Noção de família(s) no campo da saúde brasileira: ensaio teórico-reflexivo / Concepto de familia en el campo de la salud brasileña: ensayo teórico-reflexivo / The family concept in the field of Brazilian health: a theoretical and reflective essay

RESUMO Objetivo discutir o termo família no campo da saúde brasileira por meio: 1) do resgaste histórico do conceito e configuração da família no Brasil; 2) da recapitulação e problematização do termo na saúde brasileira; 3) da discussão na Política Nacional de Atenção Básica. Método trata-se de um estudo teórico-reflexivo. Resultado o texto foi dividido em: "Resgate histórico das transformações familiares no Brasil", "Primeira Unidade Básica de Saúde: a família" e "Política Nacional de Atenção Básica: de que família estamos falando?", que auxiliaram na argumentação sobre a problemática da (não)definição do termo família. Em meio a preocupação sobre alocar o cuidado voltado para a família, torna-se necessário repensar esse termo polissêmico, propondo a desnaturalização de definições cristalizadas que podem emergir na práxis dos profissionais, o que pode produzir atuações baseadas em (pré-)conceitos e negligências a famílias não hegemônicas. Considerações finais e implicações para a prática é necessário discutir sobre qual concepção de família é considerada no campo da saúde e suas repercussões, principalmente na Atenção Primária à Saúde e em políticas de saúde, como na Política Nacional de Atenção Básica, para minimizar possíveis dificuldades que possam surgir no fazer dos profissionais ao se deparar com a pluralidade das realidades familiares.

RESUMEN Objetivo discutir el término familia en el campo de la salud brasileña a través de: 1) la revisión histórica del concepto y configuración de la familia en Brasil; 2) por la recapitulación y problematización del término en la salud brasileña; 3) para la discusión en la Política Nacional de Atención Primaria. Método es un estudio teórico-reflexivo. Resultado el texto se dividió en: "Rescate histórico de las transformaciones familiares en Brasil", "Primera unidad básica de salud: la familia" y "Política Nacional de Atención Primaria: ¿de qué familia estamos hablando?", Que ayudó en la argumentación sobre el problema de la (no) definición del término familia. En medio de la preocupación por la asignación de cuidados orientados a la familia, se hace necesario repensar este término polisémico, proponer la desnaturalización de definiciones cristalizadas que pueden surgir en la praxis de los profesionales, que pueden producir acciones basadas en (pre) conceptos y negligencia de familias no hegemónicas. Consideraciones finales e implicaciones para la práctica es necesario discutir qué concepción de familia se considera en el campo de la salud y sus repercusiones, principalmente en la atención primaria de salud y en las políticas de salud, como la Política Nacional de Atención Primaria, para minimizar las posibles dificultades que puedan surgir en la actuación de los profesionales ante la pluralidad de realidades familiares.

ABSTRACT Objective to discuss the term family in the field of Brazilian health through: 1) the historical review of the concept and family arrangement in Brazil; 2) the recapitulation and problematization of the term in Brazilian health; 3) the discussion in the Brazilian National Primary Care Policy. Method this is a theoretical-reflective study. Results the text was divided into: "Historical rescue of family transformations in Brazil", "First Basic Health Unit: the family" and "Brazilian National Primary Care Policy: which family are we talking about?", which helped in the argument about the problem of (non)definition of family. Amidst the concern about allocating family-oriented care, it becomes necessary to rethink this polysemic term, proposing the denaturalization of crystallized definitions that can emerge in professionals' work, which can produce actions based on (pre-)concepts and negligence to non-hegemonic families. Final considerations and implications for practice it is necessary to discuss which conception of family is considered in the field of health and its repercussions, especially in Primary Health Care and in health policies, as in the Brazilian National Primary Care Policy, to minimize possible difficulties that may arise in professionals' actions when faced with the plurality of family realities.

Etapas históricas del proceso de orientación a la familia del niño discapacitado en Cuba / Historical periods of the guidance process of handicap child family in Cuba

El devenir histórico concreto del proceso de orientación familiar hace posible escalar distintos niveles de satisfacción en cuanto a la atención de las necesidades de los padres. De la importancia que tradicionalmente se le concede a la familia en el desarrollo integral de sus hijos, se deriva la utilidad de su adecuada preparación. A tales efectos se realizó el presente estudio con el objetivo describir las etapas del proceso de orientación a la familia para la formación ciudadana de los niños con retraso mental, lo cual permitió llegar a importantes conclusiones.

The concrete historical evolution of the family guidance process makes possible climbing different satisfaction levels as for paying attention to the parents necessities. The importance that is given to the family in the integral development of their children, results in the usefulness of its adequate preparation. To such effects, this study was carried out with the purpose of describing the stages of the family guidance process for the citizen training of children with mental retardation, which allowed to reach important conclusions

Nursing and midwifery in the history of the World Health Organization 1948-2017

Every country needs a competent, motivated, well-distributed and supported health workforce. Health workers are the cornerstone of the strong, resilient health systems needed to achieve universal health coverage. These are the people who keep the world safe, improve health, and protect the vulnerable. These are the people who detect, prevent and manage health emergencies, and who promote the well-being of women, children and adolescents. Nurses and midwives are the unsung heroes of the health workforce and the backbone of primary health care systems. Making up over half of the health workforce in many countries, nurses and midwives can transform the ways health actions are organized and how health care is delivered. Over the years, nurses and midwives have contributed to major global health landmarks, like the eradication of small pox and the dramatic reductions in maternal and child mortality that have occurred in many countries. But nurses and midwives need support and they need recognition. (AU)

Implementation of health risk assessments with family health history: barriers and benefits.

Health risk assessments provide an opportunity to emphasise health promotion and disease prevention for individuals and populations at large. A key component of health risk assessments is the detailed collection of family health history information. This information is helpful in determining risk both for common chronic conditions and more rare diseases as well. While the concept of health risk assessments has been around since the Framingham Heart Study was launched in the 1950s, and such assessments are commonly performed in the workplace today, the US healthcare system has been slow to embrace them and the emphasis on prevention that they represent. Before wider implementation of health risk assessments within healthcare can be seen, several concerns must be addressed: (1) provider impact, (2) patient impact, (3) validity of patient-entered data and (4) health outcomes effect. Here, we describe recent developments in health risk assessment design that are helping to address these issues.

Don Bloch's vision for Collaborative Family Health Care: Progress and next steps.

BACKGROUND: Don Bloch is the central figure in the origin story for the field of collaborative family health care; the journal Families, Systems, & Health; and for the Collaborative Family Healthcare Association (CFHA). He exerted extraordinary intellectual and practical leadership for all 3. He convened a national working session in 1994 that took stock of the field and set out next steps, one of which was to create the interprofessional organization dedicated to collaborative family health care that is now CFHA. PURPOSE: As part of honoring Don Bloch's contributions to the field and this journal, this article sets out tenets of his original vision and traces next steps toward this vision generated by national groups between 1994 and 2014, showing what is the same or different over these 20 years, and especially what this means for the field going forward. METHOD: Precepts of Don Bloch's original vision are drawn from his writings, including the briefing papers he prepared for the national Wingspread group convened in 1994, which also set out next steps for the field. These steps are then compared with next developmental steps for the field generated by CFHA conference attendees in 2004 and again in 2014, after reviewing the history of the organization and the field. CONCLUSION: Much of Don Bloch's vision has remained relevant to health care transformation, with a number of areas showing significant accomplishment and acceptance, whereas others remain aspirational, and a few others arguably being more difficult to achieve now than when Don articulated them.

Precarious employment, ill health, and lessons from history: the case of casual (temporary) dockworkers 1880-1945.

An international body of scientific research indicates that growth of job insecurity and precarious forms of employment over the past 35 years have had significant negative consequences for health and safety. Commonly overlooked in debates over the changing world of work is that widespread use of insecure and short-term work is not new, but represents a return to something resembling labor market arrangements found in rich countries in the 19th and early 20th centuries. Moreover, the adverse health effects of precarious employment were extensively documented in government inquiries and in health and medical journals. This article examines the case of a large group of casual dockworkers in Britain. It identifies the mechanisms by which precarious employment was seen to undermine workers and families' health and safety. The article also shows the British dockworker experience was not unique and there are important lessons to be drawn from history. First, historical evidence reinforces just how health-damaging precarious employment is and how these effects extend to the community, strengthening the case for social and economic policies that minimize precarious employment. Second, there are striking parallels between historical evidence and contemporary research that can inform future research on the health effects of precarious employment.

Historical trends in the correlation of sibling deaths in infancy in the Netherlands.

In this article, we study temporal, regional, and social variation in infant and childhood death clustering in The Netherlands, using data from three provinces. The data relate to children born in 90,000 marriages contracted between the beginning and the last quarter of the nineteenth century. Descriptive indicators show that death clustering was more frequent in the province of Zeeland and more common in the lower classes, and that it increased in two provinces over time. Shared frailty hazard models make it clear that the number of children who died before the birth of an index child had a negative effect on the mortality of index children, whereas earlier stillbirths and the number of children who died when the index child was at a young age had an increasing effect on the mortality of index children.

Did factory girls make bad mothers? Women's labor market experience, motherhood, and children's mortality risks in the past.

Prior research has suggested that the quality of maternal care given to infants and small children plays an important role in the strong clustering of children's deaths. In this article, we investigate the quality of maternal care provided by those women who most nineteenth-century social commentators declared would never make good housewives or mothers: the young girls and women working in textile mills. We carried out this examination using an analysis of children's mortality risks in two textile cities in The Netherlands between roughly 1900 and 1930. Our analysis suggests that these children's clustered mortality risks cannot have resulted from either their mothers' labor market experience or biological or genetic factors.

On statistical methods for clustering: a case study on infant mortality, Northern Sweden, 1831-1890.

This article considers the interfamily clustering of infant mortality (defined as mortality during the first year of life). We developed and evaluated statistical tools to detect clustering and a measure to quantify excess clustering for nineteenth-century data from Skellefteå, Sweden. The detection was performed using the standard methods of generalized linear models and logistic regression. The index of clustering was constructed by comparing the observed numbers of families with specific numbers of deaths to the corresponding observed numbers, after correcting for explanatory variables. To the best of our knowledge, no clustering index of this kind has ever been created.

Should we get married? The effect of parents' marriage on out-of-wedlock children.

Using a representative sample of children all born to unwed parents drawn from the Fragile Families and Child Wellbeing Study and a potential outcome approach to account for self-selection into marriage, we investigate whether marriage after childbearing has a causal effect on early child development. Comparing children with similar background characteristics and parental mate-selection patterns who differ only in terms of whether their parents marry after childbirth, we find that marriage after childbirth significantly increases a child's early cognitive performance but there is no evidence that it affects child asthma risk or behavioral outcomes.

The family history: the first genetic test, and still useful after all those years?

The family history has its origins in genealogy and over the past century has become embedded in clinical practice. Its importance in specialized circumstances is unquestioned but largely untested. Moreover, the relevance of the family history to common diseases, especially in an era of genomic markers that convey risk and the emphasis on "personalized medicine," must be given careful scrutiny. Given the time and expertise needed to obtain and interpret the family history, without a clearer sense of clinical validity and utility, its role will likely diminish. The time to perform the requisite investigations is now.

The modern Chinese family in light of economic and legal history.

Most social science theory and the currently powerful Chinese ideology of modernizationism assume that, with modern development, family-based peasant farm production will disappear, to be replaced by individuated industrial workers and the three-generation family by the nuclear family. The actual record of China's economic history, however, shows the powerful persistence of the small family farm, as well as of the three-generation family down to this day, even as China's GDP becomes the second largest in the world. China's legal system, similarly, encompasses a vast informal sphere, in which familial principles operate more than individualist ones. And, in between the informal-familial and the formal-individualist, there is an enormous intermediate sphere in which the two tendencies are engaged in a continual tug of war. The economic behavior of the Chinese family unit reveals great contrasts with what is assumed by conventional economics. It has a different attitude toward labor from that of both the individual worker and the capitalist firm. It also has a different structural composition, and a different attitude toward investment, children's education, and marriage. Proper attention to how Chinese modernity differs socially, economically, and legally from the modern West points to the need for a different kind of social science; it also lends social­economic substance to claims for a modern Chinese culture different from the modern West's.

Families, time, and well-being in Canada.

We study changes in time and money available to families with children from 1971 to 2006. Increases in incomes at the top of the Canadian income distribution since the mid-1990s have taken place without any significant increases in total family hours of paid work. On the other hand, for families in the middle of the income distribution, family income has stagnated, despite the fact that parents jointly supply significantly higher hours of paid work. If both time and money are valuable resources for the production of well-being for family members, these findings suggest that inequality in well-being has increased even more than inequality of income.

Qualitative life course methodologies: critical reflections from development studies.

This article reflects on two experiences of applying qualitative life course research in development studies. The first methodology centred on the elicited narratives of older people in Buenos Aires exploring their lifetime relations with their children and their current well-being. The second employed semi-structured interviews with young adults in Zambia to investigate their trajectories towards economic empowerment. In both methodologies, the roles of linked lives and of wider social, economic and political changes were central. The article contributes to critical reflection on methodological choices and trade-offs, by focusing on dilemmas that arise from a desire to address policy makers and more quantitatively-orientated researchers. It explores three themes: the challenges of making sense of disparate narratives of linked lives; the possibilities for engaging with individual subjectivities; and different strategies for situating individual experiences in dynamic social, economic and political contexts.

"Deseos y Dolores": mapping desire, suffering, and (dis)loyalty within transnational partnerships.

This piece considers the deseos -- wants, desires, needs -- and dolores -- pain or sorrow -- of individuals in US-Mexico transnational partnerships. For transnational Mexicans, "desire" manifests as diverse, even contradictory, expressions of emotion. Migration is intertwined with multiple desires within intimate relationships, but is also tied to suffering across borders. Conflicting articulations of deseos y dolores reveal gender politics as well as the broader socioeconomic inequalities that drive migration and result in the transborder movement that separates couples and family members in a transnational space.