Hospital-at-home is an initiative to move health care services that have traditionally been provided in a hospital setting to a patient's home. The objective of this study was to assess the impact of the oncology Huntsman at Home (HH) hospital-at-home program on health care costs from the health care system's perspective. Using a difference-in-difference approach, we compared health care costs between 169 oncology patients enrolled in HH and 198 similar patients who would have been eligible for HH but lived outside the HH service area. Costs were measured from the health system perspective using an innovative cost-accounting tool. We constructed longitudinal datasets spanning the 2 patient-quarters before enrollment and the 2 patient-quarters following an acute episode. Outcomes were total direct medical costs of health care encounters as well as subcategories of cost, including facility, imaging, supplies, pharmacy, labs, and other. We ran fixed effects linear regression models to assess the impact of HH on health care cost outcomes. We found that HH was associated with a statistically significant reduction in cost for the 6 months post-admission (total -$8,337, P=0.012) and the first quarter post-admission (-$10,516, P=0.009), with significant reductions in pharmacy, facility, and other costs. We also examined a subset of patients with gastrointestinal or gynecologic cancers as exemplars of patients at considerable risk for extended complications and found similar cost reductions 6 months (-$8006, P=0.006) and in the first quarter (-$10,438, P=0.004). We found that an oncology hospital at home lowers health care costs, particularly during the 3 months following a care episode.

To facilitate the vocational rehabilitation of colorectal cancer patients, more information is needed on the influencing factors related to the quality of work life of colorectal cancer patients after their return to work. This study examines the Quality of Working Life (QWL) among the patients with colorectal cancer (CRC) survivors after returning to work and identifies influencing factors. A cross-sectional study from January to May 2023 followed 290 CRC survivors from a Chinese hospital's oncology outpatient department. The General Questionnaire, Quality of Working Life Questionnaire for Cancer Survivors (QWLQ-CS), Simplified Coping Style Questionnaire, and the Social Support Revalued Scale were used for data collection. Descriptive statistics, T-tests, ANOVA, correlation, and multiple linear regression analyses were conducted with the Statistical Package for the Social Science (SPSS) version 25.0. The QWL score of CRC survivors was (67.72 ± 12.21). Factors such as the per capita monthly family income, medical payment method as self-employment, basic medical insurance system for urban residents, stoma status, positive coping strategies, passive coping strategies, and social support utilization emerged as significant QWL determinants, while passive coping strategies was inversely related to QWL. CRC survivors have greater room for improvement in their work life (QWL) after returning to work. To enhance their reintegration and QWL, healthcare professionals should implement individualized interventions that reflect the various challenges these individuals face. It is important to provide special attention to colorectal cancer survivors who pay for their medical care directly, have residential health insurance, have an ostomy, or have a per capita family income of less than 281⁄ per month, as they tend to report worse levels of quality of work life. Clinical personnel should rapidly detect these risk factors and offer the required assistance and resources to ensure that these patients are adequately prepared to resume employment and enhance their overall quality of work life.

Childhood cancer represents a significant cause of morbidity and mortality among children under 15 years of age and is a growing public health concern, particularly in low- and middle-income countries, including Ethiopia. The purpose of this study was to assess factors Influencing delay to diagnosis and treatment initiation among pediatric cancer patients attending at Tikur Anbessa Specialized Hospital oncology unit in Addis Abeba, Ethiopia, in 2019. An institutional-based cross-sectional study involving 244 pediatric cancer patients was conducted between February and April of 2019. Data were collected from parents/caregivers using a structured questionnaire through face-to-face interviews and supported by review of medical records. Bivariate and multivariate analyses with adjusted odds ratios were employed to evaluate the association between dependent and independent factors. Statistical analysis was performed using STATA (Version 14) with a significance level of P < 0.05. A total of 244 children participated, with an average age of 6.4 (± SD 3.2 years). One hundred twenty-seven (52.0%) were reported as patient delays (> 30 days), while 179 (73%) were reported as health system delays. Children aged 5-9 years AOR:2.98; 95% CI,1.35, 6.57; three times delayed than children 0-4 years; where as children from rural areas AOR:2.28; 95% CI, 1.07, 4.88; were about 2.28 delayed as compared to children who come from urban. Furthermore, parents of children who visited traditional healers AOR: 7.85, 95% CI; 3.88,15.89 were more likely to be delayed as compared to their counter's parts. Health system-related factors, such as lack of medical insurance AOR: 5.52, 95%CI: 2.61, 11.69 and first visit to a health institution AOR: 16.13, 95%CI: 4.00, 65.03, were identified as the cause of delay. In conclusion, prolonged patient and health system delays were significantly associated with age AOR: 2.98; 95% CI: 1.35-6.57), rural residence AOR: 2.28; 95% CI: 1.07-4.88, use of traditional healers AOR: 7.85; 95% CI: 3.88-15.89), low disease awareness, and lack of health insurance at diagnosis (AOR = 5.52; 95% CI: 2.61-11.69). To reduce delays, targeted health education for parents and healthcare providers, improved early detection and referral systems, strengthened multisectoral collaboration, expansion and decentralization of pediatrics oncology care facilities and further qualitative research to explore underlying causes of delay are recommended.

Exploring continuous nursing needs among outpatients undergoing central venous access device maintenance in the smart healthcare context: A qualitative study.

Attendants are continuously involved in coordinating and supporting cancer care, yet their service quality perceptions are rarely modelled as determinants of satisfaction. This study investigates the association between demographic factors and service quality dimensions related to attendants' satisfaction in oncology hospitals. A cross-sectional survey using a structured questionnaire was conducted among 480 attendants (accompanying patients) across oncology hospitals in Tamil Nadu, India. Service quality was assessed using six dimensions: tangibility, responsiveness, empathy, assurance, service reliability, and process reliability. Differences across demographic groups were evaluated using non-parametric statistical tests. Partial Least Squares Structural Equation Modeling (PLS-SEM) was applied to examine the relationships between service quality dimensions and attendant satisfaction, followed by Importance-Performance Map Analysis (IPMA) to prioritize improvement areas. Significant differences in service quality perceptions were observed across gender, age, education, residential status, financing category, and hospital visit frequency, while income and occupation did not show meaningful effects. Tangibility (β = 0.374), responsiveness (β = 0.313), and empathy (β = 0.196) demonstrated significant positive associations with satisfaction, collectively explaining 80.9% of its variance (R2 = 0.809), whereas assurance, service reliability, and process reliability were not significantly associated with satisfaction. IPMA result indicate that empathy represents a key area for refinement, while tangibility and responsiveness demonstrate high importance alongside strong performance, suggesting areas to be maintained. Overall, the findings provide insights into factors associated with attendant satisfaction, improving patient-centered oncology services.

ABSTRACTBackgroundMany testicular cancer patients of reproductive age experience reproductive concerns. Metacognitions may alleviate patients' fear of progression and reproductive concerns. However, this relationship has not been well established in testicular cancer patients of reproductive age.ObjectiveThis study examines the level of reproductive concerns and explores how fear of progression mediates the relationship between metacognitions and reproductive concerns in testicular cancer patients of reproductive age in China.MethodsThis study employed a quantitative cross‐sectional design and was reported in accordance with the STROBE guidelines for observational research. A convenience sample of 192 testicular cancer patients of reproductive age was recruited from a tertiary specialized oncology hospital in Guangzhou, Guangdong, China. Data were collected through the WeChat mini program “Questionnaire Star” using “the general data questionnaire”, the Metacognitions Questionnaire‐30 (MCQ‐30), the Fear of Progression Questionnaire–Short Form (FoP‐Q‐SF), and the Reproductive Concerns After Cancer–Male scale (RCAC‐M) instruments. The data were analyzed using descriptive statistics, Pearson correlation analyses, and simple mediation effect analysis via the PROCESS macro program.ResultsReproductive concerns were at a moderate level (57.86 ± 10.93), and positively associated with metacognitions (r = 0.358, p < 0.001) and fear of progression (r = 0.523, p < 0.001). Mediation analysis revealed that metacognitions had a total effect path coefficient of 0.317 on reproductive concerns (bootstrap 95% CI: 0.202–0.432). The direct effect path coefficient was 0.152 (bootstrap 95% CI: 0.026–0.277), while the mediating effect through fear of progression was 0.166 (bootstrap 95% CI: 0.094–0.239), representing 52.4% of the total effect.ConclusionsIn testicular cancer patients of reproductive age, metacognitions are significantly associated with reproductive concerns, and fear of progression acts as a mediating factor. Interventions aimed at improving metacognition levels and reducing fear of progression may help alleviate reproductive concerns in this population.

Cancer patients have a higher suicide risk than the general population. Oncology nurses play a critical role in assessing and managing this risk. However, they often lack the necessary awareness, knowledge, and skills. This study developed an Oncology-Specific Suicide Prevention Program (OSP) for oncology nurses. It aims to assess how the OSP affects nurses' suicide literacy, suicide stigma, and efficacy in suicide risk management. Researchers developed the OSP based on findings from cancer-related suicide studies. The intervention included three structured online sessions for the experimental group, each session addressing specific aspects of suicide prevention strategies in oncology care. Researchers conducted a randomized controlled trial with 86 nurses from two oncology hospitals in Ankara. Nurses were randomly assigned to an experimental group (n = 43) or a control group (n = 43) after stratifying by years of work experience. The control group received usual in-service training. Researchers collected data using the descriptive information form, the literacy of suicide scale, the stigma of suicide scale, and the efficacy perception scale for suicide risk management for oncology nurses. The experimental group showed a significant increase in suicide literacy (p < 0.001) and efficacy perception for suicide risk management (p < 0.001). They also showed a decrease in suicide stigma (p = 0.013) compared to the control group. These effects were measured at the end of the program and 3months later. Integrating the OSP into in-service training for oncology units and national and international suicide prevention strategies is suggested.

Near-death experiences (NDEs) are rare but profound phenomena that have also been reported in children. However, most existing research has focused primarily on adults, and evidence regarding pediatric NDEs remains limited. This study explored pediatric nurses' observations and accounts of children's NDEs using a qualitative approach. A conventional qualitative content analysis design was employed. Thirteen nurses working in pediatric oncology and intensive care units of a children's referral hospital in Kermanshah, Iran, were recruited through purposive and snowball sampling. In-depth semi-structured interviews were conducted between May and August 2025. Data were analyzed using the Graneheim and Lundman (2004) approach and managed with MAXQDA 2020 software. Three main categories emerged from the data: soothing perceptions, encounters with individuals, and emotional reactions. These were further organized into six subcategories: enveloped in light, secure companion, unknown observer, invitation to play, seeking security, and anxiety. Children's NDEs, as reported by nurses, are multidimensional phenomena involving feelings of peace, perceived interactions with figures, and emotional responses. These findings highlight the importance of recognizing the psychological and spiritual dimensions of children's end-of-life experiences and supporting nurses in responding to them with empathy and understanding.

This study aims to 1) explore experiences of ethnic minority patients and their relatives regarding shared decision making (SDM) in oncological hospital care, alongside healthcare professionals' (HCPs) experiences of engaging in SDM with ethnic minority patients; 2) identify opportunities to improve SDM for ethnic minorities in oncology, if needed, by linking the findings to a previously developed value structure. For this purpose, we interviewed ethnic minority patients (n = 22), relatives (n = 11), and HCPs (n = 14). Using reflexive thematic analysis, we applied Schwartz's value theory, adapted to the context of SDM, to code and analyze the interviews. From the data, we developed three themes: 1) Factors that empower(ed) and disempower(ed) patients in SDM. Knowledge, skills, and competences of both HCP and patient [i.e. Achievement], support [i.e. Benevolence], and a good HCP-patient relationship [i.e. Security] empower patients. A lack of these three disempowers them; 2) Individualizing treatment decisions. Participants individualized treatment decisions through deliberation, negotiation, and choosing; 3) HCPs' limited insight into patients' context. HCPs experienced this due to a lack of cultural competences and perceived cultural differences. SDM for ethnic minorities can be enhanced by strengthening HCPs' cultural competencies, increasing the availability of culturally and linguistically tailored information and support, and fostering ongoing relationship-building efforts. These strategies empower patients, enhance HCPs' insight into ethnic minority patients' context, and contribute to more individualized treatment decisions. We recommend educational programs to increase HCPs' cultural sensitivity in SDM, developing campaigns to focus more on the needs of ethnic minority populations, and incorporating culturally and linguistically tailored support within hospital systems. Importantly, efforts should avoid overemphasizing cultural differences, as many empowering and disempowering factors also apply to the general population, but should be responsive to cultural aspects where relevant.

This study aimed to examine the influence of missed nursing care on satisfaction with nursing care and trust in nurses among patients with cancer. A descriptive and correlational study. The study involved 271 patients with cancer hospitalised in the Medical Oncology units of a university-affiliated Oncology Hospital in Türkiye. Data were collected using the Patient Information Form, MISSCARE Survey-Patient (MCSP), Newcastle Satisfaction with Nursing Care Scale (NSNCS) and Trust in Nurses Scale (TNS) between December 26, 2022, and August 30, 2023. Descriptive and inferential statistics were conducted using SPSS 26. The STROBE checklist guided reporting. Mean scores were 1.71 (SD = 0.77; possible range = 1-5) for the communication subscale of the MCSP, 3.86 (SD = 1.19; possible range = 1-5) for the basic care subscale of the MCSP, 92.93 (SD = 13.80; possible range = 0-100) for NSNCS and 27.64 (SD = 3.21; possible range = 5-30) for TNS. Missed communication was statistically significantly and negatively correlated with both satisfaction and trust, whereas missed basic care was not significantly correlated with either. Regression analyses confirmed that missed communication significantly and negatively predicted satisfaction and trust, whereas missed basic care did not. Missed communication was associated with lower satisfaction with nursing care and reduced trust in nurses among patients with cancer, whereas missed basic care, despite higher levels, did not predict either outcome. These findings highlight the central role of nurse-patient communication in shaping patients' perceptions of nursing care quality in oncology settings. Within oncology care contexts, healthcare institutions and nurse managers should prioritise strategies to reduce missed nursing care, particularly missed communication. Short-term actions include strengthening nurse-patient communication through structured communication training and manageable workloads, while long-term strategies should embed communication and basic care standards into institutional quality frameworks to enhance patient satisfaction and trust. Patients contributed by completing questionnaires.

Evidence-based modifications to antineoplastic therapy regimens are common. The reasons for those changes are varied and include dose rounding, adjustments based on organ function or changes in weight of the patient, and adverse reactions. Given this complexity, proper documentation, and use of computerized provider order entry (CPOE) systems are essential in promoting optimal decision making and patient outcomes. The objective of this study is to explore common reasons for therapeutic regimen modification and their documentation. This was a descriptive, retrospective study. Patients who received services at the infusion clinics of a specialized oncology hospital during May 2023, and whose regimen was modified between the months of August 2022 and May 2023 were included. Changes were recorded with their explanations, as detailed by physicians. Physical records from the Department of Pharmacy were also verified. The most documented reason for changes in therapeutic regimens of patients, by both physicians and pharmacy, was dose rounding (31.61% and 45.48%, respectively). Adverse effects recorded by physicians included neurotoxicity and gastrointestinal toxicity (5.16% and 3.55%, respectively). In the evaluated documentation, 14.19% of changes showed discrepancies in both records and 2.6% were not justified in either. Dose rounding was the most common reason for antineoplastic regimen modifications documented by physicians and pharmacists. Record reviews showed opportunities to improve consistency and clarity of data. Strengthening standardized documentation and interprofessional collaboration may optimize clinical decision-making.

Autopsy remains an important diagnostic and research modality in pediatric oncology. This study examined demographic and clinical factors associated with parental acceptance or decline of autopsy in childhood cancer. This study was a retrospective chart review of autopsy consent acceptance or decline patterns between 2007 and 2017 for inpatient pediatric oncology deaths in a large single-site oncology hospital. Demographic factors (age, race, gender), diagnostic factors (primary cancer, transplant history, and neurologic status 24 h prior to death), interventions (intensive care unit location, dialysis, ventilator, chemotherapy, medically administered nutrition), and code status in the 24 h prior to death were obtained. Analysis included descriptive and statistical correlations. Among 344 inpatient decedents, 34% of families consented to autopsy. There was a difference in consent rate according to race (p = 0.015). Diagnosis, transplant status, age, and neurologic status showed no association. Use of dialysis (p < 0.001), ventilation (p < 0.001), and intensive care unit (ICU) location (p < 0.001) correlated with higher consent rates. Chemotherapy and assisted nutrition were not associated with decisions. Presence of a Do Not Resuscitate (DNR) order predicted lower consent (p < 0.001), while receipt of cardiopulmonary resuscitation (CPR) at death predicted higher consent (p < 0.001). One-third of families of inpatient pediatric oncology decedents with cancer agreed to autopsy. Demographic and diagnostic factors were not universally strong predictors, underscoring the personal nature of autopsy decisions. Further research should include multisite prospective designs and direct engagement with bereaved families.

Objective Group counselling (GC) can help people to cope with cancer-induced bodily changes. However, group counselling effects on sexual health of breast cancer patients is largely unknown. The present study aimed at investigating the effectiveness of group counselling on body image and sexual satisfaction among patients with breast cancer in Mashhad, Iran. Methods This study was a randomised controlled trial with pre-and post-tests. Respondent-driven sampling was used to sample from women, who visited oncology hospitals in Mashhad. The primary sample consisted of 60 married breast cancer women that after providing informed consent, were randomly allocated into two intervention and control groups. GC was provided to the intervention group for four 90–130 minute sessions were administered twice a week, and the control group only received routine care. Data was gathered using index sexual satisfaction (ISS) and Body Image after Breast Cancer Questionnaire (BIBCQ) questionnaires and were analysed in two stages of pre-and post-test, using the Chi-square test and two-way covariance analysis through SPSS-16 software. Results The mean of body image scores before and after GC was 14.7 ± 6.0 and 9.2 ± 4.4 respectively which showed −5.5 ± 3.2 decrease (p < 0.05) also, sexual satisfaction mean before and after GC was 93.5 ± 23.4 and 104.4 ± 22.0 respectively which showed 10.8 ± 10.9 scores increase (p < 0/05). Conclusion The GC was effective in sexual satisfaction and improvement of body image among breast cancer survivors. GC has clinical significance as it provided an opportunity for women to improve their sexual health.

The original Reproductive Concerns After Cancer (RCAC) scale is a well-validated instrument. However, its gender-specific nature hinders direct comparison of scores across genders and limits its efficiency in clinical practice. The study was conducted in two phases. First, items from the original female and male RCAC scales were rigorously evaluated and consolidated using a Delphi expert panel and face validity testing, resulting in a preliminary 7-item version. Second, psychometric validation was performed on a sample of 1,049 young cancer survivors (609 males, 440 females) recruited from two specialist oncology hospitals in China. Participants were diagnosed with a range of cancers, including colorectal, lung, breast, thyroid, gastric, and ovarian tumors. The psychometric evaluation encompassed item analysis, content validity, confirmatory factor analysis (CFA), convergent validity with the Patient Health Questionnaire-9 (PHQ-9), internal consistency reliability, and test-retest reliability. The original 18-item scale was successfully reduced to a 7-item unisex instrument, the RCAC-7. Psychometric testing demonstrated that the RCAC-7 has satisfactory internal consistency (Cronbach's α = 0.770; McDonald's ω = 0.889) and excellent test-retest reliability (r = 0.930-0.970). The content validity index was good. Convergent validity was supported by a strong positive correlation with the PHQ-9 (r = 0.783, p < 0.01). Furthermore, confirmatory factor analysis confirmed a robust one-factor structure, indicating good model fit. The RCAC-7 is a valid and reliable unisex tool for measuring reproductive concerns in young cancer survivors. Its brevity and strong psychometric properties make it highly suitable for rapid screening and use in both clinical practice and large-scale research settings.

Cancer is one of the leading causes of death worldwide. Oncology nurses play an essential role in the care of oncology patients. Providing care for cancer patients and managing complex treatment processes can be challenging for oncology nurses. The psychological effects of caring for cancer patients and facing their illness and death are often overlooked. The relationships between aging anxiety, job stress, and psychological resilience remain unclear. The aim of this study was to determine the relationship between aging anxiety, job stress, and psychological resilience in oncology nurses. This cross-sectional, correlational and descriptive study was conducted with 220 nurses working in an oncology hospital from December 2023 to February 2024. The Personal Information Form, Relational Aging Anxiety Scale (RASS), Nurse Stress Scale (NSS), and Resilience Scale for Nurses (RSN) were used to collect the data. Descriptive analyses, correlation analysis, and Structural Equation Modeling (SEM) were performed. Correlation analyses revealed a statistically significant low positive correlation between the relational aging anxiety subscale and NSS scores (r = 0.240, p < 0.05), and a low negative correlation with RSN scores (r = - 0.182, p < 0.05). SEM indicated that RAAS scores were a significant negative predictor of RSN scores (β = -0.214, p < 0.05) and a significant positive predictor of NSS scores (β = 0.608, p < 0.05). No significant direct effect between RSN and NSS scores (β = -0.007, p > 0.05). These findings suggest that higher aging anxiety among nurses is associated with greater stress and lower psychological resilience, highlighting the need for comprehensive training programs to reduce aging anxiety and job stress, and to enhance psychological resilience among oncology nurses. Interventions focusing on stress management, emotional regulation, and self-care are recommended. Experimental studies to evaluate the effectiveness of these interventions are encouraged.

Despite the global recognition of advance care planning as a critical component of patient-centred end-of-life care, its implementation remains challenged by skill-based deficiencies (e.g., inadequate training), cultural and communication barriers, and system-level structural impediments within healthcare settings. This study aimed to develop and implement a structured advance care planning communication model to improve nurses' communication practices and facilitate patient engagement in end-of-life care discussions. A participatory action research design with embedded mixed methods was conducted from September 2020 to September 2022 in an oncology palliative care unit at an oncology hospital in Beijing, China. The study integrated the Advance Directive Decision-Making Model with the Meaning-Making Intervention. Data collection included surveys, participant observation, and semi-structured interviews across three phases. Four iterative action cycles were used to co-develop and refine the communication model. Quantitative and qualitative data were triangulated through team debriefings to generate meta-inferences. Initial assessments included surveys and observations. Nurses held a foundational knowledge of advance care planning principles (mean knowledge: 68.52%), but expressed hesitation to initiate end-of-life discussions. Iterative cycles developed a three-step communication model. The steps were: (1) Recognize the Present, (2) Life Review, and (3) Face the Future. Post-action data showed improvements in in all areas. Nurses' knowledge increased significantly (mean score increase: 1.90 points). Attitudes scores increased (mean increase = 0.90) Behaviours scores also increased (mean increase = 0.57). Paired t-tests confirmed significant differences for all measures (p < 0.001). Key improvements attributed to the model included the development of time-efficient communication strategies, structured support systems, and adaptive communication techniques tailored to patient needs. The structured three-step advance care planning communication model improves nurse-patient communication and patient engagement in end-of-life decision-making. This model provides a practical framework for initiating and guiding advance care planning conversations in oncology care. Future research is needed to evaluate its applicability in diverse settings and its long-term impact on patient outcomes.

Ceftazidime/avibactam plus aztreonam has emerged as an important antimicrobial combination for empirical and targeted therapy of suspected or confirmed metallo-beta-lactamase positive carbapenem resistant Gram-negative bacterial infections (especially in Enterobacterales). As this combination is not necessarily synergistic against target pathogens it is essential that synergy test is done whenever clinically indicated. However, real-world information is scarce with regard to clinical sample and organism specific synergism data. In this study we present data from an oncology hospital in eastern India. We performed bacterial identification and phenotypic antibiotic susceptibility using VITEK®-2 Compact system. Carbapenemase resistance genes in bacteria were detected by end-point multiplex PCR. We tested phenotypic synergy of Ceftazidime/avibactam plus aztreonam by broth micro-dilution (of 302 isolates). In blood culture samples Klebsiella pneumoniae showed the maximum synergism (97.43%), followed by Escherichia coli (66.63%) and Pseudomonas aeruginosa (33.33%). Among urine culture samples Klebsiella pneumoniae showed the maximum synergism (96.22%), followed by E. coli (78.04%) and P. aeruginosa only (17.64%). Among respiratory cultures (sputum, endotracheal secretion, broncho-alveolar lavage) Klebsiella pneumoniae showed maximum synergism (91.66%), followed by E. coli (80%) and P. aeruginosa (37.5%). Among isolates from pus and other body fluid samples Klebsiella pneumoniae had maximum synergism (96.87%), followed by E. coli (93.54%) and P. aeruginosa (36.36%). Inappropriate use and over use of Ceftazidime/avibactam and aztreonam would not only harm antimicrobial stewardship but also result in development of antimicrobial resistance and financial burden. Clinical microbiology laboratories in India need to provide services for Ceftazidime/avibactam with aztreonam synergy testing to facilitate patient management.

Prostate cancer is the most common cancer in men and the leading cause of malignancy-related mortality in Mexico. The Mexican Institute for Social Security (IMSS for its initialism in Spanish) introduced its first robotic system at the Oncology Hospital of the 21st Century National Medical Center in Mexico City. To evaluate the accumulated experience, perioperative, oncologic and functional outcomes of the first 200 robot-assisted radical prostatectomy (RARP) cases. A retrospective analysis of 200 patients undergoing RARP for localized prostate cancer was conducted. Perioperative and postoperative variables, pathology results, complications, and one-year continence rates were considered. Mean surgical time was 242.1 minutes (90-600), with a console time of 197.6 minutes (68-495). Mean blood loss was 327.7 cc (10-1800). Positive surgical margins were observed in 34.5% of cases. Complications occurred in 22 patients (11%). No conversions to open surgery or mortality were reported. Mean hospital stay was 2.54 days (2-14). Postoperative antigen was undetectable in 88.5% of patients. The continence rate was 95.7%. The first 200 RARP cases at our institution demonstrate the accumulated experience with the procedure, showing low complication rates. These results are consistent with those of high-volume centers, which require additional long-term functional follow-up.

ABSTRACT Effective wayfinding design is crucial for navigating complex public spaces, especially in large-scale healthcare environments, where it significantly impacts patients, families, and medical professionals. Due to the spatial complexity of modern hospitals, effective wayfinding requires a design-led approach that prioritises the diverse needs of end-users. This paper presents a case study involving the redesign of signage at the Shanghai Oncology Hospital (SOH). Facilitated by the Research Centre for Digital Innovation and Humanities Education (RCDIHE) at Macau University of Science and Technology, the study utilised focus groups and co-design workshops to explore navigation barriers. The process engaged medical professionals to generate iterative prototypes aimed at enhancing the health-seeking experience. Results demonstrate that applying a Participatory Design-led Engagement (PD-E) framework in conjunction with the CEO (Co-design, Exploration and Outcome) framework effectively informed and validated the strategic placement and design of guide boards, proving the value of co-design within the context of a Chinese public hospital.

Rapid identification of microorganisms and resistance genes in positive blood cultures may help optimize early antibiotic therapy and improve outcomes. In this study, we compared the BioFire FilmArray Blood Culture Identification 2 (BCID2) panel results with routine microbiological examination methods in blood cultures that gave positive signals in an Oncology hospital. Gram stain results from positive blood culture bottles were reported to the clinic as panic value. After clinical evaluation, 93 positive blood cultures that met the inclusion criteria were evaluated with BCID2 panels in addition to routine microbiological examination. Microorganisms were identified at the species level with Vitek MS (MALDI-TOF, BioMérieux, France), and susceptibility tests were performed with the Vitek 2 (BioMérieux, France) system. BCID2 panel was compared with the routine microbiological methods. Using BCID2 panels, microorganisms were identified in 87 out of 93 bottles. Growth occurred in the culture in 6 bottles that gave negative results with BCID2. These microorganisms are not included in the BCID2 panel. There was no growth in the culture in one bottle in which S. pneumoniae was detected by BCID2. While all bacteria that could be identified by BCID2 and Vitek MS were the same at the genus level, only 5 were different at the species level. Using BCID2, 59 bacteria from the samples included in the study were determined to carry one or more resistance genes. BCID2 panel provided faster results and its results showed a high correlation with traditional blood culture identification and antimicrobial sensitivity results.