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Some Experts Remain Skeptical Of Withdrawal Method, Despite Recent Study On Effectiveness
Reproductive health experts were "taken aback" by a recent study that found that the withdrawal method is nearly as effective as male condoms in preventing pregnancy, the New York Times reports. The paper -- published in the June issue of the journal Contraception -- found that 4% of couples will become pregnant over a one-year period if they consistently use the withdrawal method, compared with about 2% of couples that consistently use condoms. According to the study"s authors, a more significant finding was that the rate of "typical use" for withdrawal leads to pregnancy 18% of the time, compared with 17% of the time for typical use of condoms. They wrote in the study that "it is unfortunate that some couples do not realize they are substantially reducing their risk of pregnancy when using withdrawal, as these misperceptions may cause unnecessary levels of anxiety. More speculatively, if more people realized that correct and consistent use of withdrawal substantially reduced the risk of pregnancy, they might use it more effectively." Although the authors said the goal of the paper was to encourage discussion, some experts are concerned that spreading a message that withdrawal is effective could lead young people to have unprotected sex, potentially exposing themselves to sexually transmitted infections that can be prevented through condom use, the Times reports. Melissa Gilliam, chief of family planning and contraceptive research at the University of Chicago"s Department of Obstetrics and Gynecology and a board member of the Guttmacher Institute, said the study"s data "don"t necessarily translate to youth today." She added, "In terms of a reliable method used over and over again, the risk of failure is quite high."Rachel Jones, the lead author of the study and a senior research associate at Guttmacher, said that dismissing the withdrawal method as a "legitimate" form of contraception is "counterproductive for the prevention of pregnancy and also discourages academic inquiry into this frequently used and reasonably effective method." She also said that health educators and providers "should discuss withdrawal as a legitimate, if slightly less effective, contraceptive method in the same way they do condoms and diaphragms." She noted that "most women have used withdrawal at some point in their lives."The study"s authors decided to examine the issue after noticing that many researchers and providers "just kind of dismiss withdrawal and don"t seem to realize that it can prevent pregnancy," according to Jones. She added, "Most people seem to be under the impression that you might as well do nothing." Martha Kempner, vice president for information and communications at the Sexuality Information and Education Council of the United States, said the results of the study have "made some classroom teachers nervous to give out the truth in this instance, but we do have to tell the truth." She added, "People, kids in particular, they"re using it. It is better than nothing, and it is always available" (Belluck, New York Times, 7/21).

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Appeals Court Upholds Massachusetts Law Establishing Protest-Free Zone Around Abortion Clinics
The U.S. Court of Appeals for the 1st Circuit on Wednesday ruled that a 2007 Massachusetts law requiring antiabortion-rights protesters to stay at least 35 feet away from clinic entrances does not infringe on their free speech rights, the Boston Globe reports. The law updated a 2000 statute that established a floating buffer zone, which police and clinics said was difficult to enforce. The 2007 law set a fixed 35-foot buffer zone around any reproductive health care facility and barred anyone from entering or remaining in the zone unless they work at the clinic; are entering or leaving the facility; are public safety or other municipal officials; or are walking by. Five abortion-rights opponents filed the lawsuit in January 2008. U.S. District Judge Joseph Tauro rejected their claims in August 2008, ruling that the law did not regulate speech -- only the location where the speech could occur -- and that it was drafted in response to safety and law enforcement concerns. The protesters appealed the ruling.The appeals court said that the 2007 law responded to "repeated incidents involving violence and other unduly aggressive behaviors in the vicinity of reproductive health care facilities" and "represents a permissible response by the Massachusetts Legislature to what it reasonably perceived as a significant threat to public safety." The court also said that the law was "content-neutral," as it applies to all protesters regardless of their viewpoints. According to the court, the plaintiffs argued in their appeal that the law had a "content-neutral patina" masking a "more sinister reality" that the Legislature"s true motive was to curb abortion-rights opponents" speech.Massachusetts Attorney General Martha Coakley (D) in a statement said that she was "pleased that the 1st Circuit has upheld this important law, which enhances public safety and access to medical facilities, while preserving the right to engage in expressive activity on public ways and sidewalks near clinics." Tim Chandler, legal counsel for the Alliance Defense Fund, which helped represent the plaintiffs, said abortion-rights opponents "shouldn"t be penalized for expressing their beliefs." He added that the fund and its supporters were evaluating the "next legal step" (Finucane, Boston Globe, 7/10).
Sexual Health

Budesonide/formoterol Plus Tiotropium Improves The Quality Of Life Of Patients With Severe COPD

Preliminary results from a double-blind, randomised, multicentre trial among 660 patients with chronic obstructive pulmonary disease (COPD) show that budesonide/formoterol (Symbicort®: AstraZeneca) plus tiotropium (Spiriva™: Boehringer Ingelheim Limited) significantly improves disease control and patients" quality of life.1,2 The study known as CLIMB, compared 12 weeks treatment with budesonide/formoterol (400/12 mcg one inhalation twice-daily) plus tiotropium (18 ÷µg one inhalation once daily) vs. tiotropium alone plus placebo. "Combined inhaled corticosteroid (ICS) and long-acting beta-agonist (LABA) therapy with budesonide/formoterol (Symbicort®) is indicated for COPD patients with a forced expiratory volume in 1 second (FEV1) Notes An estimated 3.7 million people in the UK have COPD; COPD is the 5th biggest killer in the UK; around 30,000 people in the UK die from COPD each year, which is more than from bowel cancer, breast cancer or prostate cancer.6 References 1. Welte T, et al. Budesonide/formoterol added to tiotropium improves the management of COPD patients. American Thoracic Society International Conference, San Diego, USA, 15-20 May 2009; Abst 953775. 2. Welte T, et al. Budesonide/formoterol added to tiotropium is well tolerated and reduces the risk of severe exacerbations in COPD patients. American Thoracic Society International Conference, San Diego, USA, 15-20 May 2009; Abst 953763. 3. Symbicort 400/12® Summary of Product Characteristics, December 2008. 4. Miravitlles M et al. Patient"s perception of exacerbations of COPD - The PERCEIVE study. Respir Med 2007; 101: 453-60. 5. "Unleash the life within..." a patient"s perspective of living with Chronic Obstructive Pulmonary Disease (COPD) Survey. Sponsored by AstraZeneca UK Ltd. 6. British Lung Foundation. Invisible Lives. Chronic Obstructive Pulmonary Disease (COPD) - finding the missing millions, November 2007. AstraZeneca


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