Browsing by Author "Greene, Alexandra"

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Developing the clinical components of a complex intervention for a glaucoma screening trial : a mixed methods study
(2011-04-21) Burr, Jennifer M; Campbell, Marion K; Campbell, Susan E; Francis, Jillian J; Greene, Alexandra; Hernández, Rodolfo; Hopkins, Debra; McCann, Sharon K; Vale, Luke D; Glaucoma screening Platform Study group; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Institute of Applied Health Sciences
Divergence or convergence? : Health inequalities and policy in a devolved Britain
(2009-05) Smith, Katherine E.; Hunter, David J.; Blackman, Tim; Elliott, Eva; Greene, Alexandra; Harrington, Barbara E.; Marks, Linda; McKee, Lorna; Williams, Gareth H.; University of Aberdeen.Other Applied Health Sciences; University of Aberdeen.Business Management
Do managed clinical networks improve quality of diabetes care? : Evidence from a retrospective mixed methods evaluation
(2009-12) Greene, Alexandra; Pagliari, C.; Cunningham, S.; Donnan, P.; Evans, J.; Emslie-Smith, A; Morris, A.; Guthrie, B.; University of Aberdeen.Other Applied Health Sciences
Patients’ Engagement With “Sweet Talk” – A Text Messaging Support System for Young People With Diabetes
(Centre for Global eHealth Innovation, 2008) Franklin, Victoria Louise; Greene, Alexandra; Waller, Annalu; Greene, Stephen Alan; Pagliari, Claudia; University of Aberdeen, School of Medicine & Dentistry, Division of Applied Health Sciences
Background: Guidelines for optimizing type 1 diabetes in young people advocate intensive insulin therapy coupled with personal support from the health care team. “Sweet Talk” is a novel intervention designed to support patients between clinic visits using text messages sent to a mobile phone. Scheduled messages are tailored to patient profiles and diabetes self-management goals, and generic messages include topical “newsletters” and anonymized tips from other participants. The system also allows patients to submit data and questions to the diabetes care team. Objectives: The aim was to explore how patients with type 1 diabetes interact with the Sweet Talk system in order to understand its utility to this user group. Methods: Subjects were 64 young people with diabetes who were participating in the intervention arms of a randomized controlled trial. All text messages submitted to Sweet Talk during a 12-month period were recorded. Messaging patterns and content were analyzed using mixed quantitative and qualitative methods. Results: Patients submitted 1180 messages during the observation period (mean 18.4, median 6). Messaging frequency ranged widely between participants (0-240) with a subset of 5 high users contributing 52% of the total. Patients’ clinical and sociodemographic characteristics were not associated with total messaging frequency, although girls sent significantly more messages unrelated to diabetes than did boys (P = .002). The content of patients’ messages fell into 8 main categories: blood glucose readings, diabetes questions, diabetes information, personal health administration, social messages, technical messages, message errors, and message responses. Unprompted submission of blood glucose values was the most frequent incoming message type (35% of total). Responses to requests for personal experiences and tips generated 40% of all the incoming messages, while topical news items also generated good responses. Patients also used the service to ask questions, submit information about their self-management, and order supplies. No patients nominated supporters to receive text messages about their self-management goals. Another option that was not used was the birthday reminder service. Conclusions: Automated, scheduled text messaging successfully engaged young people with diabetes. While the system was primarily designed to provide “push” support to patients, submission of clinical data and queries illustrates that it was seen as a trusted medium for communicating with care providers. Responses to the newsletters and submission of personal experiences and tips for circulation to other participants also illustrate the potential value of such interventions for establishing a sense of community. Although participants submitted relatively few messages, positive responses to the system suggest that most derived passive support from reading the messages. The Sweet Talk system could be readily adapted to suit other chronic disease models and age groups, and the results of this study may help to inform the design of future text message support interventions.
Representations of rituals and care in perinatal death in British Midwifery textbooks 1937-2004
(Elsevier, 2008) Cameron, Joan; Taylor, Julie; Greene, Alexandra
Objective: to assess the evolution of attitudes and practices relating to perinatal loss through an analysis of British midwifery textbooks. Design: a literature review of midwifery textbooks, written or edited by midwives, published in the UK after 1902, and a critical analysis of textbooks to determine the ideological and professional standpoints presented to readers. Findings: the rhetoric and ritual relating to perinatal loss as portrayed in British midwifery textbooks has changed, with the most dramatic changes taking place in the past 30 years. Evidence to support the changes is largely anecdotal, and little reference is made to research relating to perinatal death. The ‘dirty’ elements of perinatal death relating to the decay that takes place in the baby’s body after death are not addressed. The critique of psychological theory relating to loss is absent, as are alternatives to the model proposed by Ku¨bler Ross. Cultural aspects of loss and bereavement are rarely addressed. Key conclusions: the review of midwifery textbooks suggests that an ideological shift has taken place in relation to perinatal loss. The changing demographic trends, and the shift of birth and death from home to hospital, have altered the expectations and experiences of parents and professionals. Midwifery textbooks provide readers with a prescribed and formulaic approach to perinatal loss. Implications for practice: the absence of information relating to the appearance of the dead baby, together with the lack of clinical exposure, may mean that midwives are unable to provide parents with appropriate information. The lack of reference to an evidence base that may conflict with the ideology presented in the midwifery textbooks leaves readers with an incomplete understanding of the professional issues relating to perinatal loss.