Severity of ED : relationship to treatment-seeking and satisfaction with treatment using PDE5 inhibitors

Introduction. Research in the past 20 years has demonstrated that erectile dysfunction (ED) is an area of concern for men and their partners.

Aim. The current study was designed to evaluate the impact of the perceived severity of ED on treatment-seeking behavior and satisfaction with treatment among men with ED.

Main Outcome Measures. Participants completed a questionnaire to assess the above variables, as well as the duration of ED.

Methods. Participants were 410 men with ED who were primarily recruited over the Internet via men's health websites.

Results. The results demonstrated that men with more severe ED compared with men with milder ED were more likely to have discussed their ED with their partner and doctor, have sought assistance for their ED problem, but they were also less satisfied with the effectiveness of phosphodiesterase type 5 inhibitors, and said they were less likely to use them in the future. Men with more severe ED were also less likely to want ED medication to last for 24 hours.

Conclusions. Implications of these findings for the treatment of men with different levels of ED are discussed.

The DALY, context and the determinants of the severity of disease: an exploratory comparison of paraplegia in Australia and Cameroon

This paper summarises the findings of an empirical investigation of some of the technical and social assumptions on which the disability adjusted life year (DALY) is based. The objectives of the study were to examine the notion that the burden of disease is broadly similar without regard to country, environment, gender or socio-economic status and to develop detailed descriptions of the experiences of the burden of disease as they related to these contextual factors. The study was a multi-factorial exploratory study employing qualitative and quantitative techniques to obtain data on the effects of country (development), environment (urban versus rural), gender and socio-economic status on people with paraplegia. The data provided an extensive and detailed compilation of context rich descriptions of living with paraplegia. Striking features of the data were the differences between countries with respect to the impact of the health conditions on functioning and highlight a context in which paraplegia of like clinical severity can be fatal in one environment and not in another. While there has been some focus on the control of social determinants of disease, there has been little work on the social determinants of the severity of disease. The underlying assumptions of the DALY, which ignore context in the assessment of the burden of disease, risk exacerbating inequalities by undervaluing the burden of disease in less-developed countries. There is a need to continue to subject the development of indicators to rigorous debate to determine a balance between the assumption of a global “average social milieu” and the treatment of each individual as belonging to their own context in the assessment of population health in order for indicators to be meaningful cross-culturally.

Ecological fire regimes for the recovery and management of threatened small mammals in southern Australia

The application of fire to fauna management, particularly for endangered species, is a significant issue for wildlife managers. Mammals respond to fire regimes including intensity, frequency and season of occurrence, and changes in fire-regimes are implicated in detrimental effects on mammal communities. For many species temporal habitat change is a key factor affecting the persistence of populations. These species require the option of colonising the shifting habitat mosaic. There is substantial evidence that species such as the native rodents New Holland Mouse (Pseudomys novaehollandiae) and Heath Rat (Pseudomys shortridgei) are early successional species dependent on such temporal habitat changes. In conrast species such as the dasyurid marsupial, Swamp Antechinus (Antechinus minimus) are late successional species, which may take up to 20 years to recolonise. In many situations ecological fire regimes need to be implemented to increase areas of suitable habitat for population expansion and reintroductions. This paper assesses research findings and the development of management actions incorporating ecological fire regimes for the recovery of Pseudomyine rodents and the Swamp Antechinus. Spatially explicit models are required to determine changes and patterns at the landscape level. The prospect of global climate change also is of significance and needs to be assessed.

No smoke without fire : Benedict XVI and true liturgical reform

I read the recent comments on Pope Paul VI and the 'smoke of Satan' (July AD2000) with interest not long after I had finished re-reading the massive work by the late Archbishop Annibale Bugnini, generally considered to be the main architect of the liturgical reforms prior to, during, and after Vatican II.

Trial by fire

Victoria is facing its driest summer for nearly one hundred years, with conditions worse than in 1983 when the state was swept by the devastating Ash Wednesday bushfires. The fires were particularly fierce in Mount Macedon in central Victoria, and the Woodend Fire Brigade is in the front line of the struggle to avoid a repeat of Ash Wednesday. Trial by Fire follows this brigade as they do all that they can to keep their community safe from the devastation of the fires.