Sildenafil: two decades of benefits or risks?

Abstract

Sildenafil is a selective inhibitor of cyclic guanosine monophosphate (cGMP)-specific phosphodiesterase type 5 (PDE-5). A patent was registered for this drug in 1990, which expired in 2010. Since expiration, the drug has been marketed under various trade names or as generic drugs. Numerous clinical trials have been conducted addressing the effectiveness of the drug for erectile dysfunction (ED) and its safety regarding the presence or absence of specific comorbidities. After over 20 years in the market, we need to ask: has the scientific community reached a general consensus as to the overall efficacy and safety of the drug? Can we firmly state that the benefits of the drug outweigh its risks? This review suggests that sildenafil is an effective and easily manageable treatment for erectile dysfunction, both in the absence and in the presence of comorbidities. After two decades of the emergence of sildenafil as a drug of choice for the treatment of ED (and the numerous studies and clinical trials undertaken during this time span), it is now possible to state that the benefits of the drug do outweigh the risks, and represent an significant improvement in the quality of life in men with ED.     

Community care or therapeutic stalking: two sides of the same coin?

Although the government of the United Kingdom strives to address the needs of individuals engaged in mental health services, its policies must, by their nature, reflect a utilitarian approach. When a client chooses to disengage from services, mental health professionals can find themselves in an ethical dilemma in which adhering to policies can lead them to hyperactive conduct, whereby the client may experience what feels more like stalking behavior than therapeutic care.     

Children's nurses' experiences of child protection: what helps?

This paper reports on one area of findings of a study undertaken in the spring of 2008 at a district general hospital in the south of England. Individual semi‐structured interviews using an interpretive phenomenological approach were undertaken with 15 nurses and midwives working in paediatrics who had been involved in child protection cases. The aim was to explore their views and feelings of the experience. Very little research was found to inform this subject and none specifically with nurses working with sick children. Interviews were taped, transcribed and analysed thematically. It was discovered that involvement in child protection has a lasting impact on individuals; nurses need procedural information from a knowledgeable supporter during a case; and they need support from the right person in the right place at the right time for them. The Named Nurse was identified as being crucial in giving effective support to individuals during child protection cases and trusted advice and support helps staff follow through on niggling concerns, potentially preventing abuse. Copyright © 2009 John Wiley & Sons, Ltd.     

Conflict or Divorce? Does Parental Conflict and/or Divorce Increase the Likelihood of Adult Children's Cohabiting and Marital Dissolution?

The short- and long-term effects of family structure on child well-being remains a hotly contested area among both researchers and policymakers. Although previous research documents that children of divorce are more prone to divorce themselves, much of this research has been plagued by multiple data and analytic problems. A second problematic issue relates to whether it is the divorce per se that leads to increased divorce or rather the conflict that may precede the divorce. In this article we examine whether children who experience parental conflict and/or divorce are more likely to experience a cohabiting breakup or divorce as adults compared with children from low conflict and/or intact families. Our examination improves on past research by using a three-wave longitudinal data set and by controlling for predivorce family characteristics, including the conflict between parents before divorce. We extend previous research on the effect of parental conflict and divorce on adult children's likelihood of divorce by also examining the likelihood of a cohabiting dissolution.     

Olympic and world sport: making transnational society?

This paper introduces the special issue of the British Journal of Sociology on the subject of the transnational aspects of Olympic and world sport. The special issue is underpinned by the perspective that because sport provides a space for the forging of transnational connections and global consciousness, it is increasingly significant within contemporary processes of globalization and the making of transnational society. In this article, we examine in turn eight social scientific themes or problems that are prominent within the special issue: globalization, glocalization, neo-liberal ideologies and policies, transnational society, securitization, global civil society, transnational/global public sphere, and fantasy/imagination. We conclude by highlighting five 'circles' of future research inquiry within world sport that should be explored by social scientists.     

Children's Experience of Sport: What Do We Really Know?

Internationally, children's participation in leisure activities, including sport, is considered to be of such importance that it is enshrined as a human right. However, there is a growing awareness that children's experience of sport is not always benign; abuse and harm frequently occur within a broad range of organised sport contexts. This systematic literature review examines the international research evidence from both peer reviewed and grey literature on the abuse and harm of children that can occur in sport. Four areas of focus were apparent in this literature: first, types of abuse encountered by children in sport and the harm caused to them; second, persons responsible for the abuse and harm; third, circumstances under which children may be most vulnerable; and fourth, the role that culture plays in facilitating abuse in sport. The paper concludes identifying the need for further research in this domain.     

Adult Children's Relationships With Married Parents,Divorced Parents,and Stepparents: Biology,Marriage, or Residence?

The author compared the strength of the relationships that adult children have with different types of parents: biological parents who remained married, stepparents, and biological parents who divorced. He analyzed Dutch life history data containing detailed measures of living arrangements and used multilevel models to make comparisons both between and within children (N = 4,454). The results revealed large differences in the strength of ties across parent types, but these were strongly reduced when differences in the length of shared residence during childhood were taken into account. Nonetheless, even after differences in investment opportunities were considered, there were negative effects of divorce and positive effects of biological relatedness. The “marriage protection” effect was stronger, especially for fathers, than the biological relatedness effect, pointing to the primacy of marriage over biology for parent–child relations in adulthood.     

Wages or welfare? Compensating caregiving in two conservative social welfare states

While nearly all developed nations have some form of attendance allowance for the elderly and disabled, the United Kingdom and several of the American states have provisions to pay caregivers directly if they are family members. This paper compares and contrasts provisions in the U.K. Invalid Care Allowance with provisions of a program in one American state-Michigan. Such payments potentially benefit disabled people, caregivers, and cost-conscious states. However, two particular goals shape the programs' impacts on caregiver functioning and adequacy. One is the extent to which programs operate as welfare provisions and benefits directed at the social or household economy. The other is the extent to which they function as a substitute for wage labor in the market economy. Each of these can be assessed in relation to the real, personal choices and economic gains it provides caregivers. Presumably, both are important in sustaining adequate and satisfying long-term care. Only by truly expanding choice as well as capacity can governments expect to effectively sustain an optimal mix of care provision in the community.     

With or without you? Measuring the quality of relational life throughout the world

This paper proposes a new method for the measurement of the quality of relational life. Building on the recent literature on the determinants of subjective well-being, we use implicit valuations estimated from microeconometric life satisfaction equations to weigh scores on several dimensions of relational life. We apply the proposed method to a large sample of individuals from 94 countries, in order to construct composite indicators that focus on three dimensions of interpersonal relations: friends, family, and society. We use these indicators to compare the quality of relational life across countries worldwide and to explore its determinants at individual and country level. Overall, the results indicate that, at individual level, better economic conditions are associated with higher quality of interpersonal relationships.     

To War or Not? Engaging Middle School Students in an Ongoing Online Discussion

In seeking to prepare students to be “citizens of a culturally diverse, democratic society in an interdependent world,” teachers engage students in live, online discussions about what justifies war, while at the same time grappling with the requirements to teach the memorization of people, places and isolated events. Teachers and a university professor worked to teach students to think inductively about the justification of war, a theme found in most history curricula.     

Too Strict or Too Lenient?: Examining The Role of School Strictness With Educational and Juvenile Justice Outcomes

Abstract

Although there is research exploring how school punishment practices are influencing academic and juvenile justice outcomes, how strict or lenient school punishment practices are related to aspects of education such as grade retention and dropping out, as well as juvenile justice contact, remains unknown. This study draws from the Texas Education Agency’s Public Education Information Management System to investigate the relationship between strict and lenient school punishment practices, academic progress or failure, and juvenile justice contact. Results indicate that schools with more strict punishment practices can contribute to higher grade retention and juvenile justice referral rates; however, it also appears that lenient punishment practices also exacerbate these same outcomes as well as higher referral rates. The importance of fair, just, and balanced school punishment practices is discussed.