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Ciênc. saúde coletiva vol.16 n.10 Rio de Janeiro Oct. 2011
The health of children and adolescents in perspective
This thematic issue represents a major contribution for professionals working with children and adolescents. The articles offer different methodological approaches, present different branches of knowledge and cover different regions of the country. They provide comprehensive reflection on aspects from preterm birth to adolescence, taken as a whole integrating epidemiological studies, the assessment of behavior and practices, health education and the appraisal of healthcare programs.
Research into abandoning breastfeeding and the intention to abandon by mothers of premature babies requires a reassessment of behavior and practices associated with childbirth. Scientific evidence has shown the importance of breastfeeding to reduce infant mortality and morbidity.
This thematic issue also highlights conduct that strengthens the bond between mother and baby and can contribute to the reduction of abandoning breastfeeding among other things. Nowadays, labor and birth are predominantly performed in hospitals and involve excess medical intervention. Abandoning breastfeeding and subsequently abandoning the baby may have its roots in the institutional disregard for women in the pregnancy-puerperal cycle. It may also be due to the excess of cesarean sections, hospital practices that disempower mothers and tend to shun the father, family and social support networks. Professionals who work in management or prenatal care, delivery rooms, milk banks and outpatient clinics should pay close attention to the quality of the family bond and the construction of family networks.
The nature versus experience debate gives rise to the discussion on the influence of biological and environmental factors in child development. This topic is also discussed in this thematic issue in papers on the home environment and developmental alterations, height retardation in children under five years of age, risk factors of excess weight in adolescents and the role of social and communication networks in programs to monitor the growth and development of children.
Another salient aspect is the six papers on oral/dental health, which is important for the reorganization of activities and services within primary care in the Unified Health System (SUS).
Equally important are the papers presented here on research into the perception and representation of children and adolescents on various issues, such as the body, sexuality and violence.
With the advances in, and increasing inclusion of, hard technologies, the need for change in work processes towards greater humanization and interdisciplinarity is a priority. A mismatch between technical and relational skills must be avoided, as is discussed in the article "The Dialogy of Laughter: a new concept introducing joy for the promotion of health based on dialogue, laughter, joy and the art of the clown."
Caring for children and adolescents implies forming bonds and building networks. It involves promoting health education and fostering the construction of comprehensive care practices in the SUS, several of which are studied and presented here. These include pediatric care in the SUS for children with chronic dependence on mechanical ventilation and reflection on the role of pediatricians in the Family Health Strategy.
How does one create a bridge between knowledge and practice? The research of this special issue contributes to the construction of knowledge and elicits reflection on the quality of care in the quest to reduce morbidity and mortality of children and adolescents.
Zeni Carvalho Lamy; Antonio Augusto Moura da Silva
Departamento de Saúde Pública, Universidade Federal do Maranhão