Adult cancer survivors have an increased prevalence of mental health comorbidities and other adverse late-effects interdependent with mental illness outcomes compared with the general population. Coronavirus Disease 2019 (COVID-19) heralds an era of renewed call for actions to identify sustainable modalities to facilitate the constructs of cancer survivorship care and health care delivery through physiological supportive domestic spaces. Building on the concept of therapeutic architecture, psychoneuroimmunology (PNI) indicators—with the central role in low-grade systemic inflammation—are associated with major psychiatric disorders and late effects of post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on behaviour and mental disorders. Whilst attention is paid to the non-objective measurements for examining the home environmental domains and mental health outcomes, little is gathered about the multidimensional effects on physiological responses. This exploratory review presents a first analysis of how addressing the PNI outcomes serves as a catalyst for therapeutic housing research. We argue the crucial component of housing in supporting the sustainable primary care and public health-based cancer survivorship care model, particularly in the psychopathology context. Ultimately, we illustrate a series of interventions aiming at how housing environmental attributes can trigger PNI profile changes and discuss the potential implications in the non-pharmacological treatment of cancer survivors and patients with mental morbidities.
The practice of telemedicine started at the beginning of the 20th century but has never been widely implemented, even though it is significantly sustainable compared to traveling to healthcare However, the ongoing COVID-19 pandemic pushed organisations and patients to accept this technology. During the pandemic, telemedicine consultations took place in ad hoc environments without much preparation and planning. As a result, there is a knowledge gap in the field between telemedicine’s clinical care services and healthcare built environment, in terms of design. This research focused on addressing the quality of service and experience of telemedicine in primary healthcare settings and how this could be influenced by the digital infrastructure. Our aim was to understand the correlations between telemedicine and healthcare built environment and whether the latter could have a significant impact on telemedicine practice. The methodology included interviews with professionals involved in healthcare planning, architecture and ethnography, and end user research involving telemedicine sessions. The interviews highlighted that professionals involved in the design of healthcare environments demonstrated limited consideration of telemedicine environments. Yet, the ethnographic, end-user research identified areas where the telemedicine environment could affect user experience and should be taken into consideration in the design of such spaces.
BackgroundInflammation control is a fundamental part of chronic care in patients with a history of cancer and comorbidity. As the risk-benefit profile of anti-inflammatory drugs in cancer survivors (CS) is unclear, GPs and patients could benefit from alternative non-pharmacological treatment options for dysregulated inflammation. There is a potential for home built environment (H-BE) interventions to modulate inflammation, however, discrepancies exist between studies.AimTo evaluate the effectiveness of H-BE interventions on cancer-associated inflammation biomarkers.Design & settingA systematic review and meta-analysis of randomised and non-randomised trials in community-dwelling adults.MethodPubMed-Medline, Embase, Web of Science, and Google Scholar will be searched for clinical trials published in January 2000 onwards. We will include H-BE interventions modifying air quality, thermal comfort, non-ionising radiation, noise, nature and water. No restrictions to study population will be applied to allow deriving expectations for effects of the interventions in CS from available source populations. Outcome measures will be inflammatory biomarkers clinically and physiologically relevant to cancer. The first reviewer will independently screen articles together with GPs and extract data that will be verified by a second reviewer. The quality of studies will be assessed using the Cochrane Risk-of-Bias tools. Depending on the clinical and methodological homogeneity of populations, interventions, and outcomes, we will conduct a meta-analysis using random-effects models.ConclusionsFindings will determine the effectiveness of H-BE interventions on inflammatory parameters, guide future directions for its provision in community-dwelling CS and support GPs with safer anti-inflammatory treatment options in high-risk patients for clinical complications.
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