Mid-life fertility: Challenges & policy planning

This review highlights the challenges, priority areas of research and planning, strategies for regulation of services and the need to develop guidelines and laws for fertility treatments during mid-life. The success rate of all treatments is poor in advanced age women because of declining ovarian reserve and natural fertility. There is often a need of third-party involvement which has its own ethical, legal and medical issues. Welfare of children born to older women and early death of parents are important concerns. Most of the new techniques such as the pre-implantation genetic diagnosis, oocyte augmentation, use of stem cells or artificial gametes, ovarian tissue preservation and ovarian transplantation are directed to improve, preserve or replace the declining ovarian reserve. These techniques are costly and have limited availability, safety and efficacy data. Continued research and policies are required to keep pace with these techniques. The other important issues include the patients' personal autonomy and right of self-determination, welfare of offspring, public vs. private funding for research and development of new technologies vs. indiscriminate use of unproven technology. It is important that mid-life fertility is recognized as a distinct area of human reproduction requiring special considerations.

Advance in Exercise for Brain Health in Every Age and Associated Mechanism (review) / 中国康复理论与实践

Exercise can promote brain health in all the ages, directly or indirectly. In early childhood and adolescence, exercise can increase cardiorespiratory fitness to optimize the neuronal environment to benefit cerebral maturation and cognitive de-velopment. In mid-life, exercise may maintain cognitive function by increasing cerebral gray volume and cardiovascular fitness, and preventing a lot of neurobiological events which result in cognitive decline later in life. Finally, regular exer-cise in late life is very important for integrity of brain white matter, cardiorespiratory fitness, and prevention of future de-cline.

Depressive symptoms are related with hemostatic factors in middle-aged women: A report from the Study of Women Health Across the Nation (SWAN)

OBJECTIVE: Depression may be a risk factor for coronary heart disease (CHD) morbidity and mortality, but the mechanism(s) for the association are not established. The present study examined the relationship between one possible mechanism, hemostatic factors, and depressive symptoms in middle-aged women. METHOD: We measured levels of fibrinogen, Factor VIIc, plasminogen activator inhibitor antigen-1 (PAI-1), and tissue plasminogen activator antigen (TPA-ag) in 3,016 women aged 42-52 years enrolled in the Study of Women's Health Across the Nation (SWAN). Depressive symptoms were measured by the Center for Epidemiological Studies Depression Scale (CES-D), with scores > 16 suggestive of depression. RESULTS: Depressed women had high levels of all four hemostatic factors ( all p <0 .01). After controlling for age, smoking, ethnicity, prevalent cardiovascular disease, osteoarthritis, and dia-betes, and use of medications (including psychotropics), depressed women still had elevated levels of fibrinogen (mean, 95% confidence intervals 299, 304 ­ 295 mg/dl vs. 291, 294 ­ 288mg/dl, p= 0.003) and Factor VIIc (124, 127 ­ 121 ng/dl vs. 119, 121 ­ 117 ng/dl, p= 0.01) levels, compared to nondepressed women. CONCLUSIONS: These findings suggest that hemostatic factors may be a key me-chanism accounting for the relationship between depression and CHD. [Castilla RC, Bromberger JT, Zhang Y, Perel JM, Matthews KA. Depressive symptoms are related with hemostatic factors in middle-aged women: A report from the Study of Women Health Across the Nation (SWAN). MedUNAB 2004; 7:57-64

An Effect of Health Promotion Program in Mid-life Women / 간호학회지

The purpose of the study was to test the effect of the health promotion program in middle women. The research design was a quasi experimental, nonequivalent control-group pretest-posttest design. The data were collected from February 24 to April 14, 1988. The subjects were midlife women, age 40 to 50 years who reside in Chonju city. The experimental group consisted of 41 subjects and the control group 40 subjects. The instruments used for the study were the Self Efficacy Scale and the Health Promotion Behavior Scale developed by Park(1995). The data was analyzed by SPSS/PC. The study result were as follows: Through the 7 week education program for health promotion, self efficacy and health behavior were effectively changed in middle-aged.