Halloween is coming, and that must mean, surely as pumpkins and sexy cops, zentai! Well, this is a new association – a new trend in costumes – but it is coming on so strong it might soon be entrenched, like orange and black, as a staple of late October.

Zentai, as I have written about here before, is a Japanese word for a skin-tight, full-body spandex suit, one that covers face and hands and feet, turning one into a silhouette. The word derives from the Japanese for “full-body tights.” They are increasingly called, in North America, morphsuits, as a result of a branding campaign by one company that makes them (a company called Morphsuits). The word morph in the name comes from the use of such suits in movie-making: If you wear one made out of a particular shade of green, your shape can be easily lifted from a video image by an animator and set against a different background.

Anyway, you will be seeing, in the next week, a lot of zentai suits on offer in the pop-up Halloween stores that are now filling the malls, and in online advertising. They make excellent cheap Halloween costumes because they can be printed with detailed shapes: They are perfect for zombie and skeleton costumes, since they can make you look like a naked person with entrails or bones exposed. They are entirely to be expected in the superhero genre, since cartoon superheroes tend to wear tights anyway.

Where they are a little less expected is as variants on more traditional costumes – why do clowns need to have their bodies outlined now? Or witches? Or orcs? You can get a sexy zentai-based costume now based on almost any character from a popular film: Austin Powers, a Minion, a Ghostbuster.

And sexy they are, of course, as they are quite clingy and you have to think pretty carefully about what underwear you are going to wear under them. This is also now an expected part of Halloween: The holiday is, for adults, largely an excuse to wear something overtly sexual once a year. The best thing about a full zentai suit is that your face is covered, too – anonymity facilitates exhibitionism.

So zentai-based Halloween costumes are a strange combination of gleeful pop-culture nerdery – what the Japanese call otaku – and sanctioned exhibitionism.

These two things have long been linked, oddly enough. Cosplay – dressing up as cartoon or movie figures – mixes childish entertainments with troublingly grown-up sexiness. Anime conventions that celebrate obscure Japanese sci-fi graphic novels will have on their grounds a parade of young models dressed up in variations of Japanese schoolgirl outfits – usually some version of Sailor Moon, or one of the wide-eyed girl characters from Chobits – with very short skirts and knee socks and pigtails. Some of the sexiest anime characters – such as the tightly spandex-zipped girl warriors in Evangelion – are teens or preteens. The line between children’s or YA entertainment and adult pornography has long been blurred in Japan. There is a lot of spandex in cosplay.

Does the recent Western embrace of body-conscious costuming reflect any societal change? Probably, yes: First, it reflects the effects of a couple of decades of Hollywood’s obsession with superhero and cartoon characters in movies for grown-ups. A few hundred collective hours spent looking at Catwoman and Silk Spectre and Poison Ivy are going to have an effect on a society’s fashion sense.

That fashion sense also fetishizes an ideal and yet increasingly rare body shape. As the population grows fatter, our paragons grow ever slimmer and shinier and machine-like. Zentai Halloween can only exist in a culture obsessed with fitness. The fetish that now affects men as well as women. (Male zentai outfits easily equal female in popularity.)

Zentai fashion also poses another problem for a security-obsessed society: Masks are being made illegal in public places, even in Western countries (France, for example).

Niqabs are being prohibited all over the place, and so are scary clowns. Who knows what terror-minded authorities are going to make of the trend. The zentai suit is an odd combination: a mask that is also revealing.

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If you were hoping to watch the U.S. election from a room at Donald Trump’s new hotel in Vancouver, sorry, but you are going to have to make other plans.

The opening of the Trump International Hotel & Tower Vancouver has been delayed – again.

Long a point of controversy, the hotel was scheduled to open this summer. That date was pushed to October. Now, its developers say it will not welcome guests until the New Year, well after U.S. voters head to the polls on Nov. 8.

“The opening has been delayed due to the construction of the hotel and the associated properties,” a spokesperson for the Holborn Group, the developer behind the project, said in an e-mail.

Marketing experts say that even if construction were on schedule, the developer would be wise to wait to open the hotel until well after voters cast their ballots because of Trump’s unpopularity among so many different groups.

“It’s opening [the hotels] up as a symbol for protest,” says Alan Middleton, a professor of marketing and executive director of the Schulich Executive Education Centre at York University. “And the last thing that a hotel operator or a casino operator wants is people blocking the traffic, and even worse, making noises about the name on your property. There is no way they can afford to open a Trump property until after the election. Just no way.”

At nearly every stop along the campaign trail, Donald Trump has promised crowds two certainties. One is that he will boast about his business acumen. He is, as he sees it, an empire builder without equal. The other is that he will probably say something offensive.

Though he never seems to worry that his words might hurt that empire – if he did, wouldn’t he stop maligning so many different groups? – there are clear signs Trump’s words are doing the kind of damage that would send many companies scrambling for cover, particularly when it comes to the Trump hotels that stand at the very centre of the Trump brand.

Occupancy rates are plunging at many Trump hotels, there are reports his luxury hotels are slashing rates to attract guests, openings are being delayed, protests are being held in front of hotels and the Trump name, once seen as a symbol of luxury that’s been slapped on everything from steaks to vodka, is now for many people a tarnished symbol of the man’s world view.

On Monday, a group of approximately 40 people protested outside the Trump International Hotel & Tower in Toronto to denounce Trump’s 2005 remarks to then-Access Hollywood host Billy Bush, in which Trump bragged about sexually assaulting women.

One protester held a sign that said: “Trump is repulsive.”

The 147-room Trump International Hotel & Tower Vancouver, which has already seen Vancouver Mayor Gregor Robertson send a letter to its developer asking that the Trump name be removed from the building and one construction worker fly a Mexican flag from the building to protest Trump’s derogatory statements about Mexican immigrants, will likely avoid attracting any larger-scale protests in the lead-up to the election, thanks to its delayed opening.

According to the travel site Hipmunk, bookings for the Donald’s hotels in Chicago, New York and Las Vegas through that site have plunged 59 per cent during the first half of this year, compared with the first half of 2015.

“We are very pleased with the performance of our businesses, and the data reported by Hipmunk is manipulated to appear meaningful, when, in reality, the information is inconsequential and does not provide an accurate representation of our performance,” a spokesperson for the Trump Organization said in an e-mail. “As a company, we are in growth mode.”

The Trump brand is “collapsing” in the eyes of people with a annual household income of more than $100,000, an analyst for the research firm BAV Consulting, which specializes in brand perception, told The Associated Press this week.

As well, a new poll released this week by Morning Consult, a polling firm, found that 46 per cent of 1,983 registered American voters surveyed said they would not stay at a Trump hotel, compared with 39 per cent who said they would, Fortune reports.

It’s not only the Trump hotel business that is feeling the effects of the campaign. Nearly six in 10 women in the same survey said they would not be willing to buy clothes from Ivanka Trump’s brand. On the travel website Expedia, there are still numerous rooms still available for election night at Trump’s new hotel in Washington, as of Wednesday, when it held its grand opening.

With the Trump brand taking a beating, some people have assumed that a recent announcement from the Trump Organization for a new chain is a sign that he is stepping away from the brand. Last month, it unveiled Scion, a new hotel brand targeting millennials. In many people’s eyes, not using the famous Trump name is evidence that the organization recognizes the brand has been tarnished.

But Trump would never take his name off a project as a sign of defeat, Middleton says.

“The man’s got too much of an ego,” he says.

Besides, it is hardly out of the ordinary. Many other hotel chains, including Marriott International Inc., Hilton Worldwide Holdings Inc. and Starwood all have different name brands for different price-point customers.

It’s Trump’s business partners that have been using the Trump name under licensing agreements who are likely hoping to disassociate themselves from it, Middleton says. “I can guarantee, all those who can get out of it are looking to get out of it,” he says.

As for the Trump hotel in Vancouver, the Holborn Group has said it is contractually obligated to stick with the Trump name.

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Facts & Arguments is a daily personal piece submitted by readers. Have a story to tell? See our guidelines at .

Waking up one morning to the freshness of early fall, I am energized by the promise of a new season. A sunny warmth still lingers in the air and an aura of positivity surrounds me.

It makes me feel more hopeful in dealing with the struggles of my adult son, who has moved back home to get help with his concurrent addiction issues.

After a year of roller-coaster battles, we are all war-weary from the destructive fallout of relapses and failed recovery efforts.

Reduced to superficial communication to avoid useless confrontation, I am learning through a support group how to detach from the never-ending problems of an addicted loved one.

But today is different.

Perhaps my impulsive wave of optimism will be contagious; perhaps it will infect him with a renewed sense of purpose to commit to the complex process of recovery.

With tousled hair and a grizzly stubble, he emerges earlier than usual without rushing off to work in his typical frantic frenzy. He seems fairly relaxed, his eyes are clear – it looks like he had a good night’s sleep!

After a quick breakfast, I encourage him to come outside as we look for our family dog’s favourite ball to play fetch in the backyard.

We’re chatting more freely than usual, so I ask about his therapy session a few evenings before.

While complete abstinence is required by the therapist for ongoing sessions, my son admits to having no specific plan, but claims vaguely that he knows what he has to do.

I warily remind him that being in recovery is also a condition of living at home.

He nods in tacit agreement of our parental mantra, and we talk some more about replacing bad habits with good ones, and how reading or audio books may help with night cravings – all good, recovering-addict stuff.

Even if he’s not exactly enthusiastic, I sense a spark of motivation. Some progress is being made.

Overhead, a flock of squawking geese fly south in their distinctive V formation.

I sigh as we go inside to get on with the day – it’s getting late.

Just before leaving, my son casually asks for $60 – he’s broke again. Apparently, it’s a loan he owes for a night out with the boys from work.

Katy Lemay for The Globe and Mail

I refuse to give him cash, so he suggests an e-transfer and offers me the person’s contact info.

Because it sounds plausible, I change my mind and take money from his funds that we hold to pay various debts. I hand it over with a fleeting hesitation.

With rain suddenly starting to threaten, I throw my spaniel in the car for a quick visit to a nearby park.

He runs around happily sniffing doggy smells in the grass, marking his territory on the trees where some leaves are stubbornly hanging on for dear life.

On the short drive home, I spot my son’s work van parked on a neighbourhood street.

I pull alongside – he’s in the driver’s seat – and we both roll down our windows.

Annoyance flashes across his face, as if he’s about to accuse me of following him. He chooses instead to spin his tangled web of deceit.

Of course, he’s just giving a friend a ride somewhere – no big deal. Except, I happen to know that this is the home of a drug user, who is likely a local dealer too.

The cruel slap of reality hits hard. I tell my son it is easy to see why I have trouble trusting him – even when I want to so badly. I drive off as a few rain drops splatter on the windscreen, washing away any faint rays of hope.

Well, at least I have an answer to where he is on this difficult journey to health and wellness – lost and directionless.

For me, it’s back to Step One in The Twelve Steps program on accepting that we are powerless to change the life of an addict, no matter how much we plead, plot, scream, make excuses or try to save them.

Releasing ourselves from the responsibility of another’s actions and behaviour is supposed to lead us to calm serenity.

Right now, a sense of serenity would be really nice.

But trying to detach from a son’s deadly battle with addiction is like surrendering the protective weapons of motherhood and unlearning the “fixing” nature that comes with the role.

It implies an element of giving up, with a loss of hope, yet many claim that it works for them.

I go to look for the Twelve Steps handbook.

Turning to the page on the three Cs, I notice that it’s stopped raining and make a wry connection to the weather as I mutter the words: “We didn’t cause it, we can’t control it, we can’t cure it.” Repeat.

Jane Newman is a pseudonym used to protect the identity of the essay author’s son. The author lives in Ottawa.

Courtesy: The Globe And Mail

The question

My wife and I visit her sister and brother-in-law’s house about once a year, usually for one to three days. We always bring gifts and always invite them out to dinner, to a restaurant of their choice – and, of course, we pick up the tab. However, for the past couple of years I have found myself at odds with my wife over these dinner invitations in regard to our nephew, a man in his late 20s who seems to be a permanent resident living in his parents’ basement. He is a very nice, no-problem lad, just a bit of a recluse, a loner, has a minimum-wage job but, really, has no expenses and his parents note he has quite a growing bank account. Once we are at the restaurant, sister and brother-in-law always order conservatively, whereas nephew orders all the most expensive things, and alcohol to boot. Once we are done, as the treat is on us, we pick up the bill, including paying for nephew, who never offers. This is where my wife and I disagree. She says it’s fine with her, she rarely gets to see them all together. I think it’s a bit much, though, that this fully adult, income-earning fellow doesn’t at least offer to, say, pay the tip or pay for his wine or beer! I agree with one thing, though: My wife says there really is no way to bring it up without causing a potential family problem, so we leave it at that. What do you think?

The answer

It’s interesting: I’m getting a lot of questions lately about twentysomethings staying at their parents’ places.

And really there is only one thing to be said about that: Obviously these twentysomethings don’t want to shoulder their share of life’s burdens.

So why should they want to pick up their share of the cheque at dinner?

Too bad. For me, picking up the cheque is huge and can’t be underestimated.

For example, not too long ago I went out to dinner with about a dozen people to a fancy restaurant and was thinking: “Oh my God, this is going to be pricey, I’m enjoying myself but what a nightmare when the bill comes.”

And then the hostess, the woman who had invited us all there (I think it was for a birthday-type thing), waved her credit card around and picked up the whole tab.

To be frank, I didn’t like this person much before this dinner. But afterward? I would take a swing at anyone who’d say anything negative about her.

My point being (to reiterate), picking up cheques buys you hell’s own drag with people, and those who don’t understand that understand nothing.

Now, let’s say your nephew doesn’t understand that … and it sounds like he doesn’t.

You could play a fun game with him: Stare him down. Don’t pick up the cheque when it comes. Wait, and stare. Then wait some more, and stare some more, until finally someone (ideally him, the “mark”) asks who is going to pay the bill.

And you just shrug and say, “I don’t know.”

And if he says: “Well, why aren’t you going to pay it?”

You say: “Why?”

And if he says (something to the effect of): “Well, you’re the adult.”

You can say (something to the effect of): “Aren’t you?”

Anyway, doesn’t that sound like a fun game?

I’m obviously kidding around, but my point is that this is the adult world, and one of the – if not the – primary measures of how that works is who picks up the tab.

As Woody Allen says in (I think) the movie Anything Else, “Never trust anyone who fumbles for the cheque. … If you want to get it you will.”

And it’s amazing how true that is: I have never been in a position when I seriously wanted to pick up the tab when I was ultimately unable to do so. As a corollary, I have never been in a situation where I secretly wanted the other guy to pick up the cheque where he failed. (Example – and I’m not proud of this: The other night I went out with a friend and was really intending to pick up the cheque, because I owed him a favour, but he went to the washroom and quietly paid on the way back: I spotted him out of the corner of my eye and said nothing.)

Your nephew needs to mensch up in numerous ways: Get a real job, move out of his parents’ house – these are just a few ideas that spring to mind.

But certainly paying for dinner, or at least paying the tip, would be a great start, and I don’t think there’s anything wrong with coming out and suggesting it.

Are you in a sticky situation? Send your dilemmas to damage@globeandmail.com. Please keep your submissions to 150 words and include a daytime contact number so we can follow up with any queries.

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Beatrix Watson was five years old when she told a female doctor she would not take off her underwear unless her mother was in the room. Despite the need for a physical examination, however, the doctor discussed options with Beatrix’s father, who had taken her to the appointment and made time to see the child with her mother the following day. “She was extremely respectful of my daughter’s boundaries,” said Beatrix’s mother, Charlotte Watson of Vancouver.

Gone are the days when kids had no say at the doctor’s office. In fact, children should have opportunities to participate in decisions about their own health starting at a young age, according to a recent policy statement from the American Academy of Pediatrics. The paper, published in August, is yet another sign that medical practice is catching up with laws that empower mature minors to give informed consent – a cornerstone of patient-centred care.

In Canada, provincial legislation dating to the mid-1990s gives children, depending on their mental capacity, the right to accept or refuse medical treatments. In most provinces, a 14-year-old can decide to go on Ritalin, get a prescription for birth control or have a mole removed, with or without a parent’s consent.

As the balance of power shifts in favour of mature minors, however, thorny ethical issues continue to crop up in hospitals, examination rooms and the courts. Who has the power to decide whether a child is mentally capable of giving informed consent? Does a mature minor have a right to refuse life-saving treatments?

Despite these murky issues, there are steps parents can take to prepare their children for the complex decisions they may face in 21st-century medical care.

The Globe and Mail spoke with educators, physicians and bioethicists about how parents can help children learn to make informed choices and practise getting involved in their own health care at each developmental stage.


From the start, parents should choose a doctor who talks to their son or daughter as a patient, rather than speaking as if the child is not in the room, said Dr. Aviva Katz, a pediatric surgeon and ethicist at Children’s Hospital of Pittsburgh, and lead author of the AAP paper.

While children this age are too young to give informed consent, a physician should make every effort to obtain a child’s assent – an expression of agreement. Taking this step can help support “the moral growth and development of autonomy in young patients,” Katz and her co-authors wrote.

Children are more likely to co-operate if they understand the reasons for a given treatment, and have opportunities to make choices along the way, Katz said in an interview. Even with a five-year-old, a nurse can ask if the child wants the IV in the left arm or the right. When prescribing medication, a pediatrician can offer a choice between bubblegum flavour or grape.

Children can express their wishes in psychiatric care as well, said Dr. Jana Davidson, psychiatrist-in-chief of the children’s and women’s mental-health programs at BC Children’s Hospital. With a five-year-old patient, Davidson might ask, “Would you like to talk to me on your own, or would you like your parent to be in the room?”

A young child’s options only go so far, of course. Katz cautioned against offering yes-no-propositions to patients who don’t really have a choice, such as whether to have an appendix out. “If we’re not going to take their advice on that,” she said, “the child has been lied to – and that’s not right.”

Tween years

At age 11 or so, most children are ready to meet with a physician on their own for part of a routine visit, Katz said. Parents can work on feeling okay with this, even if they don’t trust a tween to remember everything the doctor said. By the time a son or daughter leaves home, Katz explained, “you want them to have learned how to speak to the physician and feel comfortable asking questions.”

Dawn Campbell of Vancouver says her 10-year-old son Cayden, who has asthma and alopecia areata (hair loss), sees health-care professionals on his own when he goes for breathing tests at BC Children’s Hospital. The staff ask him to fill out his own form, which includes questions about his breathing and how often he forgets to carry his inhaler. The paperwork helps to reinforce his role in managing his asthma, Campbell said, adding, “I do like that they include him on that, because he’s 10, he’s responsible and it’s nice that they treat him that way.”

Children under age 12 are seldom deemed mature enough to give informed consent. In Ontario, however, all individuals have this right automatically unless there are “reasonable grounds” to believe the person is mentally incapable, according to the province’s Health Care Consent Act.

The legislation was a target of public outrage last year, when an 11-year-old Ontario girl, Makayla Sault, died after refusing chemotherapy to treat her leukemia. The girl and her parents had opted instead to put their faith in alternative and indigenous medicine.

One way to prevent such deaths – other than a legislative overhaul – could be to teach children the critical thinking skills they need to make informed choices. A team of researchers backed by Cochrane, an international organization devoted to evidence-based medicine, has developed educational materials designed to help kids aged 10 to 11 learn key concepts in medical decision-making .


At this stage, parents should start to see themselves as trusted advisers, rather than commanders-in-chief of a child’s health care.

Children in mid- to late-adolescence should have “a lot more” decision-making opportunities, Katz said. If a 15-year-old girl has a breast abscess, for example, a physician could discuss options such as antibiotics, or inserting a needle to drain pus. Katz would explain the evidence to support each intervention, she said, and then ask, “What would you prefer that we do?”

In Canada, the concept of mental maturity has largely replaced chronological age in determining whether a young person has the right to consent to, or refuse, a medical treatment (other than in Quebec, where the age of consent is 14 years and older).

The major exception is medical assistance in dying, which Bill C-14 states may be provided only to Canadians at age 18 and up.

Normally, it is up to the physician to determine whether a child is mentally capable of providing consent. The physician should be “reasonably confident” that the child understands the nature of the proposed treatment and its predicted effects – and the consequences of refusing treatments, according to the Canadian Medical Protective Association, a not-for-profit association that advises physicians on legal matters. If a physician determines, based on discussions with the child, that he or she can make an informed decision, “parental consent is not required,” writes the CMPA.

Nevertheless, the organization cautioned that in complex medical situations, it is “prudent” for physicians to encourage mature minors to include family members in decision-making.

Even if parents and adolescents are on the same page, however, Canadian courts may rule against a minor’s wishes if rejecting a treatment could lead to the child’s death. In 2006, Manitoba courts decided that a doctor could give blood transfusions to a 14-year-old girl despite the objections of the patient, who was a Jehovah’s Witness, and her parents.

Dr. Kerry Bowman, a bioethicist at the University of Toronto, described a system that abandons the legal principle of informed consent, in cases where the patient disagrees with health-care providers, as “ethically problematic.”

A more progressive approach – and the one the AAP recommends – is to thoroughly evaluate individual patients in terms of their mental capacity, regardless of their chronological age, Bowman said. “If you’re going to respect the rights and choices of your patient,” he said, “this is the way to do it.”

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It’s a controversial topic that’s been debated by scientists for nearly a decade: Are calcium supplements bad for your heart?

While findings from previous randomized controlled trials have been inconsistent, evidence from some have raised concern that excess calcium from supplements may increase the risk of heart attack and stroke among women.

Now, a new study from Johns Hopkins University School of Medicine in Baltimore and colleagues adds to the argument that, yes, there is reason for caution.

And perhaps for men, too.

For the study, published this month in the Journal of the American Heart Association, researchers followed 2,742 multiethnic men and women, aged 45 to 84, for 10 years to determine if calcium – from diet or supplements – was linked to coronary artery calcification (CAC), an early sign of heart disease.

CAC is a buildup of calcium in fatty plaques in the heart’s artery walls.

It’s measured using a special X-ray test called computed tomography (CT scan). The test can show whether you’re at risk for heart attack before other symptoms occur.

At the onset of the study, researchers assessed participants’ diets over the previous year as well as their use of calcium supplements. At the beginning of the study, and again after 10 years, their CAC was measured using a CT scan.

The findings: The risk of developing calcified coronary arteries over 10 years was 22 per cent higher in adults who took calcium supplements than those who did not.

That was true after taking into account daily calorie intake, body weight, exercise, smoking, alcohol intake and other risk factors for heart disease.

The highest risk for plaque buildup was found among supplement users who consumed the least calcium from their diet.

Conversely, the lowest risk was observed in people who didn’t take supplements but consumed the most calcium from their diet.

It’s thought that a high intake of calcium in a single dose from supplements can cause a transient elevated blood-calcium level which, in turn, can lead to calcium depositing in artery walls. Over time, calcified fatty plaques can harden and narrow blood vessels, hindering blood flow to the heart.

Excess blood calcium may also influence inflammation, insulin activity and body-weight regulation, other factors that could accelerate hardening of arteries.

It’s thought that dietary calcium is metabolized differently than calcium in supplements. Unlike high-dose supplements, calcium in foods is absorbed into the bloodstream in smaller amounts throughout the day.

Strengths and shortcomings

A key strength of the study is that it measured changes in coronary artery calcification over time, at the start of the study and 10 years later.

Previous research looked at calcium artery scores only once, at the end of the study period. It’s impossible to know whether participants had calcified coronary arteries to begin with.

The study isn’t without limitations, though. It was observational in nature and, as such, it does not prove that calcium supplements are dangerous for heart health.

The study also relied on participants to recall their past food intake and supplement use, which can result in error.

It’s also possible that people who eat calcium-rich foods, versus those who rely on calcium supplements, eat more vegetables, nuts and fish, a dietary pattern which delivers cardiovascular benefits.

Why we need calcium

Calcium is essential to health. It’s required for muscle function, nerve transmission and hormone secretion. And it’s vital to support the structure of bones and teeth.

Consuming adequate calcium is also thought to help reduce the risk of precancerous colon polyps, maintain healthy blood pressure, prevent pregnancy-induced high blood pressure (pre-eclampsia) and ease symptoms of premenstrual syndrome.

So you need calcium. The question is, then, how should you get it?

What about my supplement?

If you use calcium supplements, you’re probably wondering what to do.

The decision to continue or stop taking your supplement requires a conversation with your doctor to weigh the likelihood of risk against the benefits of supplementation.

Consider the reason you’re taking a calcium supplement. The evidence is weak, at best, that calcium supplements prevent bone fractures in adults who do not have osteoporosis, including men and pre- and postmenopausal women.

If you have osteoporosis or you’re at high fracture risk (e.g., you have low bone mass), according to Osteoporosis Canada there’s no evidence that taking calcium supplements alone prevents fractures.

In addition to potential heart risks, research has linked calcium supplements to kidney problems, constipation and bloating.

Discuss with your dietitian or doctor your calcium intake from supplements, diet and medications (e.g., calcium-containing antacids). It’s possible you’re consuming more calcium than you realize – and more than you need.

My advice

With potential for harm and inconclusive benefits to bone health, it’s prudent to be cautious about supplementing with calcium, particularly so when studies have consistently found no increased risk of heart problems from consuming calcium from foods.

Meet your daily calcium requirement from dietary sources, preferably.

If you need to rely on a calcium supplement to do so (and some people will), choose one that’s made from calcium citrate rather than calcium carbonate.

Calcium-citrate supplements provide a lower dose of the mineral, typically 250 to 350 mg per tablet, roughly the amount found in one dairy serving. Calcium-carbonate supplements, widely available and less expensive, contain 500 to 600 mg of calcium per tablet.

To me, it makes sense to consume a smaller dose of supplemental calcium at one time.

Calcium citrate is also much less likely to cause bloating and constipation than calcium carbonate.

If you need to take more than one calcium pill, don’t take more than one at a time.

Spread your calcium intake out over the course of the day.

Leslie Beck, a registered dietitian, is based at the Medisys clinic in Toronto.

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A year ago, Cindy Martinez was struggling to walk even just a few feet and lift just five pounds.

A flesh-eating bacteria had ravaged the 35-year-old Marine veteran’s body. She had a grim choice: Amputate both legs, an arm below the elbow and parts of the fingers on her remaining arm – or face almost-certain death.

The amputations saved her life. And after months in hospital and rehabilitation, she finally found herself back home but alone during the day while her young children were in school and her husband was off at work.

“It kind of takes a toll on you mentally, just sitting there after all that I had gone through,” she said.

In the stillness of her home, she fired off an e-mail to a local gym and asked about joining. When they called back later that night, “I told the lady on the phone, well, there’s a twist to my story.”

She soon found herself sitting in a circle surrounded by trainers at Crossfit Goat – with the motto Be Your Greatest of All Time – in Dacula, about 45 miles northeast of Atlanta. She told them her story and began in February to embark on an unusual quest: becoming a Crossfit athlete. Crossfit gyms are known for high-intensity strength and cardio workouts and members often consider their “box” to be like a family as they bond over workouts-of-the-day that test their strength and resolve.

Her coach, gym owner Amanda Greaver, pledged to work with her and to find whatever way they could for her to do exercises that challenge even people with all of their limbs. She’s come away in awe of how Martinez tackles each workout.

“She will not be stopped no matter what,” Greaver said. “If something doesn’t work, there’s no getting frustrated. We adapt and move on to something else. She is always, always positive.”

Martinez has worked up to deadlifting 95 pounds – nearly her weight – and squatting 65 pounds.

She needs to use her abdominal muscles to ensure she remains balanced. The fingers on her remaining full arm have varying degrees of amputation, which makes it difficult to grip a barbell or dumbbell. Part of the latissimi-dorsi muscles on the left side of her back, the area where the infection first sprouted, were removed.

But she and Greaver constantly find ways to adapt. When she’s performing squats with the barbell behind her, she uses a strap to connect the arm that was amputated just below the elbow to the bar.

When using dumbbells to do chest presses, she uses a strap to attach the weight to her hand and arm to allow her to lift it without needing a tight grip.

When she’s performing body rows, she attaches a strap with a hook on the end so she can grab the rings, dip back then pull herself back up.

Martinez is often surprised by the attention she gets and how others see her as inspirational.

“I’m just doing it. I want it – not that other people don’t want it,” she said. “I don’t know how to explain the speed that I’ve done it with.”

The gym and its members have rallied around her. At one point, Greaver created a workout for members so they would have a greater understanding of the challenges Martinez faces and help raise money to pay for a recumbent bike.

During the workout, athletes were allowed to use only one arm. One-armed push-ups, one-armed kettlebell swings, one-armed farmer carries.

“Literally everybody who came in from doing that came straight up to me and said ‘Look at my arm. Wow, that was so difficult. You really see how hard her workouts are,’” Greaver recalled.

Martinez worked her way up to walking farther and recently got a new pair of prosthetic legs that will allow her to run. She’s getting used to the new legs, which she says feel as if she’s wearing high heels on a trampoline, but one day they will allow her to run around with her young children or perhaps enter a road race.

For now, she’s setting her sights on this month’s Marine Corps Marathon in Washington, which she will race on her recumbent bike.

“The mental aspect, it can be tough. It’s not that I don’t have a bad day,” she said. “But for the most part, I try to stay positive and I think staying active is a good way to, I don’t want to say get your mind off of it because it’s not like I can get my mind off of it, but I’ve got to work with what I’ve got. I’m here for my kids, my husband and I want them to see I can still do things with them.”

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Facts & Arguments is a daily personal piece submitted by readers. Have a story to tell? See our guidelines at .

The first time I switched on the fluorescent lights of the library I would be managing, they flickered in tandem with my rippling excitement. Then they began their slow, steady wheezing. I walked around the room, grazing the timeworn spines of books with my fingertips.

The familiar room seemed to have shrunk. After all, it had been about 15 years since I’d last browsed the library collection at École catholique Jacques-Cartier in Kapuskasing, which I’d attended as a bushy-haired girl. Seated in this room, I had once spent countless hours reading with thick eyeglasses resting on the tip of my nose.

I knew right away that weeding over-stuffed shelves would be my first order of business. They would need to be cleared of outdated resources so that eager little fingers could grasp books with ease.

Was it practical to keep that set of encyclopedias from the early 1960s? I flipped through the first musty volume and scanned an Astronomy article. It featured a photo of saddle-shoe-clad scientists, all groomed with Brylcreem, tinkering with telescopes. A caption read something like: “One day man will land on the Moon.” Getting rid of these outdated books was a no-brainer.

What about those copies of National Geographic from the 1970s and 80s?

As a kid, I had checked these same magazines for stories about Jane Goodall and her troop of gambolling chimps. They had become tattered over the years and were organized in neat stacks that hadn’t been touched in months. Maybe years.

They would best serve as collage material in art class. Instead, I would get subscriptions to age-appropriate children’s magazines that supported today’s curriculum.

Little by little over the next few months, I filled donation boxes – and at times the school dumpster – with old books. Students seemed glad to find the latest and most popular stuff without trouble. The shelves could breathe again.

Well, nearly all the shelves. I had yet to weed those in the spot housing the English novels. Classics that had once swept me away to other worlds and other times were still wedged between glossy softbacks featuring Harry Potter and Junie B. Jones.

The yellow-paged relics harked back to the days I fell in love with reading.

They hid book cards marked with the loop-de-loop names of bookish girls in my grade. Smart girls with English family names who introduced me to the worlds of Anne Shirley and Meg Murry. Kind girls who sought me out during recess so I wouldn’t remain alone in my usual corner.

I found my name inscribed on some old book cards. It usually followed those of my friends. We had all read Anne of Green Gables, Bunnicula and a slew of old Nancy Drews.

I remembered how we’d stolen scenarios from the pages of these novels to re-enact them at recess.

During the spring of 1985, we’d formed a club of sleuths that combed the grassy patches of the schoolyard for made-up clues.

The following winter, we’d watched the boys playing King of the Hill on a 10-foot snow mound and debated which one would be the ideal Gilbert Blythe for our one-act Anne of Green Gables play.

Going over the scribbles and the due dates stamped on the book cards, it seemed as if only a couple of students had borrowed these novels after us. A few sweeps of my barcode scanner were all it took to prove that my hunch was correct.

I knew that holding on to my childhood favourites was unacceptable. I could see the rough shape they were in and knew they we no longer being borrowed. Above all, I was ignoring the first rule of weeding: Do not let your emotions dictate which books to remove from a collection.

Why had I let these books sit on the shelves? Why had I left forgotten book cards, inked with history, in their paper pockets? Knowing that I was surrounded by the very novels that had once helped me overcome a bad day, find a new passion or make friends gave me comfort.

But these books and this space were no longer my safe haven – I had to make way for today’s kids.

After I came to terms with this realization, I made room for brand-new English novels with modern-day heroes, from a quirky Stargirl to a team of Screech Owls. I even got new editions of my favourites set in Narnia and Green Gables.

I ended up working in that school library nearly a decade. My time there was split between the welcome whirlwind of classroom visits and bouts of quiet time ideal for cataloguing books.

From time to time, I’d discover traces of the students I had watched grow up: a woven friendship bracelet in Gryffindor colours; a squashed paper chatterbox wheedling innocent truths and dares; a school photo with the pencilled inscription Amies pour la vie! on it flip side.

While I may have helped give a second breath to the school library during my stint, the young readers gave it life. I let their secrets and forgotten treasures weave a new history between the dog-eared pages of books.

Carole Besharah lives in Gatineau, Que.

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from the American College of Obstetricians and Gynecologists (ACOG) say women should not give birth immersed in water because of a lack of good evidence showing whether it is safe and beneficial. But going through the first stages of labour in a birthing pool may help with pain relief and could speed labour up, according to the new guidelines.

Being immersed in water during labour and delivery, often referred to collectively as a “water birth,” has become more mainstream in recent years, in part because of greater accessibility to midwives and alternative birthing centres and more options in hospitals. Many midwives support immersion either during labour, delivery or both as a way to reduce pain and improve the overall birthing experience.

It’s a controversial topic with few simple answers. For starters, it can be difficult to study the effectiveness of water immersion because other factors, such as the woman’s setting, the type of care provider she is using and her desire for pain-relieving drugs, could affect the results. And the decision over how to give birth is often personal and emotional to the individual involved, not clinical or based on a set of statistics.

So how should those considering a water birth interpret these new guidelines?


This isn’t the first time ACOG has waded into the debate over immersion during delivery and birth. In 2014, the association published a similar set of recommendations, warning that while labouring in water can be beneficial, it’s better to give birth outside the water because of the scarcity of evidence.

The response was swift. Groups like the American College of Nurse-Midwives came out with statements supporting the use of water during labour and delivery, depending on a mother’s overall health and risk factors.

There hasn’t been any groundbreaking update in the medical literature since the last guidelines were published. The major difference is that they aim to be “less prescriptive, more permissive” than before, said Joseph Wax, chair of the committee on obstetrics practice at ACOG who developed the new guideline.

That means that, instead of telling women not to have a water birth, ACOG now says they should be informed about the current state of evidence so they can make an informed decision.

“We still recommend against it, but again recognize that some women may prefer to go that route despite the recommendation,” Dr. Wax said.

What does the evidence say?

The lack of comprehensive, high-quality data looking at the safety and effectiveness of water births has been a major stumbling block.

But one piece of research provides some important insights. According to a 2009 Cochrane review – in which researchers look at the best available evidence on a given topic to draw conclusions – immersion in water during labour does seem to help with pain, reduce the need for epidurals and even speed the process of labour. Overall, the review found a lack of good evidence looking at giving birth in the water, but did cite one study that found women who did were more satisfied with the birth experience.

The ACOG recommendations mention a number of case studies where babies died because they were immersed in the water too long, as well as other problems, such as infections in the infant.

But case studies aren’t applicable to wide swaths of the population. And a lack of evidence doesn’t mean there is no evidence. In other words, the water-birth debate remains vulnerable to individual opinions and interpretation of the research, said Nicholas Leyland, professor and chair of the department of obstetrics and gynecology at McMaster University’s Michael G. DeGroote School of Medicine.

In Canada, few, if any, medical organizations have official position statements on the safety of water births. In general, Dr. Leyland said, he and his colleagues tend to favour the case in Britain, where recommendations support water births for healthy women with uncomplicated pregnancies.

There is one aspect of the debate that Dr. Leyland takes issue with: the idea that it is somehow more natural to give birth in the water. “Human beings, for as far back as we know, have never delivered that way.”

The bottom line?

Water therapy isn’t for all women and it’s clear that more research is needed, but with careful consideration and input from health-care professionals, it can certainly be an option for those women who want it.

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Even though most dermatologists recommend sunscreen to prevent skin cancer and premature aging of the skin, nearly all of them believe patients aren’t getting the message, a small U.S. study suggests.

“There is an understandably long list of reasons most people do not use or apply enough sunscreen: the lotion is uncomfortable, inconvenient to apply, not always readily available, expensive and the list goes on,” said lead study author Dr. Aaron Farberg of the Icahn School of Medicine at Mount Sinai in New York.

“However, we know that solar UV causes skin cancer, so as dermatologists we want to encourage our patients to continually improve their sun protection,” Farberg added by email. “This includes using sunscreen, seeking shade, and wearing sun protective clothing with sunglasses.”

In a survey of 156 U.S. dermatologists, every single one of them agreed that sunscreen reduces premature aging of the skin, or photoaging, and 97 per cent agreed that it also lowers the risk of cancer.

But 99 per cent of them also think their patients don’t apply enough sunscreen.

Most people need at least an ounce of sunscreen, or enough to fill a shot glass, to cover all the exposed parts of their body, according to the American Academy of Dermatology.

It should offer broad spectrum (UVA and UVB) protection and have a Sun Protection Factor (SPF) of 30 or higher, the AAD recommends. Sunscreen should be applied at least 15 minutes before going outdoors, and reapplied every two hours or after swimming or sweating even if it’s labeled as water resistant.

Nearly all of the dermatologists surveyed were comfortable recommending sunscreens with an SPF of 50 or higher, and 83 per cent of them believed that high-SPF sunscreens provide an additional margin of safety.

When advising patients on how to choose sunscreen, 99 per cent of dermatologists recommend looking at the SPF level and checking for broad spectrum protection, while 71 per cent also counsel patients to consider how it looks or feels.

One topic the majority of dermatologists don’t broach with patients is what’s known as photostability, or UV filters that work in sunlight. Certain sunscreen ingredients, including avobenzone and octinoxate, can be unstable and become ineffective in sunlight, previous research has shown.

This is tricky to discuss with patients, though, because there’s no meaningful way for consumers to assess photostability when they’re choosing sunscreens, said Dr. David Leffell, a dermatology researcher at Yale School of Medicine in New Haven, Connecticut, who wasn’t involved in the study.

“Photostability is always somewhat of an issue but the technology has improved especially for broad spectrum sunscreens,” Leffell said by email. “I recommend they go with a recognized brand.”

Beyond its small size, limitations of the study include the possibility that some participants may have provided survey responses they thought were desirable instead of reflecting their actual beliefs, the authors note in JAMA Dermatology.

It’s possible, too, that the minority of dermatologists who said they didn’t believe regular sunscreen use lowers the risk of skin cancer did so not because they think it’s a bad idea, but because they think patients need to take additional steps to protect themselves, said Dr. Elizabeth Martin, who wasn’t involved in the study.

“The data are clear that daily sunscreen use can cut the incidence of melanoma, the deadliest form of skin cancer, in half,” Martin, a researcher at the University of Alabama at Birmingham School of Medicine and president of Pure Dermatology and Aesthetics in Hoover, Alabama, said by email.

“Perhaps when considering their response, this small number of dermatologists recognized that applying sunscreen is only one part of an overall comprehensive sun protection plan, which also includes seeking shade and wearing protective clothing,” she said.

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