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.

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.

Background: Inflammation 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 is unclear in survivors of cancer, 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.Aim: To evaluate the effectiveness of H-BE interventions on cancer-associated inflammation biomarkers.Design & setting: A systematic review and meta-analysis of randomised and non-randomised trials in community-dwelling adults.Method: PubMed and MEDLINE, Embase, Web of Science, and Google Scholar will be searched for clinical trials published in January 2000 onwards. The study 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 cancer survivors 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, a meta-analysis will be conducted using random-effects models.Conclusion: Findings will determine the effectiveness of H-BE interventions on inflammatory parameters, guide future directions for its provision in community-dwelling survivors of cancer and support GPs with safer anti-inflammatory treatment options in high-risk patients for clinical complications.

Background: Psychoneuroimmunology (PNI) indicators, with the central role in low-grade systemic inflammation, are associated with major psychiatric disorders and late effects post-cancer treatment. Immune disturbances might mediate the effects of environmental determinants on the behaviour and mental disorders. Therefore, our primary objective is to evaluate whether the exposure to household environmental attributes can trigger PNI biomarker level changes, and to what extent a set of architecture parameters influence on the spatial dynamics of environmental variables. Methods: A restricted systematic review is employed to generate knowledge synthesis about housing and mental recovery for the COVID-19 context in a resource-efficient manner. This review is conducted in accordance with the Cochrane Handbook guideline and PRISMA statement. We searched in Medline, EMBASE, Web of Science, Scopus, the Cochrane Library and Google Scholar. Included studies need to be peer-reviewed, written in English and meet pre-defined eligibility criteria. Observational or intervention studies investigating the effects of either environmental determinants within home environments -air pollution, thermal comfort, lighting, electromagnetic fields, noise and nature- using objective metrics or housing design, or combination with a set of circulating biomarkers in PNI and correlate gut microbiome composition are included. Quantitative measures of mental morbidities common in the cancer survivorship are included as secondary outcomes. Study eligibility and quality assessments are carried out by one team member and verified by a second reviewer. A descriptive analysis is conducted. To the best of our knowledge, this review is the first to systematically explore and integrate the evidence available on the association multifactorial and dynamic of housing environmental and design attributes with immune and microbiome mechanisms. Key messages: Disease surrogate markers based on systems biology and PNI approaches may help understand multi-level and multi-directional interactions among neuroimmune-microbiota function and housing exposure. This timely study contributes to understand if household environmental and architecture parameters might facilitate cancer rehabilitation via home design, restoring mental-physiological functions.

Introduction: Inflammation is causally related to cancer progression and cardiovascular toxicities of anticancer treatments. Fine particulate matter (PM _2.5 ) air filtration lowers interleukin-6 and C reactive protein (CRP) levels in high-risk cardiopulmonary groups, though potential synergistic or confounding effects with routine medications—statins, cyclo-oxygenase-2 inhibitors, beta-blockers—remain poorly understood. Whether overnight in-bedroom PM _2.5 air filtration effectively reduces inflammation and prothrombotic biomarkers in survivors of adult-onset cancer at high cardiovascular toxicity risk is unknown. Methods and analysis: BREATHS is a series of randomised, adaptive, blinded, placebo-controlled N-of-1 trials conducted in densely populated urban areas of Valencia, Spain, during winter when PM _2.5 concentrations historically exceed WHO guidelines. Eligible participants are aged ≥18 years with a history of breast, colorectal, prostate, lung or haematological cancer, prior cardiotoxic cancer therapy and CRP ≥3 mg/L. Each participant will undergo up to three cycles, each comprising two 14-day periods of advanced submicron air filtration (clean air delivery rate: 275 m ³ /hour nightly) or placebo (sham filtration), in random order. Sequence duration ranges from 4 weeks to 12 weeks, depending on whether a clinically meaningful CRP reduction (<2 mg/L or ≥35% relative to placebo) is achieved during active treatment of each cycle. Non-responders will enter an open-label phase (OLP) of two 14-day periods: no treatment followed by continuous filtration. The primary endpoint is change in CRP between active and placebo phases. Secondary endpoints include changes in serum amyloid A, haemoglobin A1c and blood pressure. Indoor and outdoor particulate exposure will be quantified using paired real-time monitors at each home. Ethics and dissemination: The trial protocol was approved by the research ethics committees of University College London (REC UCL: 22105/001), Doctor Peset University Hospital (CEIm: 044/25) and General University Hospital of Valencia (CEIm: 1/2026 EO-PS), Spain. Results will be presented at relevant conferences and published in peer-reviewed journals. Trial registration number: NCT06778122 .