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Objective The Protectaid(R) sponge (Gefar Pharma, Switzerland) is a new feminine barrier contraceptive method containing three low-dose spermicidal agents. In order to evaluate its efficacy and safety profiles, an international, multicenter study has been conducted in four countries. Methods Healthy, presumably fertile and sexually active women were enrolled in this Study and were followed at 15 days, 3, 6, 9 and 12 months. Contraceptive efficacy was assessed by a pregnancy test, while safety was evaluated by performing gynecological examinations as well as reporting adverse events. The ‘acceptability’ of the sponge by the women was assessed through a standard questionnaire. Results A total of 129 women were enrolled in the study, generating 1182 cycles of use of the sponge. The overall efficacy rate was 77%, with no significant influence of age or parity. Acceptability was high, with 85% of subjects being symptom- or problem-free while using the sponge. Finally, the safety profile was very good, with no clinically significant evidence of local or systemic adverse reactions. Conclusion The now Protectaid sponge is a safe and effective non-hormonal contraceptive method for women.

Proceedings for the 1998 Command and Control Research and Technology Symposium Command and Control for the Next Millenium June 29-July1, 1998 Naval Postgraduate School Monterey, California Track 1 Architectures This paper will describe the third in a series of experiments conducted at the Naval Postgraduate School in November 1997. In particular, we will discuss the activities and results that led to form the hypotheses for test in the experiment, and the efforts that were needed to actually run the experiment: scenario design, preexperiment modeling, training and experimental design, data collection methods and instruments, simulator software, etc. The detailed analyses of the experimental results and findings may be found in companion papers in these proceedings. The Adaptive Architectures in Command and Control (A2C2) project is an ambitious ONR-sponsored research initiative to: extend 12 years of naval composite warfare decisionmaking research into the joint C2 arena; focus on adaptive architectures within these decision-making organizations; and produce results ranging from purely theoretical to those that can be used by the operational forces in the near term. This "industry-university-government" initiative involves a three-pronged, coordinated research effort that includes field, experimental, and theoretical components. The theoretical and analytical efforts provide models of decision-making and adaptation that are tested via experiments with military officers in joint settings for measurement of individual and team performance in dynamically evolving missions and scenarios.

Chlamydia trachomatis is a primary cause of acute or silent salpingitis leading to infertility and ectopic pregnancy. The C. trachomatis epidemic, undiscovered in most cases, spreads, mostly in adolescents, during the years following the onset of sexual activity. As opposed to gonococcal infection which has greatly decreased, C. trachomatis cervical and urethral infection is common in young occidentals. More then 30 different studies covering 200-12,000 subjects screened in family planning centers, college women and men, students and military recruits in different parts of the USA, in Scandinavian countries and France, indicate a prevalence of 5-20% (mean 10%) in apparently healthy young females25 years and 5-10% in males. Female prevalence is strongly related to age, being highest (15-20%) in women20 years old. Several cost-benefit analyses show that the total cost of the general screening in young populations, which can easily be carried out for women in family planning centers, could save twice the cost of treatment for pelvic inflammatory disease caused by C. trachomatis and six times the total cost of C. trachomatis epidemics if late sequelae are taken into account (tubal infertility treatment, ectopic pregnancy). There is a debate among authors concerning the relative merits of total screening versus selective screening in family planning centers, the most common opinion being to do a total screening of women20 years old and selective screening of women 20-30 years of age with at least one risk factor, the most common risk factors being more than one partner in a year, purulent, cervical discharge, failure to use condoms and use of a contraceptive pill. Although the data clearly show that C. trachomatis screening is cost-effective, conducting of the diagnostic laboratory tests used in such screening programs should be carefully evaluated relative to cost, feasibility, specificity and sensitivity and should be adapted to the presumed prevalence in screened populations.

The main side effect of the retinoids is teratogenicity. Every dermatologist has a moral obligation to ensure that this effect is avoided, and the present publication is aimed at helping prescribe these drugs. After a review of the key properties of each of the retinoids on the market, the different forms of contraception available and their indication in young patients undergoing retinoid treatment are discussed. Unless otherwise contraindicated, oral contraception with an estrogen-progestogen formulation is the contraceptive method of choice for women undergoing retinoid treatment. The intrauterine device (IUD) is of little or almost no relevance for young women undergoing treatment with a retinoid. IUDs are indicated in older multiparae who have practised this form of contraception before starting retinoid treatment and who refuse to take the pill. Natural and local methods of contraception are totally unsuitable for women undergoing treatment with retinoids. However, they may be used as an additional precautionary measure by IUD users.