Combination of Psychological Intervention and Phosphodiesterase-5 Inhibitors for Erectile Dysfunction: A Narrative Review and Meta-Analysis

INTRODUCTION Erectile dysfunction (ED) is an increasing health problem that demands effective treatment. There is evidence that phosphodiesterase-5 inhibitors (PDE5-Is) and psychological intervention (PI) are effective treatment options; however, little is known about their comparative efficacy and the efficacy of combined treatments. AIM The aim of this systematic review and meta-analysis is to evaluate the comparative efficacy of PI, PDE5-Is, and their combination in the treatment of ED. MAIN OUTCOME MEASURES Primary outcome was ED symptoms, and secondary outcome was sexual satisfaction of the patient. METHODS A systematic literature search was conducted in order to identify relevant articles published between 1998 and 2012. We included randomized controlled trials and controlled trials comparing PI with PDE5-I treatment or one of them against a combination of both. RESULTS Eight studies with a total number of 562 patients were included in the meta-analysis. The results of the included studies are inconclusive, though they show a trend towards a larger effect of combined treatment compared with PI or PDE5-I treatment alone. The meta-analysis found that, overall, combined treatment was more efficacious for ED symptoms than PDE5-I treatment or PI alone. Combined treatment was more efficacious than PDE5-I use alone on sexual satisfaction. No differences were found between PDE5-Is and PI as stand-alone treatments. None of the moderators (treatment duration, methodological quality, or researcher allegiance) altered the effects. CONCLUSIONS The combination of PI and PDE5-Is is a promising strategy for a favorable outcome in ED and can be considered as a first-choice option for ED patients. Stronger RCTs are required to confirm this initial finding. Schmidt HM, Munder T, Gerger H, Frühauf S, and Barth J. Combination of psychological intervention and phosphodiesterase-5 inhibitors for erectile dysfunction: A narrative review and meta-analysis. J Sex Med **;**:**-**.

The history of the Jews, from the taking of Jerusalem by Titus, to the present time, comprising a narrative of their wanderings, persecutions, commercial enterprises, literature, manners, customs, and forms of worship : with an account of the various efforts made for their conversion

[James A. Huie]

“Facebook Style”: The Use of Emoticons and Graphic Signs by Users in the Cape Flats

Over the last few years Facebook has become a widespread and continuously expanding medium of communication in Africa and worldwide. Being a new medium of social interaction, Facebook produces its own communication style. It is a style conditioned by the medium and the community of users. My focus of analysis is how Facebook users from the city of Cape Town create this style by means of emoticons and other graphic signs in order to reflect the reality of living in Cape Town’s underprivileged areas. This study is based on a theoretical framework which combines sociolinguistics with Computer-Mediated-Communication to study the emergence of a style peculiar of the online social networks. In a corpus of Coloured Facebook users from the Cape Flats, I have analysed the emergence of emoticons and other graphic signs related to Capetonian gang culture and then tracked the spread of these features to the extensive use by users not related to gangs. It can be deduced that in this process the analysed features amplify their meaning and are employed in a much broader context as their original use. Due to the development and spread of these features we can consider the peculiar electronic communication of Facebook as a style constrained by the electronic medium and its users. It is a style which serves the users to create social meaning and to express their linguistic identities.

Melodrama and Narrative Fiction: Towards a Typology

Recent research on melodrama has stressed its versatility and ubiquity by approaching it as a mode of expression rather than a theatrical genre. A variety of contexts in which melodrama is at work have been explored, but only little scholarly attention has been paid to the relationship between melodrama and novels, short stories and novellas. This article proposes a typology of melodrama in narrative prose fiction, examining four different categories: Melodrama and Sentimentalism, Depiction of Melodramatic Performances in Narrative Prose Fiction, Theatrical Antics and Aesthetics in Narrative Prose Fiction and Meta-Melodrama. Its aim is to clarify the ways in which melodrama, ever since its early days on the stages of late eighteenth-century Europe, has interacted with fictional prose narratives, thereby shaping the literary imagination in the Anglophone world.