New models of care and multidimensional solutions for oncological patients in the post-acute SARS-COV-2 period: a "Second Phase" also for cancer patients

In Italy, SARS-CoV-2 outbreak registered a high transmission and disease rates. During the acute phase, oncologists provided to re-organize services and prioritize treatments, in order to limit viral spread and to protect cancer patients. The progressive reduction of the number of infections has prompted Italian government to gradually loosen the national confinement measures and to start the "Second phase" of measures to contain the pandemic. The issue on how to organize cancer care during this post-acute SARS-CoV-2 phase appears crucial and a reassessment of healthcare services is needed requiring new models of care for oncological patients. In order to address major challenges in cancer setting during post-acute SARS-CoV-2 phase, this work offers multidimensional solutions aimed to provide a new way to take care of cancer patients.

Complexity of care: a concept analysis

BACKGROUND

In spite of the high number of tools designed to measure the complexity of care, there is still great diversity in the meaning of this concept.

METHODS

The study was carried out using the concept analysis method as described by Beth Rodgers; 27 international papers were selected using PubMed, Web of Science and CINAHL data sets, without any time constraints.

RESULTS

A number of similar concepts relating to multiplicity, intensity of care and workload were selected. The antecedents were classified according to personal and clinical features of patients, the characteristics of care, the social and organizational features; the tools that emerged measure the risk of complexity of care. Among the consequences, those that emerged were related to patients, operators and organization. The two attributes of complexity of care are connected with measurement, on the one side, and uncertainly, on the other.

CONCLUSIONS

As difficult as it is to define complexity of care, the analysis states that its classification should be targeted at redefining hospital organization.

Ecological correlates of polyphenism and gregarious roosting in the grass yellow butterfly Eurema elathea (Pieridae)

Eurema elathea adults were censused weekly (1992-1994) in six night-roosts around a forest fragment on a farm, and in two roosts in the urban area of Uberlândia, Minas Gerais, Brazil. Males were grouped in six phenotypic classes. These were based on a range between having a conspicuous wide black bar at the dorsal forewing inner margin (wet season dark morphs) and the absence of that bar (dry season light morphs). The body mass and wing area of co-occurring morphs were compared: differents morphs showed similar means. The abundance of butterflies and morph frequencies varied in close relation to humidity (rainfall). Individuals were infrequent and monomorphically dark in the wet season while light morphs predominated in dry periods when population peaked. A lower fraction of recaptured individuals and higher recruitment were recorded compared to other night-roosting butterflies. Dispersal potential was similar between the sexes and varied seasonally with a more sedentary population in dry periods. The maximum residence time recorded was 91 days for a female and 84 days for a male. The fraction of individuals that moved from one roosting site to another was similar in both sexes and male morphs, but significantly higher on the farm than in the urban area. Also, a significantly higher fraction (21.3%) of marked butterflies was recaptured in the urban area than on the farm (15.6%), suggesting a behavioral modification for sedentariness in the urban individuals. The selective forces shaping a gregarious roosting habit in E. elathea and other butterflies are discussed and a protocooperational strategy for saving energy is proposed.

Butterflies from the Uberlândia region, central Brazil: species list and biological comments

A total of 251 butterfly species were recorded in Uberlândia region, with collecting concentrated mainly in forest areas. Aspects of geographic distribution of some Ithomiinae, as well as interactions of both adults and immatures with plants, and reproduction periods for the more abundant species are discussed. Collections in open, riverside, and wetland areas, as well as the use of bait, should substantially increase the number of species.