Mechanizing medicine - Tomorrows history started yesterday.

History is by nature a retrospective subject, there usually being an interval between any event, a review or impact of the subject being considered. This NPSA Historian's paper, takes a long and quick historical view of influences that fostered changes resulting in the current state of affairs in the field of medicine and medical care. The fields of medicine and surgery, are undergoing rapid changes as a result of technological and other advances that are making tomorrow's medical history seemingly happening yesterday. Prospectively, the impact of current change and its rapidity has the potential to radically change the future practice of the art and craft of our profession.

History and evolution of surgical ethics: John Gregory to the twenty-first century.

As surgery grew to become a respected medical profession in the eighteenth century, medical ethics emerged as a response to the growing need to protect patients and maintain the public's trust in physicians. The early influences of John Gregory and Thomas Percival were instrumental in the formulation of patient-centered medical ethics. In the late nineteenth century, the modern surgical advances of anesthesia and antisepsis created the need for a discipline of ethics specific to surgery in order to confront new and evolving ethical issues. One of the founding initiatives of the American College of Surgeons in 1913 was to eliminate unethical practices such as fee-splitting and itinerant surgery. As surgery continued to advance in the era of solid organ transplantation and minimally invasive surgery in the latter half of the twentieth century, surgical innovation and conflict of interest have emerged as important ethical issues moving forward into the twenty-first century. Surgical ethics has evolved into a distinct branch of medical ethics, and the core of surgical ethics is the surgeon-patient relationship and the surgeon's responsibility to advance and protect the well-being of the patient.

Review of the history and development in the field of psychosocial oncology.

Psychosocial oncology is a multi-disciplinary field of practice and, as a recently developed speciality, covers the psychological, social and behavioural dimensions of cancer. We describe the historical background and changing ethos in medical practice in order to understand factors that contributed to the emergence of this new discipline. Modern psychosocial oncology covers a number of topics; the diagnosis and management of psychological morbidity and distress across the cancer continuum from diagnosis through survivorship and, for some patients, terminal illness, the recognition that behaviour and lifestyle contribute to cancer risk and prognosis, the need to include families and carers alongside patients in a comprehensive model of supportive cancer care. Best practice, based on evidence and nationally and internationally accepted guidelines, is being integrated into national cancer plans, and services are briefly described. Future challenges include the need to recognize that the behavioural and mental health sciences have a role to play in comprehensive cancer care and that multi-disciplinary care, which includes psychosocial care, is the best model for ensuring patients needs are comprehensively and adequately met. The return of modern medicine to a more holistic person-focused ethos is needed in order to put the patient back into patient-centred cancer care.

The University of Florida Department of Surgery: building a stronger tomorrow on yesterday's foundation.

Established in 1957, the University of Florida Department of Surgery has a solid foundation on which current faculty are driven to build a stronger tomorrow. The department is focused on promoting patient-centered care, expanding its research portfolio to improve techniques and outcomes, and training the surgical leaders of tomorrow. It fosters an environment where faculty, residents, students, and staff challenge long-held traditions with the goal of improving the health of our patients, the quality of our care, and the vitality of our work environment.

Plantão psicológico: uma prática clínica da contemporaneidade / Psychological duty: a contemporary clinical practice / Turno psicológico: una práctica clínica de la contemporaneidad

O objetivo desse artigo é refletir sobre plantão psicológico enquanto uma prática clínica da contemporaneidade, entendendo este tipo de intervenção como sendo mais adequada a uma nova postura da psicologia clínica, em que o psicólogo deverá estar comprometido com a escuta e o acolhimento do outro onde quer que este esteja. Visando apresentar um panorama da atualidade e de suas principais demandas foi realizada uma revisão bibliográfica acerca dos desdobramentos da psicologia clínica, bem como do sofrimento humano, trazendo uma reflexão ética e política e a defesa de práticas mais condizentes com a realidade atual. Desse modo, podemos dizer que o plantão psicológico constitui-se como uma prática clínica da contemporaneidade, na medida em que ela promove uma abertura para o novo, o diferente e oferece um espaço de escuta a alguém que apresenta uma demanda psíquica, um sofrimento, oferece um momento no qual esse sujeito que sofre se sinta verdadeiramente ouvido na sua dor, favorecendo para que este possa ressignificar o seu estar no mundo.

This paper aims to reflect on psychological duty as a contemporary clinical practice, understanding that this type of intervention would be more appropriate in a new conduct of clinical psychology, in which the psychologist should be committed to listening and sheltering the other person wherever they are. With the attempt of presenting a panorama of today’s situation and its main demands, we elaborated a literature review about clinical psychology and human suffering, reflecting political and ethical perspectives and also defending practices that are more consistent with the current reality. Thereby, we can say that psychological duty is a contemporary clinical practice, given that it promotes changes and new possibilities for the ones with psychic demand or any kind of suffering, as it offers them an open space for being listened and understood in their pain, encouraging them to construct a new meaning to their existence in the world.

El objetivo de este artículo es reflexionar a cerca del turno psicológico, una práctica clínica psicológica contemporánea. Esta práctica es percibida como el tipo de intervención más apropiado para una nueva postura de la psicología clínica, en la cual el psicólogo debe de comprometerse a escuchar y acoger a las personas sea donde sea. Con el propósito de ofrecer un panorama general de la actualidad y de sus principales demandas, elaboramos una revisión de literatura a cerca del desarrollo de la psicología clínica y del sufrimiento humano, buscando una reflexión ética y política, además de defender las prácticas más coherentes con la realidad actual. Así pues, se puede decir que el turno psicológico es una práctica clínica contemporánea, ya que promueve una apertura al nuevo y al diferente, ofreciendo a los que tienen una demanda psicológica o presentan algún tipo de sufrimiento, un espacio de escucha y acogimiento de su dolor, ayudándoles a construir un nuevo sentido a su existencia en el mundo.

I dressed your wounds, God healed you--a wounded person's psychology according to Ambroise Parè.

Ambroise Parè (1510-1590) was actively involved in wound treatment, studying wounds from various points of view. Many of his published works provide cutting-edge insights regarding nutrition, pain, and debridement, as well as psychological counsel for wounded persons--advanced thoughts, considering the times. Parè believed the energy of the human body and mind played an active role in wound healing. Parè's stature, as far as wound care is concerned, is a result of his judgment and wisdom in applying knowledge of human principles to medical practice. Detailing and celebrating events in his life relevant to the practice of wound care underscore the skills and compassion vital to healing regardless of the century. The article title is drawn from the engraving on his tombstone.

Case management: evolution of the concept in the 80's and 90's

Case Management is a term that is present in almost every American health care situation. It is mostly used to coordinate community services with satisfactory results for the patient within a certain period of time, with limited resources. Through time, it has been used for different purposes. The goal of this study was to show the historical evolution of case management as expressed by the American nursing literature, in the 80's and 90's, according to its use, meaning, and application, and following a theoretical framework for concept analysis. The data was extracted from two journals: "Nursing Management" and "Journal of Nursing Administration". The publications showed case management portrayed as a process that serves a common goal; where quality and cost of care were the prevalent and influential elements along time, and its practice focusing in a given population defined as of high risk and high cost for health care