Abstract

This article is linked with a multicenter study conducted from 2013 to 2015 in four different scenarios or cities: São Paulo, Campinas, Ribeirão Preto, and Recife. It aims to present the use of Research Diary (RD) as a device of the Institutional Analysis, which made it possible to explore different dimensions of experiences of diary researchers and restore the analysis of the implications that have occurred in the movements provoked in and through the experiences of this multicenter project. The use of research diary in fieldworks was common practice among project team members. The production of records as diaries, from the perspective of Institutional Analysis, made it possible to analyze the implications of the researchers, opposing the idea of subject neutrality in the research. As an interventional device, research diaries allowed an articulation between diary researchers of the four scenarios with their different knowledge and experiences, in daily buccal health, triggering heterogeneities and encouraging them to write, reflecting on their activities in the clinic, and above all, to share the writing of these experiences with others, which has had an effect on the clinical innovation processes.

Keywords:
Diaries; Public Health; Buccal Health; Institutional Analysis

Introduction

The multicenter research, from which this article was written, aimed to propose a technological innovation in the production of buccal health care. Initially, the team developed the following study questions: Is it possible to organize the work of buccal health care based on a clinical method? Could care include buccal health consultation, as performed in other clinical practices? Is it possible to provide care to a patient without necessarily performing surgical-restorative procedures?

These questions constituted the project challenge and the main determinant of project successes and failures. First, a “diagnosis of the situation” was obtained, or the “state-of-the-art” dental practice, based on the fact that the current care model in the Brazilian public health system reproduces, in an uncritical manner, even in the Brazilian Unified Health System (SUS), the reference dentistry practice of private offices, turning the patient-professional relationship and the patient and his/her illness into a private issue. This construction would still support the ideals in dentistry profession. Since the beginning of the Health Reform in the 1980s, the dental care model and, to a certain extent, care to dental patients, have been considered inadequate and obsolete, of poor coverage and service offering, with a focus on selected age groups, high technological density, and surgical-restorative care, an issue that has been consistently debated in the specialized literature (Amorim; Souza, 2010AMORIM, A. G.; SOUZA, E. C. F. Problemas éticos vivenciados por dentistas: dialogando com a bioética para ampliar o olhar sobre o cotidiano da prática profissional. Ciência & Saúde Coletiva, Rio de Janeiro, v. 15, n. 3, p. 869-878, 2010.; Faccin; Sebold; Carcereri, 2010FACCIN, D.; SEBOLD, R.; CARCERERI, D. L. Processo de trabalho em saúde bucal: em busca de diferentes olhares para compreender e transformar a realidade. Ciência & Saúde Coletiva , Rio de Janeiro, v. 15, p. 1643-1652, 2010. Suplemento 1.; Garrafa, 1993GARRAFA, V. Saúde bucal e cidadania. Saúde em Debate, Rio de Janeiro, n. 41, p. 50-57, 1993.; Pezzato; L’Abbate; Botazzo, 2013PEZZATO, L. M.; L’ABBATE, S.; BOTAZZO, C. Produção de micropolíticas no processo de trabalho em saúde bucal: uma abordagem socioanalítica. Ciência & Saúde Coletiva, Rio de Janeiro, v. 18, n. 7, p. 2095-2104, 2013.; Pires; Botazzo, 2015PIRES, F. S.; BOTAZZO, C. Organização tecnológica do trabalho em saúde bucal no SUS: uma arqueologia da política nacional de saúde bucal. Saúde e Sociedade, São Paulo, v. 24, n. 1, p. 273-284, 2015.).

For the team, the main objective was to experience the possibilities of expanded buccal health practice in primary health care (PHC), in the perspective of integrality, specifically to propose new technologies for buccal health care, understand the clinic as a pedagogical locus, investigate how the demand for buccal health services or needs are built in the perspective of the subject-patient, and analyze the model of buccal health care in SUS, based on the Guidelines for the National Buccal Health Policy. This multicenter study was developed in four distinct fields: public health services in São Paulo (capital), in Campinas and Ribeirão Preto (municipalities of the State of São Paulo), and in a unit of the Family Health Program (FHP) in Recife, Pernambuco.

The concept of buccality ensured potential theoretical contributions to this project and the clinical practice. It emerged as a mobilizer to reorganize buccal health work by proposing a new method to produce meetings and subjectivity and adjust care provision. Buccality is understood as the ability of a mouth to act as a mouth, that is, to perform without limitation the actions for which it is anatomically able (Botazzo, 2008BOTAZZO, C. A bucalidade no contexto da Estratégia Saúde da Família: ajudando a promover saúde para indivíduos, grupos e famílias. In: MOYSÉS, S. T.; KRIGER, L.; MOYSÉS, S. J. Saúde bucal das famílias: trabalhando com evidências. São Paulo: Artes Médicas, 2008. p. 81-88.). Therefore, it means thinking of the human mouth in its social and psychic dimension, a territory with an inexhaustible ability to “have the most distinct or the broadest forms of symbolization, an object that emerges as an icon of itself” (Botazzo, 2000BOTAZZO, C. Da arte dentária. São Paulo: Hucitec, 2000., p. 57). An articulation with the clinical work was allowed due to a theoretical arrangement that ensures the normal and pathological categories of this scope, surpassing the reductionist conceptions of dental injury, with the competent definition of buccal norm and normality, thus proceeding to reinsertion of the buccal cavity in the body (Botazzo, 2006BOTAZZO, C. Sobre a bucalidade: notas para a pesquisa e contribuições ao debate. Ciência & Saúde Coletiva , Rio de Janeiro, v. 11, n. 1, p. 7-17, 2006.; Fonsêca et al., 2016FONSÊCA, G. S. et al. A clínica do corpo sem boca. Saúde e Sociedade, São Paulo, v. 25, n. 4, p. 1039-1049, 2016.). Finally, after overcoming such barriers, which have a linguistic and organizational nature, a clinical method can be adopted to constitute buccal patients (Barros; Botazzo, 2011BARROS, R. S.; BOTAZZO, C. Subjetividade e clínica na atenção básica: narrativas, história de vida e realidade social. Ciência & Saúde Coletiva, Rio de Janeiro, v. 16, n. 11, p. 4337-4348, 2011.).

In the monitoring and evaluation stage of this multicenter study, different qualitative approaches were proposed, such as action research, intervention research, and ethnomethodology, using multiple techniques: (total, participant) observation, interviews, focus groups, and regardless of the knowledge production technology, the development of a research diary was recommended as a device for the production of institutional arrangements and define the researcher’s place in the research context, as opposed to researcher neutrality.

Since the initial formulation of the project, a diary was considered a device, “something like a skein” that could be produced in different ways, with specific directions given by the researchers (Deleuze, 1999DELEUZE, G. Que és un dispositivo? In: BALIBAR, E. et al. Michel Foucault, filósofo. Barcelona: Gedisa, 1999. p. 155-163., p. 155).

Thus, research diary - a procedure widely used in ethnography and Institutional Analysis (IA) (Pezzato; L’Abbate, 2011PEZZATO, L. M.; L’ABBATE, S. O uso de diários como ferramenta de intervenção da análise institucional: potencializando reflexões no cotidiano da Saúde Bucal Coletiva. Physis, Rio de Janeiro, v. 21, n. 4, p. 1297-1314, 2011.) - should be a common practice among the researchers of this study. Similarly, all recorded information would be used in reporting and support the analysis and interpretation of results.

The purpose of this study was to analyze the use of a research diary (RD) as an IA device to explore different dimensions of situations experienced by the diary writers/researchers and the implications from the experiences recorded in diaries in this multicenter project.

The proposal of diaries, also as a writing exercise, is associated with what Foucault (2004FOUCAULT, M. Ética, sexualidade, política. Rio de Janeiro: Forense Universitária , 2004., p. 151) states about it,

In this sense, as stated by Dias (2016DIAS, R. O. Fragmentos de diários de campo, escrita e devir texto. In: CALLAI, C.; RIBETTO, A. (Org.). Uma escrita acadêmica outra: ensaios, experiências e invenções. Rio de Janeiro: Lamparina, 2016. p. 111-123., p. 113), “self-writing as a practice is a tool in research diary,” which supports our proposal of using a diary as a research device, true “machines that help see and speak” (Foucault apud Deleuze, 1999FOUCAULT, M. História da sexualidade: a vontade de saber. Rio de Janeiro: Graal, 1999. v. 1., p. 155).

The text starts with a discussion about the concept of device in philosophy and human sciences, and then presents the perspective of a diary in this study. After that, it discusses the concept of implication and analysis of the inferences of diary writers after diary reading, promoting an understanding of innovation processes in the production of buccal health care.

What do we mean when we say device?

First, it is important to highlight the polysemy of this term and its use in the scientific literature. A quick search shows different meanings and uses of ‘device.’ In the 1960s, Foucault used it to refer to sexuality, characterizing one of the first uses of this term in his extensive production. In fact, chapter IV, volume I, of The History of Sexuality is named: Part IV - The Deployment of Sexuality. However, Foucault (1999)FOUCAULT, M. História da sexualidade: a vontade de saber. Rio de Janeiro: Graal, 1999. v. 1. does not use the term extensively in this narrative.

How is device used in contemporary scientific literature? A random search on databases of studies shows articles using device with different meanings, resulting in the following descriptors: device for septal occlusion, woman’s body, analysis, self-feeding, maternity, sustainability, load, intermittent pneumatic compression, orthopedic fixation, management, infantilization, etc. It shows the semantic weight of the term and how ‘device can be used in multiple daily phenomena.

Considering the common uses and meanings, and Foucault’s appropriation of the term, the following questions emerge: What exactly did he mean by device? And what do we understand from that? Extensive appropriations or subsumptions of the term have been observed, increasing the semantic dispersion already seen in the literature.

Then, a device could mean something ‘not abstract’ or a ‘historically situated network of knowledge/power relations’ (Fanlo, 2011FANLO, L. G. ¿Qué es un dispositivo? Foucault, Deleuze, Agamben. A Parte Rei, [s.l.], n. 74, 2011., p. 2), a device that ‘rationally impacts the field of forces where it is inserted” (Veinmann, 2006VEINMANN, A. O. Dispositivo: um solo para a subjetivação. Psicologia & Sociedade, Belo Horizonte, v. 18, n. 3, p. 16-22, 2006., p. 17), a focus of device signification on the structure of society and the disciplinary component (Pogrebinschi, 2004POGREBINSCHI, T. Foucault, para além do poder disciplinar e do biopoder. Lua Nova, São Paulo, n. 63, p. 179-201, 2004., p. 191), or on care technologies, such as therapy follow-up in mental health services, which acts as a clinical device ‘for the construction of networks that can supersede asylums’ (Palombini, 2006PALOMBINI, A. L. Acompanhamento terapêutico: dispositivo clínico-político. Psychê, São Paulo, v. 10, n. 18, p. 115-127, 2006., p. 117). Deleuze refers to device as ‘something like a skein, a multilinear set’ that is ‘comprised of lines of a different nature’ or containing ‘visible objects, formulable statements, the forces in action, the subjects in position are like vectors or tensors’ (Foucault apud Deleuze, 1999FOUCAULT, M. História da sexualidade: a vontade de saber. Rio de Janeiro: Graal, 1999. v. 1., p. 155).

These combined discursive products indicate increasing signification; however, as usually seen in these cases, the focus of the narrative is lost and, at the end, the structure referred to in the beginning becomes distant, without any relation to the original statement.

Of all contributions reviewed, Giorgio Agamben’s insight seemed the most appropriate for this discussion. Agamben, at a conference held in Brazil in 2005, added new and surprising elements to the understanding of the enunciation and theory experienced by Michel Foucault, providing an innovative reading focused on the concept of device, considering its condition of possibility.

Agamben (2005AGAMBEN, G. O que é um dispositivo? Outra Travessia, Florianópolis, n. 5, p. 9-16, 2005. Disponível em: <Disponível em: https://bit.ly/2xhQSh7 >. Acesso em: 12 nov. 2016.
https://bit.ly/2xhQSh7... ) highlights the definition of technical terms used in philosophical statements takes three distinct and complementary directions: they refer to the homologous relations between dispositif and apparatus, then the similarity or proximity between device and the Latin word dispositio, and finally refers to positivity.

When Agamben places semantic proximity between device and Latin dispositio, the dispositions of soul or character confirm the possibility of certain arrangements to function according to an internal disposition or even as something disposed or inclined to specific achievements; also here, there is homology between the categories analyzed by him. Likewise, machines, apparatuses or devices must function according to the way they are arranged, that is, built for a purpose.

Finally, the concept of positivity will be discussed. In The Archeology of Knowledge, Foucault (1985FOUCAULT, M. Arqueologia do saber. 5. ed. Rio de Janeiro: Forense Universitária, 1985., p. 317) highlights that it is the first of the categories aligned with what he called thresholds, and positivity is one of them, which would mean the moment of the object when captured in its existence, considering it as something positive and certain in its construct process, which can then be empirically apprehended, enjoying its own autonomy and existence, external to the consciousness of the researcher. Agamben emphasizes exactly this point, addressing the homologous relationship between the positivity category according to Foucault and Jean Hyppolite, to ensure precision and relevance to its significant content. This explanation is eloquent and seeks to describe the meaning of positivity.

And what would be the meaning of positive,

This way, positivity merges with Augusto Comte’s concept of positive - the given, the right, the measurable, the apprehensible, the predictable, considering that “the true positive spirit consist especially of seeing to foresee” (Comte, 1978COMTE, A. Curso de filosofia positiva. In: GIANNOTTI, J. A. Augusto Comte. São Paulo: Abril Cultural, 1978. p. 10-49., p. 49) - and with Durkheim’s concept of social fact, two possibilities of dialogue that, at first, were unconceivable. Considering that a social fact is “any way of acting, whether fixed or not, capable of exerting over the individual an external constraint […] over the whole of a given society whilst having an existence of its own, independent of its individual manifestations” (Durkheim, 1978DURKHEIM, E. As regras do método sociológico. São Paulo: Companhia Editora Nacional, 1978., p. 11).

Agamben is again considered to end this narrative, as he said at a conference held in ²⁰⁰⁵AGAMBEN, G. O que é um dispositivo? Outra Travessia, Florianópolis, n. 5, p. 9-16, 2005. Disponível em: <Disponível em: https://bit.ly/2xhQSh7 >. Acesso em: 12 nov. 2016.
https://bit.ly/2xhQSh7... :

In an interview conducted in 1977, Foucault said:

Then, according to Foucault, devices are apparatuses and objects to perform according to their intended purpose, all of them existing outside the subject, just as capitalism is a device, as well as sexuality, buccality, madness, asylum, medicine, torture, prison and… diary.

A device is also, pertinently, a tool concept for analysis used by a socio-analyst. According to Lourau (1993LOURAU, R. René Lourau na Uerj: análise institucional e práticas de pesquisa. Rio de Janeiro: EdUERJ, 1993., p. 30), the method of intervention used in socio-analysis¹1Argonauts of the Western Pacific and A Diary in the Strict Sense of the Term. “consists in creating a device for collective social analysis […]. When I talk about socio-analytic work, I mean the need, the attempt to put the device on the scene.” That is, in IA, from a device, things are put into operation and situations articulate heterogeneous elements, triggering functioning modes that will produce some effects.

Research diary in research: “how to do research”

Writing a diary is a technique widely used in qualitative studies, in their different theoretical and methodological approaches. According to Pezzato and L’Abbate (2011PEZZATO, L. M.; L’ABBATE, S. O uso de diários como ferramenta de intervenção da análise institucional: potencializando reflexões no cotidiano da Saúde Bucal Coletiva. Physis, Rio de Janeiro, v. 21, n. 4, p. 1297-1314, 2011.), a diary is an intervention tool used by institutional analysts that helps “make one see” conflicting and complex situations in the daily life of the institution being analyzed.

Diaries have also been used in other areas, such as in the daily life of many people, often becoming a lifestyle. Recording events or moods, feelings, perceptions, and reflections is an ancient practice and has become the subject of interpretation since classical antiquity. Foucault (2004FOUCAULT, M. Ética, sexualidade, política. Rio de Janeiro: Forense Universitária , 2004.) highlights a clear pedagogical position of a subject who must write in order to have clear ideas, an activity that would be a type of self-control, control of psychological drives through the exposure in the recorded material. Writing, in contrast, allows an individual, by recording the activity, to organize one’s ideas and perceptions and communicate them to others:

As stated by Dias (2016DIAS, R. O. Fragmentos de diários de campo, escrita e devir texto. In: CALLAI, C.; RIBETTO, A. (Org.). Uma escrita acadêmica outra: ensaios, experiências e invenções. Rio de Janeiro: Lamparina, 2016. p. 111-123., p. 115), inspired by the essay proposed by Foucault (2004FOUCAULT, M. Ética, sexualidade, política. Rio de Janeiro: Forense Universitária , 2004.), writing on a diary is

However, writing, recording in a diary, and making notes have always “constituted a material memory of things read, heard or thought, […] raw material for writing more systematic treaties, […] a material for exercises to be carried out frequently: reading, rereading, meditating, conversing to oneself and others” (Foucault, 2004FOUCAULT, M. Ética, sexualidade, política. Rio de Janeiro: Forense Universitária , 2004., p. 147-148).

In this sense, a diary brings, exactly, implied writing, it works or materializes as a device that is, at the same time, a research and pedagogical device, since the researcher writes his reflections, analyses, emotions, descriptions of experiences in the research activities and his own life, allowing others to interact with these records and, consequently, reflect, build other relations and networks between what is written and not written, between what was experienced and not experienced. With a diary, a moment of privilege in the study is when a researcher, or the “adult subject” according to Remi Hess, through self-writing, reviews one’s projects and perspectives of formation, because every research project has a pedagogical component.

One learns in the act of producing knowledge, which is the same as pedagogical autopoiesis or pedagogy in autopoiesis! It is the intensity in a subject’s life, a moment, an essential stage of a research project (Hess, 2009HESS, R. O momento do diário de pesquisa na educação. Ambiente & Educação, Rio Grande, v. 14, n. 1, p. 61-87, 2009., p. 86).

For Lourau (2004bLOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283., p. 276), diary writing highlights the hidden dimension of research, leading the diary writer/researcher to walk through the ‘labyrinth of how to do research.’ The author proposes a diary as a “strategy for the collectivization of experiences and analyses” of researchers involved in investigation (Lourau, 1993LOURAU, R. René Lourau na Uerj: análise institucional e práticas de pesquisa. Rio de Janeiro: EdUERJ, 1993., p. 85). For him, a diary questions the researcher “neutrality” exposing the researcher’s daily experiences and concrete institutional fragilities. This is how it can be a “strategy for the collectivization of experiences and analyses” of diary writers/researchers involved in investigation.

In order to start a discussion about the use of field diary in research, Lourau (2004bLOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283., p. 273) analyzes two diaries of Bronislaw Malinowski²2For more information about the intervention method of socio-analysis, refer to Lourau (1993, 2014) and L’Abbate (2012). to present an implication analysis technique. Similarly to narratology,³3Narratology is the study of fiction and nonfiction narratives through their structures and elements. he proposes three instances of these diaries: “1. The narrator: the ethnographer, writing a field diary; 2. The implied author, exposing in his diary concerns of an ethnologist, a philosopher, a writer; and 3. The real author of the intimate diary. Possibly, such instances have interference from each other, since both diaries were written in parallel, without “one inside and one outside the ethnographic account”, as proposed by Lourau (2004bLOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283., p. 273, bold letters added).

In this sense, we consider that there is not one inside and one outside the diary produced by the research diary writers in this study. The writers, respecting their own singularities, the different places they occupy, and their experiences, wrote in the diary about the relationships they built and kept with the institutions. Institutions are always present in the research contexts and professional and personal activities,⁴4In Institutional Analysis, the concept of institution differs from that of an organization. For more details about the concept of institution in Institutional Analysis, the approach used in this text, refer to Lourau (2014). and analyzing implications “means, above all, talking about the institutions around us” (Monceau, 2010MONCEAU, G. Analyser ses implications dans l’institution scientifique: une voie alternative. Estudos e Pesquisa em Psicologia, Rio de Janeiro, v. 10, n. 1, p. 13-30, 2010., p. 14).

As a device, research referred to a number of alternative realities that transformed “the alleged horizon of the real, the possible, the impossible” (Baremblitt, 2002BAREMBLITT, G. Compêndio de análise institucional e outras correntes: teoria e prática. 5. ed. Belo Horizonte: Instituto Felix Guattari, 2002., p. 135) which, after being written, read, reread and discussed, became the material of analysis and reporting, and above all, the implication analysis of research diary writers.

In IA, the concept of implication refers to the relations built with institutions, since “exploring an implication means talking about the institutions around us. […] it shows that what an institution sees in us is always an effect of collective production of values, interests, expectations, desires, beliefs that are intertwined in this relation” (Romagnoli, 2014ROMAGNOLI, R. C. O conceito de implicação e a pesquisa-intervenção institucionalista. Psicologia & Sociedade, Belo Horizonte, v. 26, n. 1, p. 44-52, 2014., p. 47).

By proposing implication as a new paradigm, Lourau (2004a)LOURAU, R. Implicação: um novo paradigma? In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004a. p. 246-258. categorizes implications into primary and secondary implications. Primary implications are related to the researcher regarding his research object, the research institution, and the social demands. Secondary implications are the epistemological implications, writing and other forms of research dissemination. Therefore, an implication may have five different forms.

According to Lourau (2004a)LOURAU, R. Implicação: um novo paradigma? In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004a. p. 246-258., IA involves an implication analysis, and not just implication, since implication is not a question of will, but of analysis of the places one occupies or seeks to occupy.

Also according to Lourau (1993LOURAU, R. René Lourau na Uerj: análise institucional e práticas de pesquisa. Rio de Janeiro: EdUERJ, 1993.), an implication analysis represents the “scandal of Institutional Analysis,” as it questions the sacred and unquestionable place of so-called experts.

In some of his books, Lourau published excerpts from the diaries he wrote while producing theoretical reflections that were the subject of these works. These diaries show the affective, ideological and professional dimensions (Barbier, 1985BARBIER, R. O conceito de “implicação” na pesquisa-ação em ciências humanas. In: BARBIER, R. Pesquisa-ação na instituição educativa. Rio de Janeiro: Zahar, 1985. p. 105-128.) of the author’s own implication (Lourau, 1988LOURAU, R. Le journal de la recherche: materiux d’une théorie de l’implication. Paris: Méridien Klincksieck, 1988., ¹⁹⁹⁴LOURAU, R. Actes manqués de la recherche. Paris: PUF, 1994., ¹⁹⁹⁷LOURAU, R. Implication transduction. Paris: Anthropos, 1997.). In this study, these dimensions were analyzed using the records from dairies and were shared and discussed at in-person seminars.⁵5These seminars were methodologically considered as training seminars. Every research project was admitted to imply knowledge production throughout the process and that the participating subjects do not initially share the same theoretical assumptions; therefore, they do not share the same linguistic and representational framework. Such repertoire is a construct that had these in-person seminars as one of the loci.

Research diary was proposed to the group of researchers in the beginning of the project to meet the particularities of each researcher and each field, and to enable future analysis. At first, the diaries were restricted to each researcher. Later, they were shared in small groups and, only in the third stage of the study, the monitoring and evaluation stage, they were collectively available at in-person seminars. No periodicity was established for the records; each researcher wrote at one’s own rhythm and highlighting one’s own singularities, allowed each of them to set one’s own path, writing style, and marks.

In this sense, the excerpts, written fragments of the dairies, were identified according to each one’s role in the research. Then, in the four loci where the study was developed, this study had 14 research diary writers who embraced the writing experience and diary production, among them, two university professors, two postgraduate students, three trainees attending a dentistry course, three dentists from the School Health Center and four dentists from SUS services.

The text yet to come: analysis of implications

The implication analysis presented below has no intention to reach finitude; it rather aims to ensure continuity, that is, further analysis of produced dairies. For this reason, excerpts were selected which show different dimensions of the experiences of research diary writers. Could other dimensions be identified? Certainly yes, but we wanted to identify from the records what touched us in different ways, interacting with the three diary instances proposed by Lourau (2004b)LOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283. as a technique of implication analysis: the narrator, the implied author, and the real author.

As Passos and Barros (2009PASSOS, E.; BARROS, R. B. Diário de bordo de uma viagem intervenção. In: PASSOS, E.; KASTRUP, V.; ESCÓSSIA, L. (Org.). Pistas do método cartográfico: pesquisa-intervenção e produção de subjetividades. Porto Alegre: Sulinas, 2009. p. 172-200., p. 175) stated, “the diary text presents its own production, releasing itself from the pretention of definitive knowledge about the object.”

Each excerpt of the diaries was full of meanings resulting from the experiences of research diary writers, at different intensities, because “the researcher, besides his body and his instruments, cannot avoid using everything that goes on in his head” (Lourau, 2004bLOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283., p. 267). It happened to some research diary writers, who freely reproduced their personal feelings - not often considered in research - an intimate writing resulting from research experience. As reported by Lourau (2004b)LOURAU, R. Uma técnica de análise das implicações: B. Malinowski, diário de etnógrafo (1914-1918). In: ALTOÉ, S. (Org.). René Lourau: analista institucional em tempo integral. São Paulo: Hucitec , 2004b. p. 259-283., the real author:

Based on Rodrigues (1997RODRIGUES, H. B. C. Dispositivos em ação, ação dos dispositivos. In: SILVA, A. E. et al. Saudeloucura: subjetividade. São Paulo: Hucitec, 1997. v. 6. p. 192-196., p. 195), if dairies are seen as a device that causes “disruption of historical continuities,” it can act in research as an instituting dimension that can eliminate territories, create unconceivable connections that “will assume a temporary form resulting from a confrontation between strategies on a battlefield.” Then, we can say the diary device was managed but also managed the events in the process related to the experiences during and outside the study, in the confrontation with the desire to control what is recorded and what is not recorded, what is inside the text and outside the text, and what is yet to come in the text.

During the process, we were faced with questions regarding the theoretical-methodological approach adopted in this study, as written by one of the professors in his diary, defining the implied author, the one who reflects, exposes himself after being pressured for the research results, showing that there are different theoretical-methodological conceptions among the researchers and some of the professionals invited to participate in this study.

The same concern appears in this excerpt of one of the researchers, who ended her diary record early in the research activities, also exposing her methodological doubts regarding the diary writing and what kind of relation she should establish with her experience in the study, that is, the implied author, “sorry if it is more like a testimonial than a diary, but it was from the heart!” (diary of post-graduate student, February 27, 2013).

Intervention research is open to innovation and does not operate with the idea of controlled and delimited data, which generated resistance in some participants who were used to more conservative methodologies. However, this fact led to analyses, marking different places of speech, knowledge, powers and desires, as explained in the diary of two daily writers/researchers as the narrator, showing distance and resistance to what the study proposed, a classical confrontation with the hegemonic dental practice: “Why bother to invent it, they are all the same” (diary of dentist-1, School Service, 2013); “I’ve learned social dentistry, it’s the same thing” (diary of dentist-2, School Service, 2013).

The narrator can be highlighted as the one who describes what is happening around and not what is happening to him, observed in the diary of a diary writer who claims to understand what the study proposed, is willing to adapt her clinical practice, but cannot move on from her established place: “I understood the definitions of the project theoretical framework, I just find it difficult to use them in the routine practice of the FHP dental surgeon” (diary of the dentist from the Family Health Strategy (FHS)-1, February 22, 2013).

Her writing shows some resistance to move from her place of power historically built for the dental surgeon, propose actions outside the dentist chair, meet people and their buccality and see that all of it should also be part of her practice as an FHS dentist.

These excerpts explain the game of power between the instituted and the instituting dimensions, present in the intervention field, causing disruptions and eliminating consolidated territories of the daily practice of health services.

Other diary writers/researchers, also in the same instance - the narrator -, wrote in their dairies about their challenges to implement an expansion in their daily practice, exposing their concerns and creating cracks in the instituted dimension.

These diary excerpts showed the required battles to be faced in order to create possible connections in research, professional or institutional contexts. Together, these records are about the challenges of dealing with the theoretical-methodological framework of the project, which used buccality as the structuring concept. In other words, it seems that understanding buccality (as a conceptual novelty that explains the integration of its anatomical-functional dimension and, at the same time, its privileged place in the formation of the human psyche) and seeing its practical content is not only a linguistic operation, but also some reorganization at the subjective and institutional level.

In the diary device, in its power to help see and speak, the obstacles to creating different ways of insertion in the daily practice of dental education gain visibility, as written by a diary writer/researcher - a trainee and undergraduate student who presented her concerns - the implied author -, showing some effects from the experiences during the study. “It’s irritating,” she wrote, referring to the organization of clinics during their training process,

Just as it was reported in the diary of another researcher - the implied author - an emblematic problem that has existed since the start of SUS is: how to establish other types of operation in the teaching-service-community relationship?

Another challenge refers to the act of writing, which has an effect on the research diary writers - the implied author - during the meetings with other research participants:

As Abrahão (2004ABRAHÃO, A. L. Produção de subjetividade e gestão em saúde: cartografias da gerência. 2004. Tese (Doutorado em Saúde Coletiva) - Universidade Estadual de Campinas, Campinas, 2004., p. 98) states:

Writing was a challenge imposed on and assumed by all 14 diary writers/researchers.

Final considerations

The RD device acted as a machine that produced heterogeneous effects in the researchers and the study. The diaries constituted an intervention device with potential to articulate different people, in different places, with different knowledge and experiences, including the daily buccal health. They also triggered modes of operation that caused the researchers to reflect about what they were doing in the clinic, write about what they reflected and, above all, share what they wrote about their experiences, often showing resistance during the study and in our seminars. Then, effects were produced on the clinic innovation processes in the daily dental practice of these diary writers, creating internal connections with themselves, their discoveries, disappointments, impressions and among them.

Dairies were like a protected place for ‘free speaking,’ showing their concerns about the daily routine of services and their established relations with institutions, challenges, personal and professional news to reflect and share experiences, challenges with project implementation and negotiations with administration bodies, questionings, doubts, fear of the new, assumption of anxiety, willingness to give up, how real authors narrate their experiences in and with research, implied authors. They also showed achievements, powerful situations that gave strength to continue even with the existing challenges.

The diaries fulfilled their dual function: being self-writing and provide reflections about the work performed and its pedagogical content. As a self-writing, they revealed anguish, disagreements, ambiguities, but also the investigation of the unknown; and, as a reflection, they expressed the ability of subjects to unfold towards their objects and see themselves reconfigured.

Then, as a true machine to help seek and make, the diary as a device worked in different ways, causing tension, doubts, anxiety or fear, according to the experience of each researcher that used this device, which enabled an implication analysis, expand knowledge and powers, eliminate closed territories through expansion and improved visibility to the overimplication of researchers, bringing to the analysis situations that were natural so far.

Besides, in a very objective way, it brought fundamental elements for reporting and analysis of empirical findings of the study and, above all, dairies contributed to a better understanding of the mental architectures related to dental theories about buccal diseases, as one of the diary writers stated: “I’ve learned everything in social dentistry,” often due to the practical limits of attempted innovation, as highlighted in another diary: “Why bother to invent it,” referring to the production of health care within the concept of buccality.

Assuming the place of a writer as a political and methodological path is always a choice. In diary writing, we were able to invent, together, research practices of learning, writing, to create new meanings of doing and saying for the buccal health practice.

References

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