As a result of steady government pressure, the physical safety of the vehicles on our roads has been rising steadily. When crash and rollover test results name and shame manufacturers, they act to protect their brand image. They have invested in new designs to reinforce the shell to protect the driver and passengers. Now add in the crumple zones where parts of the body collapse and absorb the impact. Finally, you make the car more easily controlled with better suspension and braking systems. All these innovations have seen the number of deaths and serious injuries falling steadily over the last ten years. But there’s little to be pleased about when more than 32,000 people die in crashes every year. The number of people merely injured is frightening. In some age groups, more people die on the roads than through disease. When driving becomes a leading cause of death, something should be done.

The Insurance Institute for Highway Safety recently issued a policy document suggesting how changes in the law might improve safety. Proposals to change the law, particularly to use the criminal law, to force people to act in particular ways is always controversial. There’s a strong libertarian culture that objects when freedom of action is limited. Their knee-jerk response is to argue many of these laws make victimless crimes or where the only people injured are the ones labeled criminals. So let’s take the first proposal to force every state to make safety belt laws primary and to make enforcement high-profile. The libertarians might say they should get to chose whether to wear safety belts. It’s their bodies at risk so their decision. The statistics say that states with effective enforcement consistently have lower fatalities. It’s the same with making motorcycle helmets mandatory. The statistics show hundreds of lives a year would be saved if laws were put in place and enforced.

Now let’s talk about increasing the age at which teens can be licensed to drive. States where the age of licensing is 17 show up to a 30% drop in the number of accidents and a real drop in the number of deaths. Now how about reducing the speed limits? Again the evidence is absolutely clear. Speed kills. It also increases the amount of pollution and burns more oil at a time we should be aiming to use less. Curiously, some states have recently been removing red light cameras as infringing the privacy of drivers, yet they also significantly reduce the accident rates. In 2009, almost 700 people were killed running red lights. Research also shows accidents fall where you replace stop lights with roundabouts. Finally, we need active policing to take the drunk and incapacitated drivers off the roads.

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One of the fascinating things we can do as human beings is put information in little boxes and pretend that’s all there is to know. It’s like when you’re at High School and, for the next test, all you need to know is [insert information]. Once you pass on to the next level, you can often forget whatever you learnt for all those tests. The lid has closed on the box and, unless there’s a crisis, you need never try to remember it again. Well, it’s like the world decided it wanted a smaller box for all the information on sexual problems. In the bad old days, we used to talk about impotence and that included quite a lot of different stuff. Now we only seem to talk about erectile dysfunction and there’s not much to say about that. All the other stuff about an inability to have an orgasm or to ejaculate, low levels of sperm or infertility has disappeared. It’s like we’re not supposed to think about anything like that now we have the erectile dysfunction dugs.

Yet, if you ask the doctors who specialize in this area, they’ll tell you that about two-thirds of the men with severe erectile dysfunction also find it difficult to reach an orgasm, and about 60% find it difficult to ejaculate. To understand what’s happening, we have to understand how drugs are marketed. When a pharmaceutical manufacturer comes to market with something new, it’s vitally important to establish a connection between the brand name and the specific condition it treats. To make this drug stand out, the other diseases and disorders in the same part of the body have to be minimized. The important problem has been solved. The marketers prefer you not to ask about the others.

So, because of this manipulation of the general discussion about sexual problems, the only one we focus on is erectile dysfunction and we do that because we have an effective treatment. Where does that leave us with all the men who cannot ejaculate or no longer have an orgasm? Well, when we do go to the doctor, we fail to report these other problems, and the doctors fail to ask us because there’s no treatment currently available. Yes, sadly, the erectile dysfunction drugs only treat the named condition. They have no effect on the other problems.

When you go back to the original statistics, two-thirds of men with severe erectile dysfunction have no remedy for the secondary problems. They could therefore find hard erections return, but they are still not able to have full sexual intercourse. For older men, children are no longer on the agenda, so their inability to produce children will be less important. Nevertheless, the failure of the pharmaceutical industry to find treatments for these other problems is disconcerting.

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The common sense answer is an unpleasant sensation caused by anything from a small broken bone to cancer. Obviously, the causes of pain are not the same. Doctors label some pain as acute where you will recover and the pain will go away naturally. So, after proper treatment, a broken bone will be strong again and you can move around like nothing happened. But cancer can be terminal. If you catch it early enough, the treatments can produce a remission and let you lead a good life. Unfortunately the more usual pattern is late diagnosis and treatment that fails to give anything more than temporary relief. Then it’s a painful decline. This is depressing, but it also points to a valuable lesson. With temporary pain, you can take a big dose of a painkiller for a short period. If you have no hope of survival, the priority is now making you as comfortable as possible. This also allows you to take large doses of the most powerful drugs. The problem comes with causes that will persist for years. This is called chronic pain and it requires a different approach.

So here’s a radical idea for you. Pain is a good thing! Indeed, any attempt to make pain go away is dangerous! OK, let’s back up a little. Think of pain as being like an alarm that goes off in your home if a burglar enters. This is a useful warning. If you are home and an NRA member, you can pick up your gun and defend yourself. Now change the burglar to bacteria or a virus that breaks into your body. Although your auto immune system is going to slow down the damage these invaders might cause, the pain is there to tell you to get some real help. Fortunately, medicine has been improving over the centuries. There are now surgeons in ERs to stitch you back together and give you whatever drugs are likely to cure you quickly. Wait, you’re complaining that once pain has done its job and you’ve got the treatment, you want to switch off the pain. Well, that’s not a good idea. Let’s say you take a massive dose of some really powerful painkillers, how are you going to know when the pain actually goes away? How are you going to know whether it’s spreading? One of the most important symptoms to help doctors give you the right treatment is to have a steady stream of information from you about how much it hurts, and whether the pain is going away or spreading. Obviously, if it’s spreading, a different treatment will be required.

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In the good old days when men sold their souls to the company store for sixteen tons and even then only got deeper in debt, there was no technology to warn the miners if gas was building up. The first they might know is an explosion bringing down the roof. Being careful men, they experimented with different ways of testing the air for gas and canaries were the most reliable indicator they found. All they had to do was keep the birds in the mine. If they fell off their perches, there was too much gas around and it was time to evacuate. So much for the history lesson.

Every year, modern medicine directs a lot of money into basic research to look for ways of detecting serious health problems in their early stages. Sometimes, technology is the answer. So many women who go for regular mammograms detect breast cancer early and the treatment is more likely to save the breast and guarantee a long life. In other cases, there are early symptoms that may not, at first sight, have any connection to the more serious condition that appears later. In the case of heart disease, there’s now very clear evidence that erectile dysfunction in younger men is a very clear warning of a possible stroke or heart attack within the next five years.

The explanation for this is slightly complicated. Various types of cells line the walls of our blood vessels. The most sensitive of these are called endothelial. For reasons no one can explain, there are more of these cells in the penis than anywhere else in the body so anything that affects them is going to show up in erectile dysfunction. If you eat a diet containing too much fat, there’s likely to be a build up of plaque on the walls of the arteries. This hardens the cells and prevents the arteries from dilating and contracting. Since the formation of an erection depends on dilation, anything preventing it in younger men signals high risk the same problem will spread to other blood vessels in the body.

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Before the advent of erectile dysfunction medications it was really hard to imagine that by taking a single pill it will be possible to get a good erection while being diagnosed with erectile dysfunction. Now it seems like something obvious as there are millions of men all over the world using ED medications on a regular basis in order to enjoy sexual activity at any age and with any underlying health conditions. And the main problem for them is not finding a drug that would be able to revamp their sexual lives – there are many products offered on the market – but choosing the optimal and most effective one.

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