Post-finasteride syndrome – does it really exist?

Abstract

Inhibitors of 5α-steroid reductase are drugs used to treat androgen-dependent conditions including prostate diseases and androgenic alopecia. Finasteride was the first on the market and is currently the most widely used inhibitor. Dutasteride was the second inhibitor to be approved and has a similar safety profile. Common adverse events of treatment consist of sexual disorders and a negative affect balance. It was described that the prolonged use of 5α-steroid reductase inhibitors in patients with alopecia can cause persistent side effects called a post-finasteride syndrome (PFS), that is not just a simple coexistence of events, but rather a definite syndrome with an iatrogenic background. PFS occurs in susceptible individuals even after small doses of the drug and can last for a long time after the discontinuation of treatment. A deterioration in the quality of life in affected individuals does not justify use of the drug. Wider recognition of PFS symptoms, its incidence, course, prevention, and treatment possibilities will allow the indications for drug use to be reconsidered and treatment to be more personalized. Knowledge about PFS will also help to provide the best treatment for affected individuals and to properly educate patients before obtaining an informed consent for therapy with 5α-steroid reductase inhibitors.     

Is naloxone really needed in buprenorphine product?

The word on the street has been out for some time — it's not true that the naloxone in the buprenorphine combination product (Suboxone, for example) prevents euphoria if the opioid, which is meant to be dissolved in the mouth, is ingested. More than 20 years ago, this was the premise when the federal government subsidized the development of the first buprenorphine‐naloxone product, paving the way for Reckitt Benckiser Pharmaceuticals — now Indivior — to make a fortune on its Suboxone product. There was yet another delay when the patent expired, but generic manufacturers couldn't break the code for blending the naloxone with the buprenorphine, furthering the fortunes of RBP/Indivior.     

Automation: is it really different this time?

This review examines several recent books that deal with the impact of automation and robotics on the future of jobs. Most books in this genre predict that the current phase of digital technology will create massive job loss in an unprecedented way, that is, that this wave of automation is different from previous waves. Uniquely digital technology is said to automate professional occupations for the first time. This review critically examines these claims, puncturing some of the hyperbole about automation, robotics and Artificial Intelligence. The review argues for a more nuanced analysis of the politics of technology and provides some critical distance on Silicon Valley's futurist discourse. Only by insisting that futures are always social can public bodies, rather than autonomous markets and endogenous technologies, become central to disentangling, debating and delivering those futures.     

Do we really need confidence intervals in the new statistics?

This paper compares the use of confidence intervals (CIs) and a sensitivity analysis called the number needed to disturb (NNTD), in the analysis of research findings expressed as ‘effect’ sizes. Using 1,000 simulations of randomised trials with up to 1,000 cases in each, the paper shows that both approaches are very similar in outcomes, and each one is highly predictable from the other. CIs are supposed to be a measure of likelihood or uncertainty in the results, showing a range of possible effect sizes that could have been produced by random sampling variation alone. NNTD is supposed to be a measure of the robustness of the effect size to any variation, including that produced by missing data. Given that they are largely equivalent and interchangeable under the conditions tested here, the paper suggests that both are really measures of robustness. It concludes that NNTD is to be preferred because it requires many fewer assumptions, is more tolerant of missing data, is easier to explain, and directly addresses the key question of whether the underlying effect size is zero or not.     

Is it really that important to you? How the topics of conflict and emotional reactions to conflicts explain the associations between attachment insecurities and relationship satisfaction

This study sought to examine the intermediary roles of different topics of conflict and negative emotions following conflicts in the associations between attachment insecurities and relationship satisfaction in a sample of 253 mixed-gender couples from the community. Results from path analyses based on the Actor–Partner Interdependence Model showed that attachment anxiety and attachment avoidance were associated with the perception, in both partners, of experiencing more conflicts in the relationship. In turn, the more participants perceived conflicts related to major issues and daily annoyances, the more they reported negative emotions following conflicts and lower relationship satisfaction. Participants’ report of conflicts related to major issues was also related to their partner's lower relationship satisfaction. Findings highlight the significance of accounting for the topics on which couples argue and of using an attachment-based framework to help couples deal with the negative emotions that they experience following conflicts.     

Reflecting on partdime private practice: Is it worth it?

Abstract

Gradual, but not so subtle, changes in Australia's political and welfare cultures have meant that over the past I0 years social workers have been showing a greater interest in private practice as a legitimate aspect of the profession. This paper presents some of the major practical considerations required for a part-time practice to be successfully initiated and maintained. The author uses her own experience as an example and explores the personal, professional and commercial decisions she has made in such a practice over the past 16 years.     

Is it time sociology started researching incompetence?

There appears to be a mismatch between apparent incompetence in the world and the amount of sociological research it attracts. The aim of this article is to outline a sociology of incompetence and justify its value. I begin by defining incompetence as unsatisfactory performance relative to standards. Incompetence is thus intrinsically sociological in being negotiated and socially (re)constituted. The next section foregrounds how widespread and serious incompetence is. This renders effective sociological understanding crucial to welfare. The article then systematically analyses uses of the term in the British Journal of Sociology (a good quality general journal) to assess the current state of research. This analysis fully confirms the neglect of incompetence as a research topic. The next section proposes suitable methods for preliminary incompetence research addressing distinctive challenges like the stigma of being incompetent. These sections then allow incompetence to be better contextualised by other contributing concepts like power, bureaucracy and meritocracy. The final section justifies suggestions about directions for future research.     

Is it ever safe to vote strategically?

There are many situations in which mis-coordinated strategic voting can leave strategic voters worse off than they would have been had they not tried to strategise. We analyse the simplest of such scenarios, in which a set of strategic voters all have the same sincere preferences and all contemplate casting the same strategic vote, while all other voters are not strategic. Most mis-coordinations in this framework can be classified as instances of either strategic overshooting (too many voted strategically) or strategic undershooting (too few). If mis-coordination can result in strategic voters ending up worse off than they would have been had they all just voted sincerely, we call the strategic vote unsafe. We show that under every onto and non-dictatorial social choice rule there exist circumstances where a voter has an incentive to cast a safe strategic vote. We extend the Gibbard–Satterthwaite Theorem by proving that every onto and non-dictatorial social choice rule can be individually manipulated by a voter casting a safe strategic vote.     

The Freshman 15: Is it Real?

Objective: The belief that college students gain 15 Ibs during freshman year is widespread, yet the evidence for this is limited. The authors aimed to determine whether college students gain weight during freshman year. Participants: The authors studied unmarried freshmen living on-campus at a private university in the northeastern United States. Methods: The authors used an online survey to collect information about social behaviors and weight. Results: The authors observed an average weight gain of 2.7 Ibs. About half of the students gained weight, and 15% lost weight. Men gained more weight than did women. Conclusions: Freshman weight gain was 5.5 times greater than that experienced by the general population.     

Genograms: Is it Time for a Change?

This article began as a letter to the Editors, expressing Anne Macvean's concern about the genogram convention that the ANZJFT follows. How does a journal decide whether or not it is time to change? This seemed to be an issue deserving of a wider debate. Here is the beginning of the debate, with comments on Anne's letter from two local users of genograms, Jenny Brown and Jan Evans, and from Monica McGoldrick, internationally known genogram expert, author of You Can Go Home Again [1995], co‐author of Genograms: Assessment and Intervention (1999).     

Is there a need for a theory of urban ecology?

Although urban ecosystems are governed by the same ecological laws as rural ecosystems, the relative importance of certain ecological patterns and processes differs between the two types of ecosystems. For instance, as compared to rural areas, urban habitats are usually more islandlike, more often represent early successional stages, and more easily invaded by alien species. All these features are results of the intense human influence on urban landscapes. The question then arises whether a distinct theory of urban ecology is needed for understanding ecological patterns and processes in the urban setting. The answer is no, because urban ecosystems can be successfully studied using existing ecological theories, such as the metapopulation theory. However, due to the intense human presence approaches that include the human aspect are useful in studying urban systems. For instance, the human ecosystem model, which emphasizes human impact by identifying social components with connections to ecology, is a useful approach in urban studies. This model, combined with the urban–rural gradient approach, forms an effective tool for studying key ecological features of urban ecosystems. Better understanding of these features would increase our ability to predict changes that land use causes in urban ecosystems, and would help to integrate ecology better into urban planning.     

Is it a Container? Young Infants' Understanding of Containment Events

The present research examined how certain features of a box affected 4.5‐month‐old infants' interpretation of containment events the box was involved in. If the box was a regular container, infants did not respond with increased attention when a tall cylinder became fully hidden after being lowered inside the box, consistent with previous research. In contrast, if a three‐sided object (the box without its back) replaced the box, or if shown that the box had a removable back, infants were able to detect the height violations, 3 months earlier than they normally would. These results demonstrate how infants' perception or representation of objects interplays with their interpretation of physical events these objects involve in.     

Is everyone really middle class? Social class position and identification in Alberta

In defining social class, researchers often rely on measures of objective class position, even though subjective perceptions of social class identity can better account for the creation of social class boundaries. We explore the relationship between measures of objective class position and subjective class identity using data from an online survey of 1155 residents in Alberta, Canada, a conservative province dependent on a fluctuating energy sector. We find that although most Albertans identified as middle class, the strength of class identity and views regarding linked social class fates varied across categories with poverty class and uppermiddleclass respondents standing out. In reporting class identity, respondents considered measures related to objective class position, especially their income and economic security levels, but gaps still remained. We then use the results of this exploratory study to advocate for more comprehensive measures of social class.     

Is there evidence to show that fetal alcohol syndrome can be prevented?

Fetal Alcohol Syndrome (FAS) is currently the major cause of mental retardation in the Western world. Since FAS is not a natural phenomenon and is created by mixing alcohol and pregnancy, the solution to decreasing the incidence of all alcohol-related birth defects is therefore entirely preventable. To date, little is known about the effectiveness of prevention programs in reducing the incidence of FAS. Therefore, it is the intention of this article to review the effectiveness of prevention programs in lowering the incidence of FAS. The present review revealed that prevention programs, to date, have been successful in raising awareness of FAS levels across the groups examined. However, this awareness has not been translated into behavioral changes in "high risk" drinkers as consumption levels in this group have decreased only marginally, indicating prevention programs have had minimal or no impact in lowering the incidence of FAS. Urgent steps must now be taken to fully test prevention programs, and find new strategies involving both sexes, to reduce and ultimately eliminate the incidence of FAS.