Exploring Current Evidence on the Past, the Present, and the Future of the Heart Team: A Narrative Review.

INTRODUCTION: Including healthcare professionals dealing with cardiovascular diseases, Heart Team is a concept/structure designed for selecting diagnostic strategies, facilitating therapeutic decisions, and improving cardiovascular outcomes in patients with complex heart pathologies, requiring input from different subspecialties and the necessity of a multidisciplinary approach. The aim of this narrative review is to search for and to summarize current evidence regarding Heart Team and to underline the future directions for the development of this concept. METHODS: We searched the electronic database of PubMed, SCOPUS, and Cochrane CENTRAL for studies including Heart Team. Forty-eight studies were included, if reference was made to Heart Team structure and functionality. RESULTS: We depicted the structure and the timeline of Heart Team, along with actual evidence-based recommendations from European Guidelines. We underlined the importance of quality of knowledge-sharing and decision-making inside the Team, analyzing bad decisions which did not reflect members' true beliefs due to "uniformity pressure, closed mindedness, and illusion of invulnerability." The observation that Guidelines' indications regarding Heart Team carry a level C indication underlines the very future of this Team: randomized controlled trials proving solid benefits in an evidence-based world. CONCLUSIONS: Envisioned as a tool for optimizing the management of various complex cardiovascular pathologies, Heart Team should simplify and facilitate the activity in the cardiovascular ward. Finally, these facts should be translated into better cardiovascular outcomes and a lower psychological distress among Team participants. Despite all future changes, there must always be a constant part: the patient should remain at the very center of the Team.

CE: A Historical Review of Nurse-Physician Bedside Rounding.

: The purpose of this article is to describe and analyze nurse involvement in hospital bedside rounding from 1873 to 1973. Interdisciplinary rounding is touted as a collaborative activity between nurses and physicians. Understanding the historical trends in nurse involvement in this process can shed light on the opportunities and barriers that clinical rounding presents today. This research was gathered using historical sources, both primary and secondary, and a social history framework. Primary sources included manuals for head nurses, nursing journals, and nursing student diaries.

[The ward round of the future ­ a person-centred, team-based meeting with the patient]. / Framtidens rond ­ ett personcentrerat och teambaserat möte med patienten - Den traditionella ronden går inte att försvara etiskt eller juridiskt.

The aim of this article is to elucidate the traditional ward round from an historical, ethical and legal perspective. On the traditional ward round in hospitals, a senior clinician leads a group of other clinicians and health professionals on a walking tour through the ward to visit the patients for whom they are responsible at bedside. It is a long-lived tradition or routine, which has been substantially resistant to change. We recommend that work designed to improve the ward round should begin from values or ethical principles, such as respecting the patient's integrity and right to participate in decision-making. Moreover, the focal point should be creating opportunities for ¼the good meeting« and patient narratives. A team-based, person-centred ward round has been implemented in some hospitals in Sweden. The patient meets the ward team in a separate room to discuss the plan of care together. We argue that it is no longer possible to defend the traditional way of walking rounds, either ethically or legally.

Sir Winston Churchill: treatment for pneumonia in 1943 and 1944.

This paper reviews Churchill's illnesses in February 1943 and August/September 1944 when he developed pneumonia; on the first occasion this followed a cold and sore throat. Churchill was managed at home by Sir Charles Wilson (later Lord Moran) with the assistance of two nurses and the expert advice of Dr Geoffrey Marshall, Brigadier Lionel Whitby and Colonel Robert Drew. A sulphonamide (sulphathiazole on the first occasion) was prescribed for both illnesses. Churchill recovered, and despite his illnesses continued to direct the affairs of State from his bed. On the second occasion, Churchill's illness was not made public.

Dr. Józef Aleksiewicz Activity in Support of the Development of Orthopedics and Rehabilitation in Iwonicz-Zdrój (1921-1957).

Based on source materials in the possession of Józef Aleksiewicz family (typescripts, manuscripts, photographs, other documents) and articles published in professional medical journals and newspapers, the authors present the contribution of Dr. J. Aleksiewicz to the development of orthopedics and rehabilitation in Iwonicz-Zdrój. In May 1921, he was appointed Surgeon General of the Spa Commission in Iwonicz-Zdrój. After holding several scholarly trips abroad in 1925 to sanatoriums treating cases of osteo-articular tuberculosis, he commenced the construction of "Sanato", a modern sanatorium. Opened in 1930, it was the only center in Poland treating osteo-articular tuberculosis in a spa setting. It was the first orthopedic rehabilitation center in what is now Podkarpackie Voivodship offering diagnostic work-up, surgery and conservative treatment of osteo-articular tuberculosis in children. Modelled on the best Western centers, Dr. Aleksiewicz widely employed physical methods, such as Swedish therapeutic gymnastics, mechanotherapy, massage, physical therapy and hydrotherapy.

Activity of Dr Józef Aleksiewicz, PhD, Towards the Development of Orthopedics and Rehabilitation in Lviv in the Years 1912-1930.

The article describes the work of Dr Aleksiewicz towards the development of orthopedics and rehabilitation in Lviv in the years 1912-1930 based on source materials belonging to his family and articles published in medical journals and daily press. In 1919, Dr Aleksiewicz established a Surgical and Orthopedic Department and a factory of prostheses at the Disabled House in Lviv. He also formed a 200-bed division for the visually impaired with basket- and comb-making workshops as well as massage and typing courses. It was an innovative undertaking aiming to provide surgical treatment, orthopaedic aids and rehabilitation for victims of World War I. From 1919, Dr Aleksiewicz ran his Private Orthopedic Clinic with Factory of orthopaedic aids and pro-stheses" at 2 Friedrichów St. in Lviv. He specialised in therapy of surgical tuberculosis, fractures, dislocations and abnormal spinal curvatures. His work in Lviv in the period 1912-1930 undeniably contributed to the development of orthopaedics and rehabilitation, which were new medical specialties at the time.

The History of Cardiothoracic Surgery at Emory University.

Over the past 50 years, the Emory Cardiothoracic Surgical Program has become one of the premier training programs in the United States. During this time, the Emory program has been sequentially led by Drs Osler Abbott, Charles Hatcher, and Robert Guyton. The program has grown from single faculty member to 25, and the culture of team collaboration, clinical excellence, research, and teaching established by Dr Hatcher has continued under the leadership of Dr Guyton for the past 26 years.

Overview of orthodontic care for children with cleft lip and palate, 1915-2015.

The purpose of this article is to review and discuss the advances in the management of children born with cleft lip and palate (CLP) as it has evolved over the past 100 years. This overview is based on articles published in the American Journal of Orthodontics, which frequently changed its name, over the past century. Additionally, other journals will be cited as craniofacial anomalies became recognized during the 20th century and the biologic basis became refined, with the new discipline of genetics replacing the term hereditary and its connotations of eugenics. The Human Genome Project, completed in 2003, has now provided an understanding of syndromic and nonsyndromic CLP that has led to advances in the diagnosis and treatment of CLP in the 21st century. These evolving concepts will be discussed in an overview of the types of procedures published from 1915 to 2015 and the major transition in the mid-20th century from multiple uncoordinated interventions from various specialists to a coordinated team approach in which the orthodontist has a specific role in the timing and sequencing of interdisciplinary treatment goals. Major technologic advancements in treatment modalities and the contemporary approach to the health-related quality of life of the patient and the caregiver have resulted in their participation in treatment options and decisions. The requirement of informed consent reflects the legal doctrine that now emphasizes the ethical imperative of greater respect for patient autonomy in the decision-making process. The orthodontist no longer makes decisions alone, but rather with the team and the patient or the caregiver.

[The first 25 years of oncopsychology at the National Institute of Oncology: antecedents and events (1988-2013)]. / Az onkopszichológia elso 25 éve az Országos Onkológiai Intézetben: elozmények és események (1988-2013).

The first oncopsychological department was established in National Institute of Oncology by Sándor Eckhardt in 1988. At an early stage the specialists who were interested in mental hygiene made a united effort with Katalin Muszbek's oncopsychologic group. Ágnes Riskó was the first specialist who seceded from this group, and she became a permanent member of the onco-hematology group in 1992. Due to the universalized approach, the psyhcologist would become a permanent member of onco-team. The overhand and increasing multidisciplinary cooperation enable to use this accepted method in the daily medical treatment. When necessary, patients' relatives may come in for treatment and this method can help for medical stuff to avoid burnout. As a result of oncopsychology techniques and cooperation of oncologic teamwork the integration of psychosocial intervention into a complex oncologic treatment has already begun. The attendance of supervised onco-psychological specialists is being increased. Our activity contributes to improve our patients' psychosocial standard of living, their cooperation with the medical staff and the atmosphere of oncologic departments. The integration of the approach and methods of psychosocial rehabilitation into the new oncologic professional guideline has also begun.

[Heritages of science history in the gerontological discussion on multidisciplinary and interdisciplinary perspectives]. / Wissenschaftshistorische Erbschaften der gerontologischen Multi- und Interdisziplinaritätsdiskussion.

Since the beginning of the nineteenth century, the history of science in modern Germany has been characterized by a development going in opposite directions. The old scientific disciplines with their traditional Gestus of knowledge acquisition are in contrast to new sciences resulting from external pressures, combining and mobilizing different areas of knowledge, which challenge former dominances and help to establish new open disciplines. However, gerontology in Germany is in this respect a clear latecomer and can only cast off the impact of medicine in the twentieth century to some extent. This article describes this process by the superposition of different lines of tradition, which have long-term effects reaching into the history of the early Federal Republic of Germany.