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Search Results: 1 - 10 of 10181 matches for " Anne Kennedy "
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Secondary infertility in women: radiologic evaluation
Jeffrey Dee Olpin, Anne Kennedy
Reports in Medical Imaging , 2011, DOI: http://dx.doi.org/10.2147/RMI.S9179
Abstract: ondary infertility in women: radiologic evaluation Review (5383) Total Article Views Authors: Jeffrey Dee Olpin, Anne Kennedy Published Date January 2011 Volume 2011:4 Pages 1 - 14 DOI: http://dx.doi.org/10.2147/RMI.S9179 Jeffrey Dee Olpin, Anne Kennedy University of Utah Health Sciences Center, Salt Lake City, UT, USA Abstract: Female infertility is a commonly encountered problem that presently accounts for a significant percentage of women seeking gynecologic services. While primary infertility is defined as the inability to conceive or carry a pregnancy successfully to full term, secondary infertility is defined as difficulty in conceiving after already having previously conceived (either carrying a pregnancy to term or a miscarriage). The causes of both primary and secondary female infertility are varied, and include various disorders involving the fallopian tubes, ovaries, uterus, cervix, and peritoneum. Imaging has become an essential tool in the workup of female infertility. Various imaging modalities are commonly employed to evaluate the female reproductive tract. Hysterosalpingography is typically performed as a baseline imaging study in the workup of female infertility. Ultrasound and pelvic magnetic resonance imaging studies are likewise routinely utilized to aid in the diagnosis of female infertility. The appropriate selection of imaging modalities is essential in establishing the etiology of female infertility in a timely, efficient, and cost-effective manner.
Secondary infertility in women: radiologic evaluation
Jeffrey Dee Olpin,Anne Kennedy
Reports in Medical Imaging , 2011,
Abstract: Jeffrey Dee Olpin, Anne KennedyUniversity of Utah Health Sciences Center, Salt Lake City, UT, USAAbstract: Female infertility is a commonly encountered problem that presently accounts for a significant percentage of women seeking gynecologic services. While primary infertility is defined as the inability to conceive or carry a pregnancy successfully to full term, secondary infertility is defined as difficulty in conceiving after already having previously conceived (either carrying a pregnancy to term or a miscarriage). The causes of both primary and secondary female infertility are varied, and include various disorders involving the fallopian tubes, ovaries, uterus, cervix, and peritoneum. Imaging has become an essential tool in the workup of female infertility. Various imaging modalities are commonly employed to evaluate the female reproductive tract. Hysterosalpingography is typically performed as a baseline imaging study in the workup of female infertility. Ultrasound and pelvic magnetic resonance imaging studies are likewise routinely utilized to aid in the diagnosis of female infertility. The appropriate selection of imaging modalities is essential in establishing the etiology of female infertility in a timely, efficient, and cost-effective manner.Keywords: female secondary infertility, reproductive system, imaging, radiologic evaluation
Implementing and managing self-management skills training within primary care organisations: a national survey of the expert patients programme within its pilot phase
Victoria Lee, Anne Kennedy, Anne Rogers
Implementation Science , 2006, DOI: 10.1186/1748-5908-1-6
Abstract: The NHS' official Expert Patients Programme website presently states that, "Pilot EPP courses began at 26 NHS PCT sites across England in May 2002, and by May 2004 approximately 300 PCTs had either actively implemented pilot courses or had committed to joining. The majority of PCTs are now coming to the end of the pilot phase, with many implementing plans to make EPP sustainable for the long-term." The NHS website heralds the pilot "a success."A national, postal survey of PCT EPP Leads was undertaken in order to examine both the evolvement of EPP during its pilot stage and future plans for the programme. A questionnaire was sent out to the 299 PCTs known to have committed to the EPP pilot, and an excellent 100% response rate was obtained over a 3-month period (April-July 2005). One marker of success of the Expert Patients Programme implementation is the actual running of courses by the Primary Care Trusts. This paper explores the extent to which the implementation of the pilot can indeed be viewed as a "success," primarily in terms of the number of courses run, and considers the extent to which PCTs have carried out all that they were committed to do. Findings suggest that the more time an EPP Lead dedicates to the Programme, the more likely it is that EPP has run successfully in the past, and the more likely it is that it will continue to run successfully in the future. Other factors indicating future EPP success include collaborating across PCTs to share co-ordinators, tutors, and funding.The United Kingdom (UK) Labour government has introduced a wide programme of reform for the prevention and management of chronic conditions [1]. One of the key areas identified for action relates to the promotion of self-care. Self-care skills training has increasingly been seen as an effective strategy for improving the quality of life and health outcomes for people living with long-term conditions. Whilst the running of self-care skills training within the voluntary sector in t
Continuity and change?: Exploring reactions to a guided self-management intervention in a randomised controlled trial for IBS with reference to prior experience of managing a long term condition
Anne Rogers, Victoria Lee, Anne Kennedy
Trials , 2007, DOI: 10.1186/1745-6215-8-6
Abstract: Self-care interventions which have been evaluated using RCTs are currently being promoted as an effective strategy for improving quality of life, health and utilisation outcomes for individuals suffering from a range of long-term health conditions. Techniques such as cognitive re-structuring form the bases of self-management interventions and dedicated self-care education training has been attributed with beneficial outcomes including improving people's confidence in their ability to take care of themselves and engagement in collaborative shared decision making with health professionals [1-4]. The success of these interventions has been predicated in large on outcomes relating to: changes in behavior (the changing of diet, relaxation, and 'planned activity'); decreased utilization of health services; and attitude (self efficacy) or being better able to 'cope with symptoms'.Behaviorally orientated self-management educational programmes work include reference to stages, critical periods, developmental tasks and notions of maturation. Psychological outcome measures such as 'self-efficacy' are viewed as being enhanced through a number of mechanisms, the most effective of which is 'performance attainment' (i.e. actual experience of the success of actions) whilst depression and anxiety are viewed as impairing both self-efficacy beliefs and the ability to engage in those behaviours that might increase self-efficacy [5].Individuals entering self-management programmes as part of an RCT are viewed as having the potential to self-manage and learn new 'skills' once they have followed a formulaic. However, RCTs are not usually designed in a way which enables the distinction of the effects of past experience when testing new interventions and there is a tendency to treat the person as a blank sheet as far as prior patient experience and management of a long term condition is concerned. We know from the sociological literature on the experience of chronic illness that disruption t
Creating 'good' self-managers?: Facilitating and governing an online self care skills training course
Anne Kennedy, Anne Rogers, Caroline Sanders, Claire Gately, Victoria Lee
BMC Health Services Research , 2009, DOI: 10.1186/1472-6963-9-93
Abstract: A qualitative analysis of postings to the discussion centre of 11 online classes (purposively selected from 27) run as part of the Expert Patients Programme. Facilitators (term for tutors online) and participants posted questions, comments and solutions related to self-management of long-term conditions; these were subjected to a textual and discursive analysis to explore:a) how facilitators, through the internet, engaged participants in issues related to self-management;b) how participants responded to and interacted with facilitators.Emergent themes included: techniques and mechanisms used to engage people with self-management; the process facilitators followed – 'sharing', 'modelling' and 'confirming'; and the emergence of a policing role regarding online disclosure. Whilst exchanging medical advice was discouraged, facilitators often professed to understand and give advice on psychological aspects of behaviour.The study gave an insight into the roles tutors adopt – one being their ability to 'police' subjective management of long-term conditions and another being to attempt to enhance the psychological capabilities of participants.Healthcare settings are becoming evermore varied and boundaries of expertise are shifting alongside contemporary cultural and policy changes. In chronic disease management, patients are now cast as 'experts' increasingly called upon to undertake a new quasi-professional role as lay tutors within self-management training programmes. [1] This section of the health-care workforce is valued not for any medical training they may possess but because of their experience of living with a long-term condition. Access to self-management programmes for high numbers of people with long-term conditions has been made possible because of a large volunteer workforce of trained tutors; this group is the focus of this paper.In particular, we are interested in how individuals tasked with running an online self care support programme attempt to achieve the
An interprofessional approach to improving paediatric medication safety
Moira Stewart, Joanna Purdy, Neil Kennedy, Anne Burns
BMC Medical Education , 2010, DOI: 10.1186/1472-6920-10-19
Abstract: An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions.Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p < 0.001), with the greatest increase noted among medical students. Highly significant changes in students' attitudes to shared learning were observed, indicating that safe medication practice is learnt more effectively with students from other healthcare disciplines. Qualitative data revealed that students' participation in the workshop improved communication and teamworking skills, and led to greater awareness of the role of other healthcare professionals.This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula. However, a number of studies have reported that medical students feel unprepared for this aspect of clinical practice and on completion of undergraduate training they would not meet the competencies identified by the General Medical Council [1-3]. Nurses have reported limited understanding of pharmacology, dissatisfaction with the pre-registration teaching of the subject and feeling unprepared to perform certain tasks within nursing practice because of a lack of knowledge about the drugs they administer [4,5].Drug prescribing is very different in adult and paediatric practice. Infants and children are prescribed fewer drugs than adults, but
An antibody present in everybody that attacks malaria infected erythrocytes  [PDF]
James Kennedy
Journal of Biomedical Science and Engineering (JBiSE) , 2013, DOI: 10.4236/jbise.2013.67A1001
Abstract: These malaria targeting antibodies are band 3 antibodies and they recognize a special configuration of a molecule called band 3 that is present on erythrocytes. The special band 3 configuration is present on the surface of senescent erythrocytes, malaria infected erythrocytes, the erythrocytes of certain hemoglobinnopathies such as sickle cell disease and on the erythrocytes of some metabolic disorders such as G6PD. Note that these hemoglobinopathies and metabolic disorders all aid in the survival of falciparum malaria to such an extent that their incidence is increased in falciparum endemic areas [1-3]. Though there are many adhesive molecules involved in the pathology of falciparum malaria and sickle cell anemia, the focus here is on the band 3 molecules.
Promoting patient engagement with self-management support information: a qualitative meta-synthesis of processes influencing uptake
Joanne Protheroe, Anne Rogers, Anne P Kennedy, Wendy Macdonald, Victoria Lee
Implementation Science , 2008, DOI: 10.1186/1748-5908-3-44
Abstract: Four published qualitative studies from a programme of research about self-management were analysed as a group; these included studies of the management of inflammatory bowel disease (IBD); self-help in anxiety and depression (SHADE); menorrhagia, treatment, information, and preference (MENTIP) study; and self-help for irritable bowel syndrome (IBS). For the analysis, we used an adapted meta-ethnographic approach to the synthesis of qualitative data in order to develop an evidence base.The ontological status and experience of the condition in everyday life was the most dominant theme to emerge from this synthesis. This, coupled with access to and experience of traditional health services responses, shaped the engagement with and use of information to support self-management. Five key elements were found which were likely to influence this: the perception and awareness of alternative self-management possibilities; the prior extent and nature of engagement with information; the extent of and ability to self-manage; opportunities for use of the information and the stage of the illness career; and congruence and synergy with the professional role.People with chronic conditions need support from providers in both supply and engagement with information, in a way which gives legitimacy to the person's own self-management strategies and possible alternatives. Thus, a link could usefully be made between information offered, as well as patients' past experiences of self-management and engagement with services for their condition. The timeliness of the information should be considered, both in terms of the illness career and the type of condition (i.e., before depression gets too bad or time to reflect on existing knowledge about a condition and how it is to be managed) and in terms of the pre-existing relationship with services (i.e., options explored and tried).More considered use of information (how it is provided, by whom, and at what point it should be introduced) is key
The Contribution of Social Networks to the Health and Self-Management of Patients with Long-Term Conditions: A Longitudinal Study
David Reeves, Christian Blickem, Ivaylo Vassilev, Helen Brooks, Anne Kennedy, Gerry Richardson, Anne Rogers
PLOS ONE , 2014, DOI: 10.1371/journal.pone.0098340
Abstract: Evidence for the effectiveness of patient education programmes in changing individual self-management behaviour is equivocal. More distal elements of personal social relationships and the availability of social capital at the community level may be key to the mobilisation of resources needed for long-term condition self-management to be effective. Aim To determine how the social networks of people with long-term conditions (diabetes and heart disease) are associated with health-related outcomes and changes in outcomes over time. Methods Patients with chronic heart disease (CHD) or diabetes (n = 300) randomly selected from the disease registers of 19 GP practices in the North West of England. Data on personal social networks collected using a postal questionnaire, alongside face-to-face interviewing. Follow-up at 12 months via postal questionnaire using a self-report grid for network members identified at baseline. Analysis Multiple regression analysis of relationships between health status, self-management and health-economics outcomes, and characteristics of patients' social networks. Results Findings indicated that: (1) social involvement with a wider variety of people and groups supports personal self-management and physical and mental well-being; (2) support work undertaken by personal networks expands in accordance with health needs helping people to cope with their condition; (3) network support substitutes for formal care and can produce substantial saving in traditional health service utilisation costs. Health service costs were significantly (p<0.01) reduced for patients receiving greater levels of illness work through their networks. Conclusions Support for self-management which achieves desirable policy outcomes should be construed less as an individualised set of actions and behaviour and more as a social network phenomenon. This study shows the need for a greater focus on harnessing and sustaining the capacity of networks and the importance of social involvement with community groups and resources for producing a more desirable and cost-effective way of supporting long term illness management.
Delivering the WISE (Whole Systems Informing Self-Management Engagement) training package in primary care: learning from formative evaluation
Anne Kennedy, Carolyn Chew-Graham, Thomas Blakeman, Andrew Bowen, Caroline Gardner, Joanne Protheroe, Anne Rogers, Linda Gask
Implementation Science , 2010, DOI: 10.1186/1748-5908-5-7
Abstract: Normalisation Process Theory provided a framework for development of the intervention. Practices were recruited from an inner city Primary Care Trust in NW England. All practice staff were expected to attend two afternoon training sessions. The training sessions were observed by members of the training team. Post-training audio recordings of consultations from each general practitioner and nurse in the practices were transcribed and read to provide a narrative overview of the incorporation of WISE skills and tools into consultations. Face-to-face semi-structured interviews were conducted with staff post-training.Two practices out of 14 deemed eligible agreed to take part. Each practice attended two sessions, although a third session on consultation skills training was needed for one practice. Fifty-four post-training consultations were recorded from 15 clinicians. Two members of staff were interviewed at each practice. Significant elements of the training form and methods of delivery fitted contemporary practice. There were logistical problems in getting a whole practice to attend both sessions, and administrative staff founds some sections irrelevant. Clinicians reported problems incorporating some of the tools developed for WISE, and this was confirmed in the overview of consultations, with limited overt use of WISE tools and missed opportunities to address patients' self-management needs.The formative evaluation approach and attention to normalisation process theory allowed the training team to make adjustments to content and delivery and ensure appropriate staff attended each session. The content of the course was simplified and focussed more clearly on operationalising the WISE approach. The patient arm of the approach was strengthened by raising expectations of a change in approach to self-care support by their practice.The effective management of long-term conditions is a key focus of health for which policy and support for self-management has been a core com
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