The availability of published data from organized cervical screening programmes in southern Europe is scant. In the Italian area of Romagna, a first round of organized screening (based on a 3-yearly Pap smear for women aged 25-64 years) was initiated between December 1995 and January 1997 and was completed in an average of 42 months (range 36-48 months). The target population included 305 478 women. Of these, 253 949 were eligible and received a personal letter of invitation. Age-specific screening performance indicators were calculated according to standard methods. The response rate within 6 months of invitation was 49.1% (n=124 621). The total participation rate including women who presented later was 61.7% (n=156 735). The recall rate was 35.2 per 1000 of participants (n=5514). Positive cytology results were distributed as follows: atypical squamous cells of un-determined significance/atypical glandular cells of undetermined significance (ASCUS/AGUS) 40.1%, low-grade squamous intraepithelial neoplasia (LGSIL) 48.6%, high-grade squamous intraepithelial neoplasia (HGSIL) 10.7% and carcinoma 0.7%. Compliance to colposcopy follow-up was 93.4% (n=5149). The biopsy rate was 52.4% (n=2696) of patients undergoing colposcopy. The detection rate was 4.5 per 1000 of participants (n=707) for CIN2-3 and 0.5 (n=75) for invasive carcinoma. The proportion of microinvasive carcinomas was 36.0% (n=27). The positive predictive value for CIN2-3/carcinoma was 5.8% for the cytology reports of ASCUS/AGUS, 7.6% for those of LGSIL, 76.5% for those of HGSIL, and 100.0% for those of carcinoma (80.4% for combined HGSIL/carcinoma). The ratio of observed to expected (or prevalent to incident) cases of invasive carcinoma was 2.35 (95% confidence interval (CI) 1.85-2.95). In conclusion, most early results of the programme were compatible with an acceptable performance.

There is increasing recognition of the potential to use mobile health (mHealth) technologies such as smartphone apps to support clinical care. Mobile apps are progressively being implemented to manage chronic diseases like cancer to improve patient care. The app deployed at the Brazilian National Cancer Institute enables patients to access the appointments/exam booking, medication prescription, and cancer-prevent educational resources, improving self-management, autonomy, and cancer treatment outcomes in resource-limited environments. Despite acknowledging the importance of mHealth, research is still scarce regarding patients’ views on using these innovations in cancer care management.

No ambiente hospitalar os serviços envolvem processos complexos, de alto risco e custos elevados, particularmente numa unidade de emergência hospitalar. Essa é uma das áreas mais complexas e críticas de um hospital, onde a rapidez no atendimento é fundamental. A agilidade no encaminhamento dos pacientes que necessitam de cuidados médicos é fator crítico de sucesso para  redução de seqüelas e nas chances de restabelecimento. Nesse contexto,  torna-se importante a gestão da capacidade de atendimento, a adequada alocação e o dimensionamento dos recursos.  Este artigo objetiva investigar alternativas que agilizem o atendimento a pacientes. Neste contexto são aplicados princípios de gestão da capacidade de serviços,  feita a análise do fluxo de tratamento a pacientes,  utilizada a teoria das restrições na identificação de gargalos e desenvolvido um modelo de simulação a eventos discretos. A partir desse ferramental teórico elaborou-se uma proposta de melhoria para a redução do tempo entre o registro do paciente de urgência e o início do seu efetivo tratamento. Palavras-chave:  Teoria das restrições (TOC) , Gestão da capacidade de serviços, Simulação, Hospital, serviços de saúde.

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This paper presents information for the characterization of the productive structure, the relationship among the participants of this structure and of the relationships among these agents, in Porto Real technological region, Rio de Janeiro State, under the perspective of the structures of organizations network.