What are ergogenic aids?

Introduction

In the history of sport, athletes have attempted to find a competitive advantage through advanced techniques in training, nutrition, and even in ergogenic aids, such as nutritional supplements and pharmacological aids. The use of these substances—such as anabolic-androgenic steroids (AAS), testosterone precursors (such as androstenedione), and nonsteroidal aids such as human growth hormone (GH) and creatine—have become increasingly popular in recent years, even without thorough scientific data supporting their efficacy and safety.

The population using such performance-enhancing drugs ranges from collegiate to professional athletes to adolescents and high school students. Recent meta-analyses estimate that 3 to 12 percent of adolescent boys have used an anabolic steroid
at least once, and 28 percent of collegiate athletes admit to taking creatine. Other studies have suggested that the number may be closer to 41 percent.

Though such ergogenic aids are thought to improve strength, endurance, agility, and overall performance, most athletic improvement is anecdotal at best. Scientific evidence supporting these ideas is scarce and incomplete. Even with aids that may improve strength and/or performance, the safety of these substances has been seriously questioned, such as with the use of AAS, GH, and ephedra.

Types of Ergogenic Aids

Anabolic-androgenic steroids (AAS) as ergogenic aids in sports are chemical compounds that resemble the structure of testosterone, the naturally occurring male sex hormone that affects muscle growth and strength. “Anabolic” refers to the growth of cells, and “androgenic” refers to the stimulation of the growth of male sex organs and masculine sex characteristics. AAS bind to cells that are used for muscle repair and that can transform into muscle fibers.

AAS has been one of the most studied ergogenic aids, yet many of its mechanisms and adverse effects are still not well understood. Studies have shown that increased doses of testosterone can decrease total body adipose tissue in the body and can increase strength and fat-free mass. Adverse effects of AAS use include hypothalamic-pituitary dysfunction, gynecomastia, severe acne, infection as a result of sharing needles, aggressive and depressive behavior, and a possible association with premature death.

Androstenedione (andro) is a testosterone precursor produced by the adrenal glands and gonads. Its ergogenic effect occurs after it is converted to testosterone in the testes as well as in other tissues. It can also be converted to estrone and estradiol, which are steroid compounds that are primary female sex hormones (found in both men and women). The creation of testosterone is regulated by the amount of testosterone precursors in the body. Theoretically, an increase in androstenedione would increase the production of testosterone and thus can increase protein synthesis, lean body mass, and strength.

Older studies showed that andro supplementation results in increased serum testosterone levels. However, more recent studies have shown that andro supplementation fails to directly improve lean body mass, muscular strength, or serum testosterone levels. Possible side effects to andro use are suppressed testosterone production, liver dysfunction, cardiovascular disease, testicular atrophy, baldness, acne, and aggressive behavior.

Similar to androstenedione, dihydroepiandrosterone (DHEA) is a precursor of testosterone and is also formed in the adrenal glands and gonads. DHEA is the most abundant steroid hormone in circulation and is a precursor to androstenedione and other testosterone precursors (such as androstenediol). Studies of DHEA supplementation have not been shown to increase lean body mass, strength, or testosterone levels. Possible side effects are similar to andro and AAS use.

Human growth hormone (GH) is a metabolic hormone that is secreted into the blood by cells found in the anterior pituitary gland. After its secretion, GH stimulates the production of insulin-like growth factor (IGF)-1 in the liver. These hormones stimulate bone growth, protein synthesis, and the conversion of fat to energy. Athletes have been attracted to GH not only because of such theoretical benefits but also because of the limited techniques in detecting GH in the urine. GH levels vary in individuals of different, ages, sex, and activity and can vary throughout the day, so no reliable benchmark can be made to determine if illicit use has taken place.

Scientific studies have been unable to show that GH leads to increased muscle strength and exercise performance or changes in protein synthesis. Because of ethical limitations, it is difficult to study the effect of larger doses of GH on healthy individuals. Adverse effects of GH use include cosmetic damage, joint pain, muscle weakness, fluid retention, impaired glucose regulation (which may lead to diabetes mellitus), cardiomyopathy, hyperlipidemia, and possibly death.

Erythropoieten (EPO) is a hormone secreted by the kidneys that is a precursor to bone marrow. EPO increases the oxygen-carrying capacity of blood and, as a result, aids in endurance and aerobic respiration. The appeal of EPO among athletes is this endurance-enhancing effect. As a result, many users have been found to be skiers, cyclists, and other athletes who require high levels of endurance. Early use of EPO as an ergogenic aid, termed “blood doping,” came in the form of autologous blood transfusions, in which athletes would harvest their own red blood cells and reintroduce them into their systems before events. A synthetic form of EPO, recombinant human erythropoietin (r-HuEPO) became available in 1988.

Scientific studies have shown that EPO and r-HuEPO treatments do increase certain blood concentrations and can aid in endurance. EPO may also have serious and dangerous side effects, however, such as hypertension, seizures, thromboembolic events, and possibly death.

Creatine monohydrate is an amine synthesized in the kidneys, pancreas, and liver, and it can also be obtained through the diet from meat and fish. Approximately 90 to 95 percent of creatine in the body is found in skeletal muscle. Creatine, which is converted to creatine phosphate (PCr), is an important limiting factor in the resynthesis of adenosine triphosphate (ATP), which plays a significant role in energy reserves within the body. Theoretically, an increase of PCr in the body would increase the regeneration of ATP, resulting in an increase in sustained maximal energy production for short-term exercise. This could lead to increased intensity and repetition frequency, and thus possible increases in skeletal muscle mass.

In 2002, A. M. Bohn and colleagues argued in an article in Current Sports Medicine Reports that there are “no studies demonstrating benefit with the relatively indiscriminant use of variable amounts of creatine by large numbers of athletes on a specific team.” Nevertheless, creatine has been shown to enhance performance in small populations of athletes of various sports. Possible adverse effects of creatine include muscle cramping, dehydration, gastrointestinal distress, weight gain, increased risk of muscle tears, inhibited insulin and creatine production, renal damage, and possibly nephropathy.

Stimulants are drugs that increase nervous system activity. Examples of stimulants commonly used as ergogenic aids include the class of drugs called amphetamines, as well as specific chemical compounds such as caffeine and ephedrine. The use of caffeine has been shown to improve exercise time to exhaustion and may even significantly increase intestinal glucose absorption. It has been suggested that caffeine increases fat utilization for energy and delays the depletion of glycogen (the stored form of glucose). As a result, caffeine and other stimulants are popular ergogenic aids for extended aerobic activity.

Caffeine in small doses has been shown to increase performance. Possible adverse effects of caffeine may include anxiety, dependency, withdrawal, and possibly a diuretic effect (dehydration). Ephedrine may have similar adverse affects. Other stimulants, such as amphetamines or cocaine, have more serious and detrimental effects.

Perspective and Prospects

The use of ergogenic aids in the history of sport has progressively moved from primitive aids to more sophisticated performance enhancers. Crude natural concoctions and stimulants have paved the way for complex pharmacological agents (such as erythropoietin) and designer
anabolic steroids (such as tetrahydrogestrinone). Athletes and trainers have utilized any and all means to gain a competitive edge, even if that results in damage to health and even a risk of death.

The biggest problem stemming from the use of such aids is the difficulty in detecting them. This is evident in recent media attention given to ergogenic aids and their popularity, as seen through the 2007 Mitchell Report, an independent congressional investigation of the use of performance-enhancing drugs in Major League Baseball, as well as the 2012 discoveries of abuse by high-profile cyclists and athletes at the Summer Olympics held in London. This media attention has also shown the difficulties among investigators, such as the International Olympic Committee, the World Anti-Doping Agency, and the United States Anti-Doping Agency, in detecting the use of new designer steroids and new ergogenic aids among elite athletes.

Bibliography

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Bohn, Amy Miller, Stephanie Betts, and Thomas L. Schwenk. “Creatine and Other Nonsteroidal Strength-Enhancing Aids.” Current Sports Medicine Reports 1, no. 4 (August, 2002): 239–245.

Foster, Zoë J., and Jeffrey A. Housner. “Anabolic-Andogenic Steroids and Testosterone Precursors: Ergogenic Aids and Sport.” Current Sports Medicine Reports 3, no. 4 (August, 2004): 234–241.

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Shekelle, Paul G., et al. “Efficacy and Safety of Ephedra and Ephedrine for Weight Loss and Athletic Performance: A Meta-analysis.” Journal of the American Medical Association 289, no. 12 (March 26, 2003): 1537–1545.

Singbart, G. “Adverse Events of Erythropoietin in Long-Term and in Acute/Short-Term Treatment.” Clinical Investigation 72 (1994): S36–S43.

Sotas, Pierre-Edouard, et al. "Prevlance of Blood Doping in Samples Collected from Elite Track and Field Athletes." Clinical Chemistry 57, no. 5 (May 2011): 762–769.

Stacy, Jason J., Thomas R. Terrell, and Thomas D. Armsey. “Ergogenic Aids: Human Growth Hormone.” Current Sports Medicine Reports 3, no. 4 (August, 2004): 229–233.

Yesalis, C. E., and M. S. Bahrke. “Doping Among Adolescent Athletes.” Baillieres Best Practice and Research in Clinical Endocrinology and Metabolism 14, no. 1 (March, 2000): 25–35.

In Pride and Prejudice by Jane Austen, what is Jane's view on Charlotte's marriage to Mr. Collins? How does her view contrast to Elizabeth's?

Jane thinks that Elizabeth is being too critical of Mr. Collins and Charlotte's upcoming union.  She reminds her younger sister that Charlotte has a "'steady, prudent character'" and that Mr. Collins is a respectable man.  This makes their match more reasonable to Jane.  She explains to Elizabeth that Charlotte could not have found better man to be her husband because her parents have many children.  Sir Lucas and Lady Lucas have several daughters, so they cannot afford a large dowry for Charlotte.  Also, she is plain and this is considered undesirable.

Elizabeth is adamant that her friend cannot possibly love Mr. Collins because he is a "'conceited, pompous, narrow-minded, [and] silly man.'"  She thinks that Charlotte was not in her right mind when she accepted the proposal from Mr. Collins.  Jane tells her sister that Charlotte "'may feel something like regard and esteem for [their] cousin.'"  Elizabeth believes that Charlotte will trade "security for happiness."  Charlotte will have a home, a respectable husband, and someone to provide for her when she marries Mr. Collins.  Jane wishes that Elizabeth will eventually "'be convinced [that it is a good match] by seeing them happy together.'"

Describe violence committed by children and teenagers.

Introduction

Some children and teenagers prey on vulnerable people, exhibiting antisocial behavior, neurological dysfunctions, and mental illnesses. These youths may assault other children or adults for a variety of reasons, ranging from invoking fear as a form of entertainment to causing bodily harm as retribution for perceived wrongs such as social ostracism.

Youth crimes doubled during the late 1980s and early 1990s. Although homicide rates for teenage perpetrators began to decline in the United States by 1997, youth violence remained an urgent issue. By the beginning of the twenty-first century, violent youths were committing callous acts at increasingly younger ages. They also behaved more extremely with regard to weapons used or number of victims attacked during violent sprees. Crimes such as school shootings targeted individuals both known and unfamiliar to perpetrators.

Who Is Violent?

Violent youths represent varying social classes and ethnicities, living in both rural and urban areas. Young males are twice as likely to act violently outside the home than are young females, but both genders are equally likely to be violent toward their families. Violent tendencies sometimes emerge when children are toddlers. Aggressive children may fight with other youngsters, act up in class, challenge authority figures, or steal. Some sadistically abuse animals. Such aberrant behaviors can intensify during adolescence.

Researchers offer contrasting theories about why some youths become violent. Violent youths may suffer from severe mental illnesses, display disruptive behavior disorders or antisocial personalities, or have experienced brain damage. Some researchers suggest that brain circuits containing the neurotransmitter serotonin have malfunctioned in violent youths. A few researchers speculate that some infants have innate repressed violent characteristics that develop when the child encounters biological or psychological triggers, such as sexual or physical abuse, illegal substances, or peer pressure.

Authorities agree that many violent children and teenagers have been exposed to violence in their homes or communities. Inadequate or abusive parenting can prevent children from learning appropriate values of right and wrong. Neglected or abused children can feel emotionally abandoned and become self-centered. Egocentric youths are more likely to lack consciences and to be incapable of feeling empathy or compassion for others. Emotions such as depression, frustration, rage, and shame can intensify a child’s perceived inadequacies. Many violent youths are alienated from emotional support systems and feel isolated and discriminated against. They may become desensitized to violence or emotionally numb and seek excitement through violence. Some are suicidal and resigned to accepting and participating in violence.

How Violence Is Committed

Youth violence can be categorized into four major types. Situational violence, one of the most common types of violence committed by children and teenagers, is sparked by an event that upsets or enrages the victimizer. For example, a student might assault a teacher who gave a failing grade. Relational violence occurs when a child or teenager is violent toward a relative or friend with whom he or she has a personal dispute. Dating violence is one of the most prevalent forms of this type of violence, as when a teenage boy attacks a girl who terminates their relationship. Predatory violence describes thefts and muggings involving violence or violent activities carried out to prove loyalty and ensure acceptance by a group. Violence connected to competition, drug dealing, riots, and gang fights and the use of concealed weapons with intent to maim or murder is considered predatory. Less than 1 percent of juvenile cases involve psychopathological violence, which involves perpetrators who probably are neurologically damaged or mentally ill and who commit extremely violent acts. These individuals require pharmaceutical and management therapy. Other violent acts that may be committed by youths include hate crimes, vandalism, bombings, or activism such as ecoterrorism. Some violent youths are attention seekers who believe that they will become celebrities through their acts.

While engaged in violent acts, youths may be dissociated from what they are doing and may feel as if they are experiencing a dreamlike or fantastical state instead of reality. Violent youths may verbally antagonize and ridicule their victims, who are often people whom the perpetrators view as weak, such as young children, the elderly, and handicapped individuals. Sometimes, groups of youths plan assaults to surround and attack one person. Preteens have raped or murdered children their own age or younger. A notorious case of youth violence occurred in England in 1993, when two ten-year-olds kidnapped and beat to death a two-year-old. Some children who commit violent acts are not sufficiently mature, intellectually and morally, to realize that their actions can hurt other people. In 2000, a six-year-old who shot a classmate at a Michigan school expressed confusion when she died.

Intervention

Mental health professionals stress that children who display violent behaviors should be identified as young as possible so that intervention measures can be implemented to prevent them from harming other youths. Facilities that treat violent juvenile offenders include boot camps, detention centers, wilderness programs, and group or private psychotherapy sessions. Both public and private schools attempt to identify emotionally disturbed students who might interfere with the learning process of other students by disrupting classes and challenging faculty members.

Violent youths who are mentally ill should receive counseling and medication. Other options are available to those whose behavior has social and emotional roots. These youths may be enrolled in programs that promote self-esteem, emotional resilience, and self-control. Parents can teach their children appropriate coping techniques to prevent violence. Communities and churches can provide children with supervised recreational activities during afternoons, which are the hours when youths are most likely to act violently. Mentoring programs can demonstrate alternatives to destructive behavior. Peer counseling has been shown to be an effective deterrent to violence. Violence-prevention curricula can teach children to resolve conflicts creatively and help them develop skills to control emotional outbursts.

Bibliography

Eron, Leonard D., Jacquelyn H. Gentry, and Peggy Schlegel. Reason to Hope: A Psychosocial Perspective on Violence and Youth. Washington, DC: Amer. Psychological Assn., 1996. Print.

Garbarino, James. Lost Boys: Why Our Sons Turn Violent and How We Can Save Them. New York: Anchor, 2000. Print.

Gentile, Douglas A., ed. Media Violence and Children: A Complete Guide for Parents and Professionals. Westport: Praeger, 2008. Print.

Hoffman, Joan Serra, Lyndee M. Knox, and Robert Cohen. Beyond Suppression: Global Perspectives on Youth Violence. Santa Barbara: Praeger, 2011. Print.

Holden, Constance. “The Violence of the Lambs.” Science 289 (July 28, 2000): 580–81. Print.

Katch, Jane. Under Deadman’s Skin: Discovering the Meaning of Children’s Violent Play. Boston: Beacon, 2001. Print.

Kellerman, Jonathan. Savage Spawn: Reflections on Violent Children. New York: Ballantine, 1999. Print.

Paludi, Michele A. The Psychology of Teen Violence and Victimization. Santa Barbara: Praeger, 2011. Print.

Richman, Jack M., and Mark W. Fraser, eds. The Context of Youth Violence: Resilience, Risk, and Protection. Westport: Praeger, 2001. Print.

Seifert, Kathryn, Karen Ray, and Robert Schmidt. Youth Violence: Theory, Prevention, and Intervention. New York: Springer, 2012. Print.

In Harper Lee's To Kill a Mockingbird, how might Maycomb and the events of the novel be different if there were more than two races represented in...

A lot of this answer depends on what the race relations are like between the three groups.  Do they all get along and treat each other fairly?  If so, then there hopefully wouldn't be any "us" vs. "them" mentality during the court battle.  That's naive of me to think though.  

Another unknown is what are the population percentages of the races?  Is it an even 33% per race?  Or is it 50% white, 25% black, and 25% third race?  If it's the latter, I don't think anything changes in the book.  Likely there would still be the us vs. them mentality from the minorities toward the majority, but the total split would be 50/50.  However, if the split was in thirds, then the "non-white" races have a majority. I doubt the lynch mob scene happens then.  I also see something as drastic as Tom being found innocent as a possibility in order to keep the peace.  Even if he were to be found guilty, I don't think he would have been gunned down in quite the same way.  More races in the novel would likely make the people of Maycomb more tolerant of other races.  

What are bruises?

Causes and Symptoms

A bruise is a usually benign condition that happens when an individual has some type of injury. It may be a fall or a direct blow to any part of the body. As a result of the trauma, the affected body part undergoes various changes. A bruise can also occur spontaneously (a more serious illness or disease state) or from an allergic reaction. In most cases, bruises are not serious and resolve without any medical treatment.

Bruises occur when small blood vessels that are just beneath the skin are broken. They then begin to leak their contents (blood) into the surrounding soft tissue underneath the skin, which produces the characteristic black-and-blue discoloration. There are three types of bruises: subcutaneous (just beneath the skin), intramuscular (in the underlying muscle), and periosteal (in the bone). Bruises can last from several days to months. The typical black-and-blue mark begins to fade as the blood that leaked into the surrounding tissue is reabsorbed. The discoloration turns to a light yellowish-green and then fades completely.

Treatment and Therapy

The initial treatment of bruises should include decreasing the bleeding, minimizing any swelling, and controlling the pain. Ice is very effective and should be applied to the affected area for thirty to sixty minutes at a time. This can be done several times a day for two to three days. The ice should be in a container and covered by a towel to prevent damage to the skin. If possible, the affected area should be elevated above heart level. This helps in minimizing the swelling, which also helps decrease pain. If there is still discomfort after this period, then heat can be applied for twenty minutes at a time. The application of heat will help the blood to be reabsorbed into the tissue. The last component of the treatment regimen should include pain control. Pain can be easily controlled by using acetaminophen (Tylenol) or ibuprofen (Advil or Motrin).

Medical care should be sought if there is increased pain, a decrease in function (the affected part can no longer be used), headache, dizziness, fever (101 degrees Fahrenheit or more), or a noticeable change in vision, or if the symptoms continue.

Perspective and Prospects

Bruises are benign conditions that usually resolve without treatment. Simple self-care therapies will generally decrease discomfort and aid in a complete return to normal. Bruises are significant, however, in an individual experiencing bruising without any clear reason for the occurrence. In this case, bruises can be indicative of something more serious, such as clotting disorders or other diseases.

Bibliography

"Bruise." Medline Plus, May 1, 2011.

"Bruises, First Aid." Logical Images, December 22, 2008.

"Bruising and Bleeding." Merck Manual Home Health Handbook, May 2012.

Gottlieb, William. Alternative Cures: More than One Thousand of the Most Effective Natural Home Remedies. Emmaus, Pa.: Rodale, 2008.

Griffith, H. Winter. Complete Guide to Sports Injuries: How to Treat Fractures, Bruises, Sprains, Strains, Dislocations, Head Injuries. 3d ed. New York: Body Press/Perigee, 2004.

The Doctors Book of Home Remedies. Rev. ed. New York: Bantam Books, 2009.

How effective was the New Deal legislation in bringing the US out of the Depression?

Most historians would say that the New Deal programs were at least somewhat effective in getting the United States out of the Great Depression.  They would say that the New Deal began to get the country out of the Depression, but they would also say that the programs were not enough to get the country completely back on track.  The United States only really got back to prosperity when it started to prepare for World War II.

Almost all historians (outside of some conservatives) believe that the New Deal really did help the economy.  The numbers suggest that this is true.  As you can see in the link below, the US economy bottomed out in 1932 before President Franklin Roosevelt was elected.  After he was elected and started to implement the New Deal, the economy clearly improved, though it did suffer another downturn in 1937.  This suggests that the New Deal actually caused the economy to improve.  (Conservative economic historians believe that the recovery would have been faster and longer-lasting if the government had not implemented the New Deal.) 

However, it is also clear that the economy remained very weak for years after the New Deal began.  By 1939, the US’s GDP was still no higher than it had been before the Depression began.  This means that, even after the New Deal had six years to work, it had still not really gotten the economy back on track.  Instead, the economy did not manage to take off until 1939, when the US started to manufacture more military materiel as it prepared for World War II.  This is why historians generally say that the New Deal managed to help stop the Depression, but that it did not actually end that economic crisis. 

What point is Robert Frost trying to make in the last two lines of his poem "Out, Out—"

Life goes on. The boy made a fatal mistake and Frost says "No more to build on there" meaning the boy is now useless to his family. He can't be taught anything else and so those who are left must move on since "they Were not the one dead". While it seems a harsh verdict and a brutal way to think of death, it is realistic in a rural setting where work continues. The boy's relations and friends have their own "affairs" to look after and cannot dwell on the boy's death. Death is a way of life for working people in the country. Animals die, crops whither and a new cycle starts. They cannot stop to ponder the seemingly meaningless death of the boy. Frost suggests that life is meaningless in the allusion he uses for the title of the poem which comes from Shakespeare's MacBeth:

Out, out, brief candle!

Life’s but a walking shadow, a poor player

That struts and frets his hour upon the stage

And then is heard no more. It is a tale

Told by an idiot, full of sound and fury,

Signifying nothing.

The final lines of Frost's poem represent the family's moving on. Since the death seems irrational, they seek meaning and rationality in the chores of the farm. Life offers no intrinsic meaning other than labor and looking after one's affairs.