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New Resources

16 Aug, 12 | by shellraine, e-Media Editor

  WHO Guidance – Safe abortion: technical and policy guidance for health systems

The second edition of this guidance has now been published and is available from:  http://extranet.who.int/iris/bitstream/10665/70914/1/9789241548434_eng.pdf

  RCOG – The Initial Management of Chronic Pelvic Pain,  (Green-top 41)

New guidance published in May available from: http://www.rcog.org.uk/womens-health/clinical-guidance/initial-management-chronic-pelvic-pain-green-top-41

RCN – SDI and IUT Accreditation Guidance Documents – Sixth Edition

Accreditation, which is valid for 5 years costs £360 for members and £480 for non-members – re-accrediation is £180 and £240.

Available from: http://www.rcn.org.uk/development/learning/accreditation/LARC_accreditation

“Don’t go in without a skin”

Online condoms and lubes provider the Freedoms Shop (Central & North West London NHS Foundation Trust) has teamed up with Terrence Higgins Trust to launch the Summer Lovin’ campaign – urging gay men across London to use condoms – with a new online health resource. The downloadable resource brings together stacks of health and sexual safety information, presented in a cheeky, accessible way, while Freedoms is providing a half price condoms

 

SRH News from American Journals

1 Jun, 12 | by shellraine, e-Media Editor

Effectiveness of Long-Acting Reversible Contraception

From the New England Journal of Medicine: A large (7486 paticipants) prospective cohort study, by researchers at Washington University School of Medicine in St. Louis, to evaluate contraceptive methods has found dramatic differences in their effectiveness. Women who used pills, the patch or vaginal ring were 20 times more likely to have an unintended pregnancy than those who used longer-acting forms such as an intrauterine device (IUD) or implant.

And from the American Journal of Obstetrics & Gynecology

Rapid repeat pregnancy in adolescents: do immediate postpartum contraceptive implants make a difference?

The purpose of this study in Colorado was to determine contraceptive continuation and repeat pregnancy rates in adolescents who are offered immediate postpartum etonogestrel implant insertion and showed excellent continuation 1 year after delivery; rapid repeat pregnancy was significantly decreased compared with control participants.

Predictors of long-acting reversible contraception use among unmarried young adults

The objective of the study from South Carolina was to improve the understanding of long-acting reversible contraception (LARC) use patterns among unmarried, young adults at risk of unintended pregnancy. LARC use was associated with older age, high IUD knowledge, and earlier onset of sexual activity and concluded that increasing knowledge of IUD among certain groups may improve LARC use among young, unmarried adults and in turn decrease unintended pregnancy.

Knowledge of contraceptive effectiveness

Another study from St Louis, Missouri looking at 4144 women’s knowledge of contraceptive effectiveness and, not surprisingly, showed many gaps.

Unintended pregnancy and contraception among active-duty servicewomen and veterans

The number of women of childbearing age who are active-duty service members or veterans of the US military is increasing. These women may seek reproductive health care at medical facilities operated by the military, in the civilian sector, or through the Department of Veterans Affairs. This article reviews the current data on unintended pregnancy and prevalence of and barriers to contraceptive use among active-duty and veteran women. Active-duty servicewomen have high rates of unintended pregnancy and low contraceptive use, which may be due to official prohibition of sexual activity in the military, logistic difficulties faced by deployed women, and limited patient and provider knowledge of available contraceptives. In comparison, little is known about rates of unintended pregnancy and contraceptive use among women veterans. Based on this review, research recommendations to address these issues are provided.

Antenatal sexually transmitted infection screening in private and indigent clinics in a community hospital system

The study aimed to determine whether clinics that serve indigent patients demonstrate equal compliance with sexually transmitted infection testing guidelines when compared with private clinics in North Carolina. They concluded that clinics serving indigent patient populations had a higher compliance with required testing compared to private clinics. HIV testing in the third trimester remains the greatest need for improvement for all practice types.

Journal: January 2012 and News

3 Feb, 12 | by shellraine, e-Media Editor

The January edition of the Journal of Family Planning and Reproductive Health Care includes a number of articles previously available at Online First (the Dinger/Shapiro VTE commentary, Advances in IUD training by Connolly & Rybowski and Brown’s study looking at young mens’ views on contraception) as well as:

  • a thought-provoking commentary by Raine-Fenning et al on pregnancy of unknown location (PUL) which points out that a recent recommendation from CMACE to abandon the term is at odds with current scientific evidence and clinical experience;
  • a commentary by Wilkins of the Men’s Health Forum on men and sexual health;
  • a study by Draper et al on 525 GP fittings over a period of 30 years confirms that routine IUD checks confer no benefit.  The paper suggested that current guidelines recommend annual checks though this is based on a statement from Australia dated 2007 and USA advice from 2000 and ignores more up to date FSRH and WHO guidance;
  • a questionnaire study of clinic attendees and staff about what we should call ‘attendees’. This appears to show that there is a preference to retain the term ‘patient’ but was based on the respondents picking from only 4 options (‘patient’, ‘client’, ‘user’ or ‘customer’ – ie didn’t include ‘women’ and ‘men’) or asking them what they would prefer to be called;
  • Kipp et al highlight the unmet need for effective methods of FP in HIV+ individuals in rural Uganda;
  • womens’ views of the use of their leftover LBC samples for research purposes (Cooper et al);
  • an important restrospective audit comparing unscheduled reattendance among women having EMA (early medical abortion) at home vs hospital (Astle et al);
  • a review of appropriate use of Co-cyprindiol in a general practice (Tandy);
  • a review of Clomifene use for ovulation induction in general practice (Wilkes & Murdoch)

Plus at Online First on 31 January 2012: Encouraging IUD uptake after medical TOP [Cameron et al.] 

Sharon Cameron and her colleagues in Edinburgh created a fast-track referral service so that women who had undergone early medical abortion who wished to use intrauterine contraception afterwards could be seen promptly for IUD/IUS fitting. However, only about half the women who were given appointments actually attended. In their article they analyse the differences between the attenders and the non-attenders and suggest ways to enhance the uptake of these effective methods for the prevention of further unwanted pregnancies. While some women would benefit from IUD/IUS insertion at the place of abortion, provision of a fast-track service to the family planning clinic may yet remain the best strategy for maximising uptake of intrauterine contraception in this specific client group. from David Horwell, Advisory Editor, JFPRHC

Journal Fiction Book Reviews for April 2012:
The fiction book that has been reviewed for the next Journal is:
“Sense of an Ending” by Julian Barnes.  Read this and see if your views coincide with our reviewer.  If anyone has read “The Marriage Plot” by Jeffrey Eugenides and would like to review it and see their review in print in the April issue please submit a maximum of 400 words to journal@fsrh.org by 12 February at the latest.  In addition, let us know if there are any other books you have read recently that you feel would be of interest to readers.

New GMC Guidance
Two new documents have been published by the GMC: Raising concerns about patient safety and Leadership and management for all doctors 2012 which they “hope will contribute to a culture change within the health service – where raising and acting on concerns becomes part of every day practise in the UK.”

New mobile website for Brook
Brook, the young people’s sexual health charity, have launched a version of their website optimised for viewing on a mobile phone, funded by the JLS Foundation. See a screenshot of the new site below:

Online First and Emergency Contraception for Christmas

16 Dec, 11 | by shellraine, e-Media Editor

The latest article to be published at Online First is:

Questions about intimate partner violence should be part of contraceptive counselling: findings from a community-based longitudinal study in Nicaragua by Mariano Salazar, Eliette Valladares, Ulf Högberg.

Neelima Deshapande (Associate editor) writes:

Effect of domestic violence on contraceptive choice

Sadly, domestic violence against women continues in many countries. This study from Nicaragua looks at the impact of intimate partner violence (IPV) on the choices that women make about their contraception. It appears that women who are abused tend to use more reversible contraception than women who are not and that women actually make conscious choices about delaying pregnancies far more often when their partner is violent than if they are in a non-violent relationship This study quantifies the high proportion of women suffering from IPV and adds strength to the argument that enquiry about domestic violence should be included in contraceptive choices consultations and steps taken to identify and refer appropriately.

Emergency Contraception in Advance:
The BPAS christmas campaign (at www.santacomes.org) to offer free EHC through the post caused the usual mixed tranche of reactions in the media – all of which will hopefully succeed in raising awareness, as described in Marge Berer’s wonderful blog on 12th December. The FSRH have issued a Faculty statement on the subject saying that at a time of limited access advance provision will be in the best interests of many women.

FPA/Brook have issued a response to the Systematic Review of Induced Abortion and Women’s Mental Health discussed last week.

FPA have, today, issued a reaction to the Health Survey for England 2010, published yesterday, which shows that 1 in 4 women claim to have lost their virginity before their 16th birthday. Like the BPAS EHC campaign, above, the Survey has brought out the worst of our tabloid and conservative press with predictable, extreme headlines. However, as reported in The Independent, the authors noted that surveys of sexual behaviour are hard to interpret as responses are subject to both exaggeration and concealment. In addition (but less reported) it showed 26% of women and 32% of men aged 16 to 24 say they have never had sex and across all age groups, men have typically had 9.3 female sexual partners in their lifetime, while women have slept with an average of 4.7 men and almost a quarter of all women (24%) have only ever had one sexual partner, compared to 17% of men. With regards to methods of contraception it showed that equal numbers of women (22%) were using condoms or pills compared with 7% using LARC.

COC / VTE Controversy continues

2 Dec, 11 | by shellraine, e-Media Editor

Following publication of the extended analysis of the Danish Cohort Study on VTE risk (with combined oral contraceptives with different progestogens and oestrogen doses) in the BMJ and the rapid responses since, Shapiro S and Dinger J have now produced a Commentary for the January 2012 edition of the Journal of Family Planning and Reproductive Healthcare (JFPRHC). This is now published at BMJ Online First.

To accompany the commentary Anne Szarewski, Editor in Chief of the JFPRHC writes

VTE and the Pill … again

The re-analysis of the Danish Cohort Study has recently been published in the British Medical Journal (BMJ). Unfortunately, there are still many methodological issues with it, as discussed in this commentary by Dinger and Shapiro. They also point out that the important analysis that was actually requested by the regulatory authority (but not published in the BMJ paper) showed no difference in risk between combined oral contraceptives.

FSRH Workforce Planning Committee

The Faculty has vacancies for 2 members on its Workforce Planning Committe (1 associate member and 1 diplomate, member or fellow). Details available on the Faculty website.

2 New Publications for Nurses -

as reported by Wendy Moore, Vice Chair of the Faculty Associate Members’ Working Group

RCN Competences for nurses undertaking bimanual pelvic examinations

Nurses working in sexual and reproductive health are increasingly extending their role, benefitting both the nurses and their client groups. The ability to carry out pelvic and bimanual examinations is now a key requirement for nurses working in these specialisms in primary, secondary and community care. The purpose of the competency framework is to ensure that women requiring a pelvic exam are cared for safely and that training and assessment processes are in line with local guidance.

RCN Competences for nurses assessing and counselling women who request and/or receive long-acting reversible methods of contraception (LARC)

Aimed at sexual and reproductive health practitioners this new set of competences is aimed at nurses who are assessing and counselling women who have requested or received long-acting reversible methods of contraception (LARC). The purpose of this competency framework is to ensure such women are cared for safely and helps professionals to identify their training needs, ensuring they have the skills and knowledge to undertake the delivery of contraception services competently and safely.

And finally we hope that reports from America that Apple’s new voice recognition software, Siri, is anti-abortion are exaggerated – the ‘tech’ giant says it will improve the software’s unintentional omissions so that it doesn’t say it cannot find abortion clinics. Knowing the age we live in we suspect this ‘issue’ will run for a while in blogs and tweets around the world.

Online First & Museums

18 Nov, 11 | by shellraine, e-Media Editor

The following 2 articles were published via jfprhc Online First this week:

Advances in intrauterine technique training (Connolly)

This article describes an innovative new way for doctors and nurses to be able to learn how to fit intrauterine devices and systems with realistic simulation, which is much better than a ‘Zoe’. This should increase their confidence and make the first encounter with the ‘live’ patient less stressful for all concerned.  Anne Szarewski (Editor in Chief, jfprhc)

US Administration’s attitude to family planning  (Joseph)

The winner of the 2010 Margaret Jackson Prize Essay for undergraduate medical students has looked at the differences between the Bush and Obama administrations’ attitudes to family planning and abortion. It is taking a long time to reverse the damaging initiatives put in place by the Bush administration: we can only hope that the Right Wing does not triumph in the next election. Anne Szarewski (Editor in Chief, jfprhc)

The following Museum piece was spotted by Toni Belfield (Specialist in sexual health information):
The Phallus Museum in Iceland!

The Icelandic Phallological Museum has the collection of penises of all animals whether on land, sea or air…..  They have plans for a future specimen belonging to Homo sapiens……as reported in The Times 15th November 2011.

and not to forget the more conventional:

Museum of contraception and Abortion (based in Vienna)

Around the Globe

13 Oct, 11 | by shellraine, e-Media Editor

The latest edition of the American Journal of Obstetrics and Gynecology includes a supplement entitled: A Hormonal Contraception Update: A Decade of Innovation & Transformation.

In addition AJOG published (online 11th July 2011) a study on the impact of long-acting reversible contraception on return for repeat abortion by Rose S B and Lawton B A. The objective of the study was to determine the rate of return for repeat abortion in relation to postabortion contraceptive method choice 24 months onward from an intervention study.  Its conclusion states: “This study provides strong support for the promotion of immediate postabortion access to LARC methods (particularly intrauterine devices) to prevent repeat abortion.”

September saw the European Society of Contraception (ESC) hold its 11th Seminar in Kaunas, Lithuania. One of the most notable features was the number of participants for a regional symposium  – 533, with the majority being from Poland and Latvia. A number of our colleagues from the UK were involved in either presentations or workshops: Dr Sarah Randall, Dr Anne Webb and Dr Simone Reuter. In addition there was a Board of Directors’ meeting which involved the 2 UK representatives, Dr Meera Kishen and Shelley Mehigan.

Kaunas itself was fascinating for its combination of old and new: elements left over from its communist-dominated past with many crumbling, abandoned buildings and its, especially young, people who are trying to adapt to a new world with western influences. This was particularly evident in the apparent twin obsessions of pizza and eating outside – as well as this may work if the pizzas are made in the Italian way and the cafes are in the Mediterranean it suffers a little in translation to a chilly Baltic state with locally made fare.  This was partly corrected by an apparent benefit to the local blanket industry!

The next full Congress will be in Athens in June 2012.

Meanwhile at home:

Have you completed elements of the new DFSRH: e-SRH; Course of 5; Clinical Exerience and Assessment; e-Portfolio or the LoC SDI or IUT? The Faculty would like to hear from you. They have commissioned an independent review by Professor Ed Piele of the University of Warwick. Visit the Faculty website to give your feedback on your experiences.

UK Agony Aunts bed-in to make sexual health a priority -

What would be the correct, collective noun for a group of agony aunts?

Well in this case it could be a ‘bedful’ or maybe a ‘boudoir’ as 8 of the UKs finest gather to add their support to a group of sexual health charities – Brook, FPA (Family Planning Association), Terrence Higgins Trust, and MedFASH – calling on the government to protect sexual health services as many have seen reduced funding lead to cuts in vital services. This at a time when:
i) a survey by Brook confirms that only 6% of children learn the facts of life from their parents – the internet, TV and friends being the usual source of information (sometimes misinformation) and
ii) the House of Lords HIV and Aids Select Committee report last month found efforts to control the spread of HIV are woefully inadequate as £2.9m is spent on prevention compared with £762m on treatment.

Fiction Book Reviews

Have you enjoyed reading the fiction book reviews in the Journal? Did you agree with the reviews this time of The Room by Emma Donaghue and The Hand That First Held Mine by Maggie O’Farrell? The book for January 2012 will be Pain of Death by Adam Creed (Faber & Faber).

Latest from JFPRHC

Latest from JFPRHC