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N J Mathers

Publications and source records attributed to N J Mathers.

11 recordsLinked to original sources
PubMed2006

A comparison of sexual satisfaction and post-natal depression in the UK and Taiwan.

AIM: To compare the sexual expression and sexual satisfaction of women in the UK and Taiwan before and after childbirth, to determine if there is an association between self reported sexual satisfaction and postnatal depression (PND) and the main sources of sexual information for women during this period. METHOD: A comparative survey of postnatal women in the UK and Taiwan using a selfadministered questionnaire, a semi structured interview and the Edinburgh Postnatal Depression Scale (EPDS) to investigate sexual satisfaction, sexual expression and main sources of information as well the prevalence of postnatal depression. RESULTS: Seventy per cent of the UK women and 89% of the Taiwanese women were generally satisfied with their sex life during the postnatal period although in both countries women thought that sexual expression was not as important to themselves as to their partner. There were differences in ranking criteria for physical and emotional sexual satisfaction in the two countries. Eighty-three per cent of UK women had sufficient information about sex during the postnatal period compared to 60% of Taiwanese women. There was no significant difference in the prevalence of PND (18% UK, 19% Taiwan p < 0.01 ANOVA) but significant negative associations (correlation coefficient) between 'sexual self-confidence' and PND in the UK (p < 0.01) and Taiwan (p < 0.05). UK Women with an unsatisfactory sex life (p < 0.05), insufficient sexual information (p < 0.05) and sexual worries after birth (p < 0.05) were more likely to have symptoms of PND. There was a strong association between a poor relationship with her partner and PND (p < 0.001). CONCLUSIONS: These associations may be either a consequence of or a contributing factor to PND. The observed differences between the two countries may be attributed to cross cultural factors and differences in health care systems although further investigation is required.

Adult↗
PubMed2006

Computer interviewing in urogynaecology: concept, development and psychometric testing of an electronic pelvic floor assessment questionnaire in primary and secondary care.

OBJECTIVE: To develop and evaluate a Web-based, electronic pelvic floor symptoms assessment questionnaire (e-PAQ)1 for women. DESIGN: A cross-sectional study in primary and secondary care. SETTING: Two general practices, two community health clinics and a secondary care urogynaecology clinic. SAMPLE: A total of 432 women (204 in primary care and 228 in secondary care) were recruited between June 2003 and January 2004. METHODS: The e-PAQ was located on a workstation (computer, touchscreen and printer). Women completed the e-PAQ prior to their appointment. Untreated women in primary care were asked to return seven days later to complete the e-PAQ a second time (test-retest). MAIN OUTCOME MEASURES: Factor analysis, reliability, validity, patient satisfaction, completion times and system costs. RESULTS: In secondary care, factor analysis identified 14 domains within the four dimensions (urinary, bowel, vaginal and sexual symptoms) with internal consistency (Cronbach's alpha)>or=0.7 in 11 of these. In primary care, alpha values were all>or=0.7 and test-retest analysis found acceptable intraclass correlations of 0.50-0.95 (P<0.001) for all domains. A measure of face validity and utility was gained using a nine-item questionnaire, which yielded strongly positive patient views on relevance and acceptability. CONCLUSIONS: The e-PAQ offers a user-friendly clinical tool, which provides valid and reliable data. The system offers comprehensive symptoms and quality of life evaluation and may enhance the clinical episode as well as the quality of care for women with pelvic floor disorders.

Ambulatory Care↗
PubMed1999

Portfolios in continuing medical education--effective and efficient?

INTRODUCTION: A cross over comparison between 'traditional' continuing medical education (CME) activities and portfolio-based learning in general practice is described. METHOD: Thirty-two volunteer general practitioners (GPs) were divided into two cohorts; each cohort spent six months following a 'traditional' route to postgraduate educational accreditation (PGEA) and six months following a portfolio-based learning route supported by three CME tutors. OUTCOME MEASURES: These were the submission of a completed portfolio with evidence of the completion of learning cycles and participants reflections on the educational process. Qualitative and quantitative evaluation data were collected by questionnaire, semi-structured interview, participant observation and review of completed portfolios. RESULTS: The themes identified by GPs as hopes for the portfolios were largely fulfilled and the anxieties generally confounded. The flexibility of the portfolio learning process was particularly important to the participants. The breadth of topics covered by the portfolios was extremely wide and comparison with the submissions for 'traditional' PGEA showed a much smaller spread of learning activities and fewer subjects of study. EFFECTIVENESS: The use of the portfolios of critical incidents and the completion of learning cycles with application to practice provided evidence of the effectiveness of such learning. EFFICIENCY: The mean number of hours spent by GPs preparing the portfolios was 24.5 +/- 12 (SD) which was significantly more than the 15 hours of PGEA awarded. CONCLUSIONS: This study demonstrates that a portfolio-based learning scheme can meet the needs of GPs relevant to their professional practice; it can give learners control over how, what and when they learn and encourage active and peer-supported learning; it can build personal and professional confidence and be thought both valid and reliable by participants. Learning outcomes can also be reliably assessed by PGEA within the context of an individually created learning plan.

Cohort Studies↗
PubMed1997

Portfolio-based learning: continuing medical education for general practitioners--a mid-point evaluation.

In October 1994 a project was initiated by the General Practice Continuing Medical Education Tutors in the Department of General Practice at Sheffield University. The project sought to evaluate the efficiency (effort expended) and effectiveness (distance travelled) of a model of continuing professional development for general practitioners through individual portfolio-based learning in co-mentoring groups. Learning demonstrated through the portfolio was accredited for the postgraduate education allowance of participants. This paper addresses the process of portfolio development at the mid-point of a year-long trial to ascertain the strengths, weaknesses and possible future development of such a process within the context of continuing medical education.

Family Practice↗
PubMed1995

Surviving the 'heartsink' experience.

The authors describe a pilot workshop designed to help doctors achieve a greater understanding of and ability to cope with their 'heartsink' patients. Participants were asked to list their personal objectives in attending and a number of cases were discussed in the group. A 'heartsink survival kit' was provided which consisted of skills and strategies which are useful in difficult consultations and an approach to reassessing the goals of the relationship which might promote a more realistic understanding. The workshop was videotaped and two scenarios are presented. The implications for further training are discussed.

Adaptation, Psychological↗
PubMed1987

Diagnostic audit of C-reactive protein in neonatal infection.

A prospective study of 250 consecutive neonatal admissions to a regional perinatal referral centre and of 10 additional consecutive cases with culture-proven neonatal septicaemia was undertaken. Quantitative C-reactive protein (CRP) determination, white cell count and differential were performed on blood samples obtained from all babies on admission, as well as 10-14 h and 22-26 h later. Using clinical signs, chest X-rays, blood cultures, tracheal aspirates obtained within 4 h of delivery and an abnormal immature/total neutrophil ratio (I/T), infected babies were defined as belonging to one of the following groups: culture-proven septicaemia (n = 19); clinical septicaemia (n = 35); congenital pneumonia (n = 28). The sensitivity, specificity, positive and negative predictive value of CRP were calculated for each sampling time and patient group. No baby had a rise in CRP (greater than 6 mg/l) before an abnormal I/T ratio was first detected. A delayed rise in CRP concentration in the majority of infected babies occurred approximately 12-24 h after the abnormal I/T ratio was first detected. The overall specificity of a CRP level of greater than or equal to 10 mg/l remained approximately constant (97%-94%) while sensitivity increased from 22%-61% with increasing time after admission. The same pattern emerged if each patient group was considered separately. The positive predictive value for a CRP level of greater than or equal to 10 mg/l 22-26 h after admission was 83% and the negative predictive value 82%. CRP had no value in the early diagnosis of neonatal infection. Its main role lies rather in the exclusion or confirmation of infection 24 h after the first clinical suspicion.

C-Reactive Protein↗
PubMed1985

Urinary sediment dolichol excretion in patients with Batten disease and other neurodegenerative and storage disorders.

Nonesterified dolichols have been measured in the urinary sediment of 20 patients with the late infantile and juvenile forms of neuronal ceroid lipofuscinosis (Batten disease), in 15 patients with other storage and neurodegenerative disorders and in 10 control subjects. Dolichols were measured by a high performance liquid chromatographic method and were related to urinary creatinine concentration. The levels of dolichols in Batten disease were not significantly elevated when compared to the normal subjects or to patients with other neurodegenerative disorders. The highest levels seen were in two patients with mucopolysaccharidosis types II and IV, respectively. Measurement of dolichols in urinary sediment is of little value in the diagnosis of Batten disease or in furthering our understanding of the underlying primary defect.

Adolescent↗