Pathways, Practices and Architectures: Containing Anti-Microbial Resistance (AMR) in the Cystic Fibrosis Clinic

TY - JOUR

T1 - Pathways, Practices and Architectures: Containing Anti-Microbial Resistance (AMR) in the Cystic Fibrosis Clinic

AU - Brown, Nicholas Gerard Francis

AU - Buse, Christina

AU - Lewis , Alan

AU - Martin, Daryl

AU - Nettleton, Sarah Joan

N1 - This is an author-produced version of the published paper. Uploaded in accordance with the publisher’s self-archiving policy. Further copying may not be permitted; contact the publisher for details.

PY - 2021/3/1

Y1 - 2021/3/1

N2 - Antimicrobial resistance (AMR) and the adaptation of microbial life to antibiotics is recognised as a major healthcare challenge. Whereas most social science engagement with AMR has focussed on aspects of ‘behaviour’ (prescribing, antibiotic usage, patient ‘compliance’, etc), this article instead explores AMR in the context of building design and healthcare architecture, focussing on the layout, design and ritual practices of three cystic fibrosis (CF) outpatient clinics. CF is a life-threatening multi-system genetic condition, often characterised by frequent respiratory infections and antibiotic treatment. Preventing AMR and cross-infection in CF increasingly depends on the spatiotemporal isolation of both people and pathogens. Our research aims to bring to the fore the role of the built environment exploring how containment and segregation are varyingly performed in interaction with material design, focussing on three core themes. These include, first, aspects of flow, movement and the spatiotemporal choreography of CF care. Second, the management of waiting and the materiality of the waiting room is a recurrent concern in our fieldwork. Finally, we take up the question of air, the intangibility of air-borne risks and their material mitigation in the CF clinic.

AB - Antimicrobial resistance (AMR) and the adaptation of microbial life to antibiotics is recognised as a major healthcare challenge. Whereas most social science engagement with AMR has focussed on aspects of ‘behaviour’ (prescribing, antibiotic usage, patient ‘compliance’, etc), this article instead explores AMR in the context of building design and healthcare architecture, focussing on the layout, design and ritual practices of three cystic fibrosis (CF) outpatient clinics. CF is a life-threatening multi-system genetic condition, often characterised by frequent respiratory infections and antibiotic treatment. Preventing AMR and cross-infection in CF increasingly depends on the spatiotemporal isolation of both people and pathogens. Our research aims to bring to the fore the role of the built environment exploring how containment and segregation are varyingly performed in interaction with material design, focussing on three core themes. These include, first, aspects of flow, movement and the spatiotemporal choreography of CF care. Second, the management of waiting and the materiality of the waiting room is a recurrent concern in our fieldwork. Finally, we take up the question of air, the intangibility of air-borne risks and their material mitigation in the CF clinic.

U2 - 10.1177/1363459319866894

DO - 10.1177/1363459319866894

M3 - Article

SN - 1363-4593

VL - 25

SP - 196

EP - 213

JO - Health: An Interdisciplinary Journal for the Social Study of Health,Illness and Medicine

JF - Health: An Interdisciplinary Journal for the Social Study of Health,Illness and Medicine

IS - 2

ER -