Factors Affecting Bone Mineral Density in Elite Female Runners

Introduction: The benefits of regular exercise on skeletal health have been well-documented in terms of stimulation of bone accrual and bone maintenance. Medium-impact sports activities such as running have been demonstrated to exert site-specific enhancement of bone mass in the lower appendicular skeleton. However, elite female runners engaged in high intensity training and sports activity may also be at risk of amenorrhea and low bone mineral density (BMD) resulting from inadequate caloric intake. Purpose: To investigate the effect of intensive exercise and maintenance of adequate caloric intake on BMD in a group of elite female runners. Methods: This study represents a secondary assessment of existing data that were obtained between 1994 and 2009. Using dual-energy X-ray absorptiometry, a group of elite runners (n=11) in this study was screened in the Laboratory for Elite Athlete Performance at Georgia State University. This was a longitudinal study in which three sequential measurements of BMD, as well as fat and lean tissue body composition of each athlete took place. The average interval between measurements was 1.1 years and 2.6 years respectively. Regional BMD measurements for head, arms, legs, trunk, ribs, pelvis, and spine were assessed, as well as the value for total body BMD. The study participants also received dietary counseling emphasizing daily caloric balance and adequate calcium intake. Results: The average age of the runners increased from 24.59 (±4.41) to 28.14 (±5.94) years over the study. This was accompanied by an increase in body mass (54.98±3.54 to 56.11±4.07 kg), while height remained constant. The average body mass index (BMI) of the subjects increased from 19.34 to 19.71 kg/m2, largely due to an increase in total per cent body fat (13.97±2.96% to 16.01±4.28%). Average regional and total BMD values increased over the study period and increases were between 2 and 4%. A majority of subjects (n=7) had a BMI\u3e19 kg/m2, while a sub-group of runners (n=4) had a BMI˂19 kg/m2. Mean trunk, pelvis and spine BMD parameters for the two BMI groups were significantly different (p˂0.05), with reduced BMD values in the lower BMI sub-group. The average T-scores associated with arm BMD were considerably lower than T-scores associated with leg BMD values in the runners. The average T-scores for leg BMD values were almost two standard deviations higher than leg BMD values for a reference population at peak bone mass. Two subjects were osteopenic, resulting in an 18% prevalence rate of osteopenia in the group of runners. Conclusions: The majority of elite runners in this study exhibited a positive trend in BMD parameters. This was reflected as increased total as well as regional BMD values. Increased body mass in addition to the activity of running positively contributed to bone mass via a weight-bearing effect. Increased adipose tissue may also have been a source of endocrine hormones such as estrogen and leptin, which exert a positive effect on bone accrual

Provision, protection or participation? Approaches to regulating children’s television in Arab countries

One notable feature of Arab broadcasting has been the belated emergence of free-to-air channels for children. Today, with children’s channels a still-expanding feature of the Arab satellite television landscape, the region is witnessing growth in the local animation industry alongside intensified competition for child audiences through imported content and a selective squeeze on state funds. In this context the policies and rationales that inform production and acquisition of children’s content remain far from transparent, beyond occasional public rhetoric about protecting children from material that ‘breaches cultural boundaries and values’ and providing programmes that revere a perceived ‘Arab-Islamic’ heritage and preserve literary forms of the Arabic language. Attempts at promoting children’s genuine participation in Arab television have been rare. Drawing on theoretical literature that links protection and participation in the sense that children’s safety depends on their agency, this paper explores emerging guidelines developed by Arab regulators, broadcasters and others in relation to television content for children

Ethics and images of suffering bodies in humanitarian medicine

Media representations of suffering bodies from medical humanitarian organisations raise ethical questions, which deserve critical attention for at least three reasons. Firstly, there is a normative vacuum at the intersection of medical ethics, humanitarian ethics and the ethics of photojournalism. Secondly, the perpetuation of stereotypes of illness, famine or disasters, and their political derivations are a source of moral criticism, to which humanitarian medicine is not immune. Thirdly, accidental encounters between members of the health professions and members of the press in the humanitarian arena can result in misunderstandings and moral tension. From an ethics perspective the problem can be specified and better understood through two successive stages of reasoning. Firstly, by applying criteria of medical ethics to the concrete example of an advertising poster from a medical humanitarian organisation, I observe that media representations of suffering bodies would generally not meet ethical standards commonly applied in medical practice. Secondly, I try to identify what overriding humanitarian imperatives could outweigh such reservations. The possibility of action and the expression of moral outrage are two relevant humanitarian values which can further be spelt out through a semantic analysis of 'témoignage' (testimony). While the exact balance between the opposing sets of considerations (medical ethics and humanitarian perspectives) is difficult to appraise, awareness of all values at stake is an important initial standpoint for ethical deliberations of media representations of suffering bodies. Future pragmatic approaches to the issue should include: exploring ethical values endorsed by photojournalism, questioning current social norms about the display of suffering, collecting empirical data from past or potential victims of disasters in diverse cultural settings, and developing new canons with more creative or less problematic representations of suffering bodies than the currently accepted stereotypes