Tese de Doutorado. Pruzinsky, T. Body image change in cosmetic plastic surgery. Nova Iorque: The Guilford Press. Reppeto, G.
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Nunes, J. Coutinho, Orgs. Rezende, F. Riener, R. Psychosocial variables, eating behavior, depression, and binge eating in morbidly obese subjects. Eating Behaviors, 7 4 , Reis, M. Samuel, I. Bariatric surgery trends: an 18 years report from the International Bariatric Surgery Registry.
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Once identified, it becomes possible to strengthen research governance and collaborate on improving research standards and uses, such as by having the committees ensure compliance with research registration, appropriate ethical standards including methodological standards , and the use of research findings in the protocols they review. In another significant development, several countries -such as Argentina, Colombia, and Mexico-have set standards for the development and adaptation of technical guidelines and recommendations, repositories , and evidence summaries.
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The countries also have defined and organized international standards in order to systematically report on health research through initiatives such as the EQUATOR Network. The network regularly compiles-and makes available in Spanish and English-international guidelines and standards for writing and publishing research in health, with the participation of editors and regional experts who contribute to the progress of the initiative 30 , Although the need to have measures in place that can ensure the sustainable development of human resources in research has been much discussed and acknowledged throughout the Region, overall, this has not translated into the promotion, education, training, recruitment, and retention of researchers in the countries 7 , This illustrates the difficulty involved in attempting to link investment in health research to the valuable contributions such research makes to other social and economic sectors- the benefits of investing in health research are often reaped through other social and economic development sectors.
Conversely, the failure to invest in health research means that a crucial driver of social and economic development remains untapped. Few countries have a global strategy for the education, training, and incorporation of human resources that is directed toward cultivating local talent and addressing the priorities set out in national policies for science, technology, and innovation for health Moreover, such education and training should be coordinated with the productive sector, and research teams need to be multidisciplinary and stable 9 , In this framework, the training of "student researchers" beginning with secondary education could be an agent of social transformation and a pillar for scientific capital The quantitative upsurge in science and technology resources financial and human in the Region is the result of disparities in how different countries apply public policies, whereby only a few-e.
While progress has been made in South—South cooperation, it is still necessary to strengthen dialogue for the promotion of strategies that foster scientific capabilities It indexes the articles of nearly 5, journals published in 70 countries, 85 of them in Latin America and the Caribbean. Brazil is followed by Argentina, with 0.
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LILACS indexes the articles of journals from 18 countries of the Region, in addition to other materials such as monographs, theses, government documents, and nonconventional literature also known as gray literature. The consistent use, in recent years, of the findings from research carried out in Latin America and the Caribbean improves the likelihood that decision—making in health will increasingly be based on evidence drawn from those countries.
The systematic reviews, and their summaries, are examples of the types of literature associated with the knowledge—translation strategy. As a result of the EVIPNet initiative in the Americas, countries are beginning to prepare policy briefs, deliberative dialogues, and practical guides, all critical tools for informing, developing, and implementing policies designed to strengthen national health systems. Despite this progress, policy briefs from Latin America and the Caribbean are still not indexed in the body of literature found in the main indices. According to preliminary data from a supplementary evaluation currently in progress, more than systematic reviews were published in and As shown, reviews-the vast majority-were published in Brazilian journals, while the remaining 34 were published in six countries Mexico, Argentina, Colombia, Chile, Venezuela, and Peru.
Another indicator of scientific output is the number of primary studies generated in Latin America and the Caribbean and included in the systematic reviews. It is followed by Colombia 6.
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Access to quality health information is critical for the functioning of the health systems and for health services delivery. To date, a great deal of this information can be published and accessed through the Web, a practice that will only increase in the future. Brazil, Chile, and Mexico, for example, have web portals offering information about their ministries of health and about health networks, as well as providing online services As the Internet evolves, Web—based technologies and their application to health systems and services will help make health care more equitable.
By bringing health care information to different audiences health administrators and professionals, patients, and the public at large in a variety of contexts, these technologies can help overcome barriers such as insufficient human and infrastructure resources; a lack of equipment and medicines; the separation, both physical and cultural, between the services and the population that needs them; and low income In addition, the emergence of online collaborative spaces and social networks supported by Web applications-such as user groups and virtual communities, blogs, message threads, second—life applications, wikis, live—event broadcasts, real—time meeting feedback, mobile health and telemedicine , and eLearning opportunities-is empowering individuals and groups.
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Web—based movements, as well as global and regional information services, are also attempting to democratize the access to quality health information. The open access of scientific information is an example; in , Argentina, Brazil, Colombia, Chile, Mexico, and Venezuela spearheaded this effort in the Region Creative Commons 8 Creative Commons is a nonprofit organization that issues alternative licenses to the more restrictive copyright licenses, in order to enhance the ability to copy and distribute material and maximize digital creativity, sharing, and innovation.
Worldwide, projects under this type of knowledge—sharing license skyrocketed from 50 million in to million in In Latin America, Argentina, Brazil, Chile, and Mexico were the countries that most used this modality during the reporting period. Connectivity in the Region is generally fairly good. Challenges remain, however, including difficulties in harnessing accurate and up—to—date health information, leveraging the right technological tools, securing infrastructure funding, and developing sustainable dissemination models that are culturally relevant and that can be tailored to diverse health care and geographic environments.
Spurred by the rapid pace of technological evolution between and and the substantial opening up of information and communications through new technology, public and private institutions have adopted new work methods using Web—based technology. These methods embody doctrines of information expansion and exchange premised on the comparative advantage derived from the production, transfer, and practical application of knowledge. The Region of the Americas made enormous strides in this regard with the creation of virtual rooms-compared to just 33 in that hosted nearly 20, virtual meetings. Besides speeding up the work of an organization, this type of activity offers the added benefits of remote data transfer, creating a synergy in work and in knowledge management.
Virtual collaboration tools and methods not only facilitate such exchanges, but also encourage interactions and learning among the participants. Moreover, they promote the acquisition of strategic and competitive capacities and help reduce the costs and time involved in planning and implementation. When used in a systematic and standardized way, these methods boost productivity exponentially. E—mail and information searches are by far the most common activities on the Internet.
Added to this are the remarkable developments-hastened by increased bandwidth and technological developments-brought about by Web 2. Based on the philosophy of citizen empowerment, Web 2. The interest in Web 2. These tools play an important role in health by facilitating information—sharing, which helps strengthen health promotion and disease prevention, and by persuading other information consumers to change their views. A study conducted by PAHO in revealed over 9 million connections people on Facebook and Twitter interested in topics related to chronic, noncommunicable diseases.
Moreover, by facilitating the rapid flow of information in real time, sites such as Facebook, Twitter, LinkedIn, or YouTube have proven effective in the management of public health emergencies and disasters. This was clear during the pandemic H1N1 virus outbreak , the earthquake and subsequent cholera outbreak in Haiti , and the earthquake in Chile Social networks clearly played a significant role in both the Chilean and Haitian earthquakes, particularly in instantaneously relaying what was occurring e. Sites such as Flickr, Twitpic , and YouTube also were used to share videos and other images from the emergencies and became information sources for the main international agencies and media outlets.
Public health entities have, therefore, begun to include social communications strategies in their broader communications plans, so that they can effectively benefit from Web 2. According to Internet World Stats , Internet access in the Americas jumped from ,, users in to ,, in 37 , Even with this expanded access to ICT, the digital divide is still a hurdle in the countries of the Americas, mainly due to socioeconomic factors, constantly evolving technologies, limited infrastructure, and lack of digital literacy.
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These barriers significantly hamper the development of eGovernment and eHealth policies in the Region. Access to mobile telephony in the richest households doubles that of the poorest households, while Internet access in the richest households is 37 times higher than in the poorest ones The use of ICT in the production and delivery of government services enhances their flexibility and effectiveness.
In the Americas, the evolution of eGovernment can be summed up in four stages:. In the health field, the declining cost of ICT and the focus on innovation and quality in health care have brought the Region closer to the promise of unprecedented strides in health—related services in the era of the knowledge society. The adoption of a regional Strategy and Plan of Action on eHealth in September provides an important opportunity for collaboration in key areas such as telemedicine, mHealth, and eLearning and in tackling challenges such as electronic medical records and the interoperability of health management systems at the national and international levels.
Other recognized innovations in ICT in recent years have made it possible to introduce the concept of "virtual health services. Directed by radiologists and general practitioners, the program offers teleradiology, telemedicine, and continuing education services.
This service delivery model facilitates speedy and timely diagnoses, which means that the patient can receive immediate treatment, and helps bridge the gaps in health care services and reduce waiting periods.