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‘Ground-breaking’ male contraception gel put to the test

Condoms and vasectomy are currently the only form of contraception available to men.

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Birth control pill / contraceptive / condom
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Couples are being invited to take part in a ground-breaking international study trialling a new form of male contraception.

Men will be asked to use a daily gel that suppresses sperm production as their sole method of birth control as part of two-year study to assess whether the gel is effective in preventing pregnancy and whether this method is acceptable to couples.

The gel – called NES/T – is a hormone-based treatment that is designed to reduce sperm production without affecting libido. Men will apply the gel daily to their upper arms and shoulders and attend monthly clinics to monitor their sperm count.

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Condoms and vasectomy are currently the only form of contraception available to men. Many women experience unacceptable side effects with their contraceptive method and so couples are looking for alternatives.

Recruiting couples.

The study is being led in the UK by Saint Mary’s Hospital, part of Manchester University NHS Foundation Trust, and the University of Edinburgh.  It is part of an international project funded by the US National Institute of Health and led by the Los Angeles Biomedical Research Institute and the University of Washington School of Medicine.

Men aged between 18 and 50, who are in a stable relationship with a woman aged between 18 and 34, are invited to be part of the trial by calling 0161 276 3296 (Manchester) or 0131 242 2669 (Edinburgh).

Dr Cheryl Fitzgerald, Consultant Gynaecologist at Saint Mary’s Hospital, who is leading the study in Manchester said: “Currently the contraceptive options for men are limited to condoms and vasectomies. We believe this preparation will allow men to control their fertility in a safe and simple way”

Professor Richard Anderson, of the University of Edinburgh’s MRC Centre for Reproductive Health, said: “Previous trials have shown that hormonal contraception for men can be safe and effective. This trial allows men to self-administer a gel, which may be much more convenient and acceptable than needing repeated injections, as was the case with previous trials.”

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Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

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Nurse with patient in bed

Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

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Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

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Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

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Observations

A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

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Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

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