While this program uses the ugly ribbon bar that Microsoft Office 2007 unfortunately introduced as a replacement for the much easier to use menu and toolbar system that all other programs use, you should still be able to eventually find all the options to allow you to edit your PDFs.
A vast improvement over the prior version of Nitro PDF. This version was easier to install (although it did overwrite my PDF file associations even though I asked it not to). Shortcut keys for obvious things like copy and past now work with the expected key combination (as wasn't the case with the prior version) and finding the options to be able to select content from the page, move content around on the page, and insert new content into the page is not too difficult.
Unfortunately the program still uses the ribbon bar that Microsoft introduced for Office 2007 rather than the far more user friendly menus and toolbars that other programs use and there doesn't appear to be an option to switch it to use menus instead of the ribbon (there isn't one in Office 2007 either which is one of the reasons why I prefer to use OpenOffice instead).
The program appears to have all of the facilities that you are likely to need in order to be able to edit PDFs, just that finding them is more difficult due to the use of a non-standard interface.
During the install you also get the option of installing an extra option for PDF handling into the various MS Office products but an equivalent option for the alternative office programs is not available.