسان و مصنوعات و محیط پیرامونش، واجد کیفیات مشترکی است. ازآنجا که این کیفیات هم در
انسان حاضر است و هم در آنچه پیرامون اوست، به مدد آنها می توان انسان و محیط پیرامونش و رابطۀ این دو را
با رویکردی کل نگر و در چارچوبی واحد، شرح و تبیین کرد. کلنگری و تبیین متناظر انسان و عالم و شناخت مبتنی
بر کیفیات مشترک، ویژگیهایی است که ترغیب به رجوع به این رویکرد می‌کند. لذا میتوان چنین دستگاهی را
شناخت و بر مبنای آن، نظامی نظری برای کاروبار معماری امروز پی افکند. این نظام نظری «معماری طبایع» نامیده شده است. با این رویکرد میتوان حوزههای مختلف معماری را بررسی و در آنها نظریه هایی طرح کرد؛ ازجمله در
کم و کیف پدید آوردن اثر معماری و پدیدآورندۀ اثر، مطالعه و بررسی خصوصیات اثر (محیط مصنوع)، نسبت اثر
با احوال و خصوصیات انسان و نسبت سیاق با اثر و بهر هبردار. در این مقاله، با راهبرد استدلالی، امکان طرح این
رویکرد بررسی و پرسشهای پیش روی آن طرح شده است. مقاله در چهار بخش اصلی تنظیم شده است. بخش
اول و دوم مقدمات ورود به موضوع اند: نخست مقدماتی دربارۀ کلیت و سابقۀ موضوع آمده و در بخش دوم به نکات
معمارانه در متون طب و چگونگی اقتباس این دستگاه از آن پرداخته شده است. بخش سوم بیانِ مختصرِ چیستی
و چگونگی طبیعیات و چهارگانه ها در آن است. در بخش چهارم نیز چگونگی حضور این مفاهیم در معماری شرح
شده است. برای این منظور نخست کلیت رویکرد در قالب گزارههایی روشن بیان و سپس چگونگی تسری آن در
حوزه های مختلف معماری در خلال پرسش هایی نشان داده شده است.
کیفیات مشترک، ارکان (آب، باد، خاک، آتش)، مزاج، معماری، طب، طبیعیات، حکمت

Three main principles of healthcare planning when considering new hospital projects. Abstract When it comes to building a modern hospital, there are many design principles to consider. The place and timing of every construction, the relationship with the environment and the respect of daily life are core issues that play an essential role in every development. The one thing that characterizes a project successfully is its ability to manage and listen to the needs of the people who will live in it but also integrate with every new requirement harmoniously. In the modern world affected by COVID-19 disease, there could not be a more demanding environment for planning than hospitals. Starting from the massive need for adaptability, conscientiously following the principles of sustainable design and the need to integrate modern technology, below are analyzed three of the most essential principles of healthcare planning when considering new hospital projects.

The paper examines two operations carried out almost simultaneously in the Kingdom of Sardinia and in the State of Milan starting from 1770, i.e. the restoration of the 15th-century hospital of San Matteo in Pavia and the construction of the new hospital of Sacramento in Vigevano. The two events are placed in chronological contiguity and share the broader scenario, Italian but above all European, of developing more rational and more efficient healthcare facilities, paying specific attention to the relationship with city planning. However, within parameters that touch similar historical contexts and theoretical debates, the two cases stand out for the different options adopted by government institutions.

Inscrita no corpo das investigações sobre a arquitetura da saúde, a definição de concepções da Arquitetura, cumprindo o papel de ‘auxílio’ proposto sob o signo da caridade, da filantropia e da assistência, constitui o cerne deste artigo. Propõe-se destacar o projeto de arquitetura, considerando o entrelaçamento desses dois campos de saber: arquitetura e saúde, na trajetória histórica da instituição hospitalar, seja em aspectos físico-funcionais, estéticos, médico-científicos, tecnológicos, geográficos, socioculturais, políticos ou econômicos. Cumpre ainda compreender a Arquitetura assistencial no contexto de seus financiadores e projetistas, sejam eles monarcas, arquitetos, médicos, mecenas, filantropos ou instituições, acentuando os trânsitos entre Brasil e Portugal, nos séculos XIX e XX e o diálogo com pesquisadores de outros domínios territoriais. Este artigo, que apresenta os resultados da sessão que compôs o IV ENANPARQ, faz parte do Grupo de pesquisa “Saúde e Cidade: arquitetu...

Healthcare facilities have the potential to be active urban centers. They can be the generators of urban density and collect new forms of public space within their gravity, offering themselves up to the public as a new type of civic building. In 2013, students and faculty working in an undergraduate design studio developed schemes for an urban healthcare facility to be located in Birmingham, AL. In the past ten years, this city has dramatically reshaped its downtown by reclaiming industrial property as venues for recreation, exercise and sporting events. Medical facilities have a major influence in this rapidly changing district, and they act as catalysts for attracting other facilities and services. Here, the unique potential of an ongoing downtown revitalization at the edge of an influential medical district guides a specific intersection of design and health.

The studio proposed a “Super Clinic,” not a hospital but a new type of facility that anticipates important changes in our current healthcare system. Developed with input from a healthcare architect, the program addresses equitable access to healthcare. While developing options for this new typology, invited practitioners helped students adjust projects to practical constraints such as programmatic appropriateness, code compliance and structural efficiency. Case studies were assembled and adapted to Birmingham, and the results help position the multi-specialist clinic as an increasingly important civic institution. Because scales range from civic exteriors to individual exam rooms, the Super Clinic suggests numerous urban responses from street walls to civic courtyards to separate pavilions. More than 50 students participated in this studio, and the range of proposals can be categorized into nine types that are inherently mixed-use. Broadly categorized, the proposals prove a range of practical and suggestive options for urban healthcare.

A hospital creates a specific environment, focused on a patient and patient-centered. The complexity of the system that constitutes a hospital also involves certain design solutions. Designing with Evidence Based Design allows not only creating an environment suitable for the patient, but also for all users. It also has an impact on staff, the level of environmental stress and length of stay in hospital, but also allows reducing the costs of operation of the unit.

The spread of infectious diseases claimed more lives than battle wounds during the Crimean
War (1853-1856). Istanbul, then the Ottoman capital, was transformed into a medical hub
where new ideas were tested and exchanged among doctors and nurses from all over Europe
to control the spread of disease. Although the most well-known figure of this international
effort was Florence Nightingale, the medical community serving in Istanbul at the time
had many other heroes and heroines. While Nightingale’s work played an important role in
shaping healthcare facilities in the second half of the 19th century, there were other factors
at play that lead to this transformation. Notably, the Crimean War was the first major armed
conflict that was directly reported from the front by newspaper reporters as it was happening;
a possible catalyst for the significant improvements in hospital conditions that Post-Crimean
War Europe witnessed. Most of these improvements were measures that had already been
proposed prior to the Crimean War. Pavilion style typology in hospital architecture was one
such measure dating back to the first quarter of the 18th century. This article attempts to
question the changing attitudes in Europe towards healthcare facilities immediately after the
Crimean War and questions their links to political aspirations of the time.

Many universities in the United States are investing in classrooms and campuses designed to increase collaboration and teamwork among the health professions. To date, we know little about whether these learning spaces are having the intended impact on student performance. Recent advances in the identification of interprofessional teamwork competencies provide a much-needed step toward a defined outcome metric. Rigorous study of the relationship between design and student competence in collaboration also requires clear specification of design concepts and development of testable frameworks. Such theory-based evaluation is crucial for design to become an integral part of interprofessional education strategies and initiatives. Current classroom and campus designs were analyzed for common themes and features in collaborative spaces as a starting place for specification of design concepts and model development. Four major themes were identified: flexibility, visual transparency/proximity, technology and environmental infrastructure. Potential models linking this preliminary set of design concepts to student competencies are proposed and used to generate hypotheses for future study of the impact of collaborative design spaces on student outcomes.

Inscrita no corpo das investigações sobre a arquitetura da saúde, a definição de concepções da Arquitetura, cumprindo o papel de 'auxílio' proposto sob o signo da caridade, da filantropia e da as-sistência, constitui o cerne deste artigo. Propõe-se destacar o pro-jeto de arquitetura, considerando o entrelaçamento desses dois campos de saber: arquitetura e saúde, na trajetória histórica da instituição hospitalar, seja em aspectos físico-funcionais, estéti-cos, médico-científicos, tecnológicos, geográficos, socioculturais, políticos ou econômicos. Cumpre ainda compreender a Arquitetu-ra assistencial no contexto de seus financiadores e projetistas, se-jam eles monarcas, arquitetos, médicos, mecenas, filantropos ou instituições, acentuando os trânsitos entre Brasil e Portugal, nos séculos XIX e XX e o diálogo com pesquisadores de outros domí-nios territoriais. Este artigo, que apresenta os resultados da ses-são que compôs o IV ENANPARQ, faz parte do Grupo de pesquisa " Saúde e Cidade: arquitetura, urbanismo e patrimônio cultural " , registrado no Conselho Nacional de Pesquisa – CNPq (Brasil), re-unindo pesquisadores da Universidade Federal do Pará e da Fun-dação Oswaldo Cruz (FIOCRUZ) e busca dar continuidade ao Coló-quio Internacional Arquitetura assistencial luso-brasileira da Idade Moderna à contemporaneidade: espaços, funções e protagonistas, realizado em novembro de 2015 em Lisboa, em cooperação entre a Universidade Federal do Pará, a Universidade de Lisboa e a Uni-versidade Lusíada, integrando neste painel a Universidade Federal de Alagoas. No âmbito das pesquisas realizadas por esse Grupo, as investigações sobre a arquitetura da saúde ampliaram-se, ga-nhando novos contornos com o diálogo interinstitucional, no Brasil e Além-Mar, abrangendo a assistência à saúde da população de um modo geral e suas especificidades como a institucionalização da assistência à saúde do trabalhador, sempre entendidas a partir da materialidade da Arquitetura, em que aspectos estéticos e téc-nicos somam-se às demandas socioculturais. Palavras-chave: arquitetura assistencial, patrimônio da saúde, modelos hospitalares, intercâmbios culturais. Abstract Inscribed in the body of research on the health architecture, the definition of conceptions of architecture, fulfilling the role of 'aid' proposed under the sign of charity, philanthropy and service, is at the heart of this paper. It's proposed to highlight the architectural design, considering the intertwining of these two fields of knowledge: architecture and health, the historical trajectory of hospitals, either in physical and functional aspects, aesthetic, medical and scientific, technological, geographical, socio-cultural, political or economic. We should also understand the Assistance Architecture in the context of its funders and designers, be they monarchs,

V ENANPARQ SESSÃO TEMÁTICA Arquitetura Assistencial e saúde: discutindo concepções e protagonistas, coordenada pelas Professoras Cybelle Salvador Miranda (FAU/PPGAU/UFPA) e Marcia Rocha Monteiro (FAU/UFAL) está recebendo propostas de comunicação no período de 15 de março a 10 de abril.

Significativo esempio di architettura sociale degli anni cinquanta, il Dispensario Antitubercolare di Cesano Maderno costituisce la testimonianza del progetto ministeriale di segnare il territorio italiano attraverso la capillare presenza di osservatori e presidi sanitari locali. Oltre a enucleare le fasi salienti progettuali e dell’iter burocratico che hanno portato all’edificazione del centro igienico-assistenziale cesanese, il saggio ripercorre le fasi precedenti alla sua realizzazione connesse al tema della dismissione dell’antico cimitero urbano e allo smaltimento dei resti dalla sua demolizione. Poggiandosi sulla lettura e interpretazione critica di un’ampia documentazione archivistica completamente inedita, l’autore mostra come il valore dell’esperienza cesanese non sia di portata esclusivamente locale, ma appartenga alla storia del vasto processo culturale e medico-scientifico nazionale e alla storia dei tentativi di contrastare le malattie endemiche e alle patologie tubercolari che diede origine a specifiche tipologie architettoniche non ancora pienamente studiate e valorizzate.

The Antitubercular Dispensary, a stage in the Italian history of healthcare in Cesano Maderno
Significant example of social architecture of the fifties, the Anti-tubercular Dispensary of Cesano Maderno is the testimony of the ministerial project to mark the Italian territory through the widespread presence of observatories and local health centers. In addition to identifying the salient design phases and the bureaucratic process that led to the construction of the Cesanese health and hygiene center, the essay retraces the previous phases to its construction connected to the theme of the disposal of the ancient urban cemetery and the disposal of the remains from the demolition. Relying on the reading and critical interpretation of a vast, completely unpublished archival documentation, the author shows how the value of the Cesanese experience is not exclusively local in scope, but belongs to the history of the vast national cultural and medical-scientific process and to the history of attempts to combat endemic diseases and tuberculous pathologies that gave rise to specific architectural typologies not yet fully studied and valued.

Even in the twenty-first century, pandemics lead to a particular kind of spatial organization, such as quarantine. The outbreak of the contamination era re-justifies the medicalization of spaces. Throughout history, there have been several attempts to design spaces for contagious diseases and pandemic situations all over the world-quarantine islands, lazarettos, and healthcare architecture. In the nineteenth century, the first quarantine procedures started in the Ottoman Empire, and Urla-Izmir (Smyrna) island was established as one of the examples of the quarantine system. This study investigates the architecture organization of the quarantine island as an example of a "panoptic" space.

This chapter is intended to provide a common language to enable both medical and design professionals to improve their dialog and collaborative work processes when designing pediatric cardiac care settings. This approach will help provide knowledge that can be applied to new construction or renovation of cardiovascular operating rooms and cardiac catherisation laboratories. It is not uncommon during the course of healthcare facility design for numerous people to use common terms that have different meanings for each person and community, and then be surprised to later discover that their conversations were about different meanings that led to a different understanding and mindset. Within the context of this chapter, the term "hybrid (surgical) room" is used to describe a procedure room designed and intended for either "open" or "closed" procedures, or both. They may be built for use by specifi c sub-specialists, or they may be shared by diverse users. This is a prime example of the necessity to clarify the operational, technological, cultural and political strategies explicitly prior to design inception and master planning. This chapter is not only about architectural design and planning, although that is its primary focus. Its underlying message is that the design of cardiovascular surgical procedure rooms or suites-regardless of how innovative they are or how much advanced medical technology they contain-will likely only be successful if they are closely aligned with the evolving changes in models of care, medical practices, local culture, politics and a concern for safety and high reliability of care. Cardiovascular spaces must also be designed with strategies that enable them to constantly evolve and be B. Rostenberg (

The design of hospital environments is determined by functional requirements and technical regulations, as well as numerous protocols, which define the structure and system characteristics that such environments need to achieve. In order to improve people's well-being and the quality of their experience within public hospitals, design elements (soft qualities) are added to those 'necessary' features. The aim of this research has been to experiment a new design process and also to create health care spaces with high environmental quality and capable to meet users' emotional and perceptual needs. Such needs were investigated with the help of qualitative research tools and the design criteria for one of these soft qualities - colour - were subsequently defined on the basis of the findings. The colour scheme design for the new San Paolo Hospital Emergency Department in Milan was used as case study. Focus groups were fundamental in defining the project's goals and cri...