Lima, C.M.G. Oral health children in early childhood: the look of family caregivers. Ribeirão Preto, 2007. 208p. Doctoral Dissertation-University of São Paulo at Ribeirão Preto College of Nursing. This study aimed to understand the experiences of family caregivers of children in early childhood related to oral health care, and to identify in their daily lives the elements that interfere in this care. The empirical base consisted of twelve interviews with family caregivers of children under the age of six, living in the Eastern Health District of Ribeirão Preto-SP, which were tape-recorded. In addition to the interview, observation and search in the children's patient files were used as strategies. Based on the qualitative approach, supported by the hermeneutical perspective, the empirical material was interpreted and discussed. Five empirical categories were identified: who are the caregivers, the children and their families; the family caregivers'; the meanings of oral health care; the interactions in care for the child's oral health; in search of the causes and prevention of oral diseases and the actuality of health services and of dentistry. The analysis made it possible to apprehend the child's vulnerability to oral diseases by identifying other than biological elements, present in the daily life of family caregivers which increase their vulnerability or protect them from disease, according to the dynamics and complexity of their interaction. The caregivers' experiences contributed to the revision of oral health prevention and promotion strategies, which had been directed at the focus of risk and individual accountability until then, providing elements to help health services to reorganize oral health care for children in early childhood. Thus, with a view to an actual contribution to comprehensive care for children's health, together with other knowledge and practice areas, attention should be directed at other dimensions of human existence. Acknowledging the Other in his/her singularity reveals to be essential, respecting his/her experiences and feelings and searching, through shared and responsible choices, the true meeting, which is the essential meaning of care.

Esta caminhada não foi fácil, mas teria sido muito mais difícil sem o estímulo, sugestões e críticas de várias pessoas. Agradeço a todos, a quem apoiou: "...trouxe esse texto, acho que vai te ajudar [...] veja esta referência, pode ser importante..." (REGINA) "...se não puder vir não faz mal, quando der você vem." (RU e MAMA) a quem leu e releu: "...não concordo [...] ficou muito melhor." (JAIME) a quem sofreu junto: "...hei amiga, nós vamos conseguir." (GLÓRIA) a quem tranqüilizou e descontraiu: "...fica tranqüila vai dar tudo certo [...] já posso organizar o brunch?" (MARIA LÚCIA)Agradeço, também, aos funcionários das bibliotecas por me ajudarem na busca dos artigos, em especial a Maria Bernadete, pela sua atenção nas muitas vezes que a procurei tentando acertar referências; a Maria José, pela lição de "português"; a Adriana e Maria Elisa, pela gentileza e eficiência. Sou imensamente grata aos meus amigos e amigas pela compreensão e apoio, nessa fase da minha vida. Não poderia, ainda, deixar de agradecer a Professora Silvana pelas sugestões valiosas que me auxiliaram no momento do exame de qualificação. Meu especial agradecimento ao Professor Capel e ao Professor José Ricardo, pelo desprendimento em compartilharem seu "tempo" e "conhecimento" e à Professora Semiramis, pelo voto de confiança e convivência agradável que tivemos, dispersando, muitas vezes, os assuntos da "pauta" da reunião.

The aim of this study was to comprehend the experiences of family members regarding the oral health care of children. This was a qualitative study, conducted in 2007, in the health district of Ribeirão Preto, with 12 caregivers. The theoretical framework of vulnerability and the hermeneutical perspective were used. Three empirical categories were established: the meanings of oral health care, in search of the causes and prevention of oral diseases, and the reality of oral health services. Among other potentiating factors of infantile vulnerability to oral diseases, the overvaluation of biological causality, of high complexity care and of esthetic dentistry emerged, and among the protective factors, the valorization of popular knowledge and the integration of professional actions and knowledge were observed. This study indicates the necessity for a review of prevention and oral health promotion strategies and provides elements to assist health services to reorganize oral health care for children.Descriptors: Oral Health; Vulnerability; Child. 1 Paper extracted from Doctoral Dissertation "A saúde bucal da criança na primeira infância: o olhar do cuidador familiar" presented to Programa Utilizou-se referencial teórico da vulnerabilidade e a perspectiva hermenêutica. Três categorias empíricas foram elaboradas: os significados do cuidado com a saúde bucal, em busca das causas e da prevenção de agravos bucais e a realidade dos serviços de saúde bucal. Entre outros elementos potencializadores da vulnerabilidade infantil aos agravos bucais, emergiu a supervalorização da causalidade biológica, do atendimento de alta complexidade e da odontologia estética e, entre os protetores, a valorização do saber popular e a integração de ações e conhecimentos profissionais. Aponta-se para a revisão das estratégias de prevenção e promoção de saúde bucal, fornecendo elementos para auxiliar os serviços de saúde a reorganizarem o cuidado com a saúde bucal de crianças.Descritores: Saúde Bucal; Vulnerabilidade; Criança. Experiencias del familiar en relación al cuidado con la salud bucal de niñosEste estudio objetivó verificar la comprensión de las experiencias de los familiares en relación al cuidado con la salud bucal de los niños. Es un estudio cualitativo, realizado en 2007, en un distrito de salud del municipio de Ribeirao Preto-SP, con 12 cuidadores.Se utilizó el referencial teórico de la vulnerabilidad y la perspectiva hermenéutica. Tres categorías empíricas fueron elaboradas: los significados del cuidado con la salud bucal, en busca de las causas y de la prevención de daños bucales, y la realidad de los servicios de salud bucal. Entre otros elementos potencializadores de la vulnerabilidad infantil a los daños bucales, emergieron la supervalorización de la causalidad biológica, la atención de alta complejidad y la odontología estética; y, entre los protectores, la valorización de la sabiduría popular y la integración de acciones y conocimientos profesionales. Se señala que debe ser efectuada la revisión de las estrategias de prevenc...

The aim was to evaluate the care for at-risk newborns under follow-up in their first year of life by the Growing Happily Program, developed in a city in inner São Paulo state. It is a population-based epidemiological health program evaluation study, which was based on the national guidelines of the Agenda of Commitments to Children and Child Mortality Reduction for data analysis. Results showed the program's institutional vulnerability, caused by problems related to its structure and process, with implications for its outcomes.Considering the adaptation of the criteria adopted by the Program for defining at-risk newborns, as well as the proposed interventions and strategies, in consonance with the Agenda of Commitments, the need for managers to make it a priority is appointed, by effectively including it in public health care policies to be developed in cities, in order to reverse the institutional vulnerability identified.Descriptors: Health Services Evaluation; Risk Groups; Infant, Newborn; Vulnerability. Evaluación de la atención al recién nacido con riesgo bajo la perspectiva de una política pública de salud Se objetivó evaluar la atención a la salud de recién nacidos con riesgo acompañados en el primer año de vida por el Programa Crecer Feliz, desarrollado en un municipio del interior del estado de Sao Paulo. Se trata de un estudio epidemiológico poblacional del tipo evaluación de programa de salud que se basó, para el análisis de los datos, en las directrices nacionales de la Agenda de Compromisos del Niño. Los resultados evidenciaron la vulnerabilidad institucional del programa, proveniente de problemas relacionados a la estructura y proceso, con implicaciones en los resultados. Considerando la adecuación de los criterios adoptados por el programa para definición de los recién nacidos con riesgo y de las intervenciones y estrategias propuestas, que se muestran en consonancia con la Agenda de Compromisos, se apunta la necesidad de los administradores de priorizarlo, introduciéndolo efectivamente en la política pública de salud a ser desarrollada en el ámbito del municipio, para reversión de la vulnerabilidad institucional identificada.