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Margaret Glogowska Rosemary Simmonds Sarah McLachlan Helen Cramer Tom Sanders Rachel Johnson Umesh T. Kadam Daniel S. Lasserson Sarah Purdy 《Annals of family medicine》2015,13(5):466-471
PURPOSE
The purpose of this study was to explore the perceptions and experiences of health care clinicians working in multidisciplinary teams that include specialist heart failure nurses when caring for the management of heart failure patients.METHODS
We used a qualitative in-depth interview study nested in a broader ethnographic study of unplanned admissions in heart failure patients (HoldFAST). We interviewed 24 clinicians across primary, secondary, and community care in 3 locations in the Midlands, South Central, and South West of England.RESULTS
Within a framework of the role and contribution of the heart failure specialist nurse, our study identified 2 thematic areas that the clinicians agreed still represent particular challenges when working with heart failure patients. The first was communication with patients, in particular explaining the diagnosis and helping patients to understand the condition. The participants recognized that such communication was most effective when they had a long-term relationship with patients and families and that the specialist nurse played an important part in achieving this relationship. The second was communication within the team. Multidisciplinary input was especially needed because of the complexity of many patients and issues around medications, and the participants believed the specialist nurse may facilitate team communication.CONCLUSIONS
The study highlights the role of specialist heart failure nurses in delivering education tailored to patients and facilitating better liaison among all clinicians, particularly when dealing with the management of comorbidities and drug regimens. The way in which specialist nurses were able to be caseworkers for their patients was perceived as a method of ensuring coordination and continuity of care. 相似文献995.
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Soo Khai Ng MBBS John PM Wood DPhil Glyn Chidlow DPhil Guoge Han MBBS Thaksaon Kittipassorn MD Daniel J Peet PhD Robert J Casson DPhil FRANZCO 《Clinical & experimental ophthalmology》2015,43(4):367-376
The retina, like many cancers, produces energy from glycolysis even in the presence of oxygen. This phenomenon is known as aerobic glycolysis and eponymously as the Warburg effect. In recent years, the Warburg effect has become an explosive area of study within the cancer research community. The expanding knowledge about the molecular mechanisms underpinning the Warburg effect in cancer promises to provide a greater understanding of mammalian retinal metabolism and has motivated cancer researchers to target the Warburg effect as a novel treatment strategy for cancer. However, if the molecular mechanisms underlying the Warburg effect are shared by the retina and cancer, treatments targeting the Warburg effect may have serious adverse effects on retinal metabolism. Herein, we provide an updated understanding of the Warburg effect in mammalian retina. 相似文献
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Michael J Curtis Richard A Bond Domenico Spina Amrita Ahluwalia Stephen P A Alexander Mark A Giembycz Annette Gilchrist Daniel Hoyer Paul A Insel Angelo A Izzo Andrew J Lawrence David J MacEwan Lawrence D F Moon Sue Wonnacott Arthur H Weston John C McGrath 《British journal of pharmacology》2015,172(14):3461-3471