WHAT IS THE RIGHT AGE TO REPRODUCE?

2006 ◽  
Vol 17 (3) ◽  
pp. 185-204 ◽  
Author(s):  
M NWANDISON ◽  
S BEWLEY

This article examines the question as to what is the right age to reproduce from the biological point of view of its purpose; that of achieving a healthy mother and baby. We start with an assumption that issues surrounding sex, fertility, pregnancy, miscarriage, abortion and childbearing are private and emotionally laden. We are not looking at, nor judging, individual reproductive choices; what might be “right” for one person, or couple, in one context will be unsuitable for another. It is traditional obstetric and gynaecological teaching that human reproductive outcomes are worse at the extremes of maternal age. Yet the advice given in a recent BMJ editorial entitled “Which career first? The securest age for childbearing remains 20–35” appeared to be controversial. The ensuing scientific and media interest raised such headlines as “Horns of the dilemma”, “A sinister article”, “Late mums face baby misery” and “Are we having children too late? IVF not the answer, say docs”. Products have recently appeared on the market offering kits to women to indicate the time left on their ‘biological clock’ so they can choose whether to continue pursuing their career or try for a baby. Why is there so much interest in the right time to reproduce? Are women (and men) doing something differently compared to the past? If there has been a demographic shift in the age women reproduce (hitherto unexplained), there are important and specific risks older women may face as compared to younger women.

Robotica ◽  
2009 ◽  
Vol 28 (2) ◽  
pp. 279-296 ◽  
Author(s):  
Alessandro Gasparetto ◽  
Vanni Zanotto

SUMMARYIn the past years a large number of new surgical devices have been developed to improve the operation outcomes and reduce the patient's trauma. Nevertheless, the dexterity and accuracy required in positioning the surgical tools are often unreachable if the surgeons are not assisted by a suitable system. Since a medical robot works in an operating room, close to the patient and the medical staff, it has to satisfy much stricter requirements with respect to an industrial one. From a kinematic point of view, the robot must reach any target position in the patient's body, being as less invasive as possible for the surgeon's workspace. In order to meet such requirements, the right robot structure has to be chosen by means of the definition of suitable kinematic performance indices.In this paper some task-based indices based on the robot workspace and stiffness are presented and discussed. The indices will be used in a multiobjective optimization problem to evaluate best robot kinematic structure for a given neurosurgical task.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Shlomi Toussia-Cohen ◽  
Aya Mohr-Sasson ◽  
Abraham Tsur ◽  
Gabriel Levin ◽  
Raoul Orvieto ◽  
...  

Abstract Objectives We aim to study the association of maternal age with maternal and neonatal complications in twin pregnancies. Methods A retrospective cohort study of dichorionic–diamniotic twin pregnancies stratified into three groups according to maternal age (“A” <25, “B” 25–34 and “C” 35–44 years old). Outcome measures included pregnancy, delivery and neonatal complications. A sub-analysis of in vitro fertilization pregnancies only was conducted. Results Compared with younger women (groups A [n=65] and B [n=783]), older women [group C (n=392)] demonstrated significantly higher rates of gestational diabetes mellitus (B 6.6% vs. A 0%, p =0.027, C 10.2% vs. B 6.6%, p =0.032), were more likely to undergo cesarean deliveries (C 66.6%, B 57.6%, A 52.3%, p =0.007), and were at increased risk of having more than 20% difference in weight between the twins (C 24.5%, B 17.4%, A 16.9%, p =0.013). Other outcomes, including preeclampsia, did not differ between the groups. A sub-analysis of the in vitro fertilization only pregnancies was performed. Compared with younger women (groups A [n=18] and B [n=388]), older women (group C [n=230]) underwent more cesarean deliveries (p=0.004), and had more than 20% difference in weight between the twins (p<0.004). Other outcomes, including gestational diabetes mellitus rates and preeclampsia, did not differ between the groups. Conclusions Women at advanced maternal age with dichorionic twin pregnancies had significantly higher rates of gestational diabetes mellitus, cesarean deliveries and fetal weight discordancy as compared with younger women. In contrast, the incidence of preeclampsia was not affected by maternal age.


2017 ◽  
Vol 45 (3) ◽  
pp. 222-229 ◽  
Author(s):  
Lovisa Brehmer ◽  
Kristina Alexanderson ◽  
Erica Schytt

Aims: To explore whether older women differ from younger women with respect to sick leave and inpatient care at the time around their first pregnancy and delivery. Methods: This was a descriptive population-based cohort study. The study population included all 236,176 nulliparous women registered as living in Sweden who gave birth to their first singleton infant in 2006–2010. Data from nationwide Swedish registers were used. Maternal age was categorized in five-year intervals. Time was calculated in years with the delivery date as the starting point, from two years before and up to three years after delivery. Descriptive statistics were used to calculate mean values and ANOVA tables were used to obtain the 95% confidence intervals of the means. Restriction was used to reduce potential confounding. Results: Women aged ⩾35 years had a higher annual mean number of sick leave days from two years before to one year after their delivery date compared with younger women. The range for all age categories in the year before the delivery date, including pregnancy, was 15.3–37.4 mean sick leave days. The mean number of inpatient days increased with each age category during the year after the date of delivery in the range 1.4–4.3 days. Conclusions: This first explorative study indicates the need for more knowledge on morbidity among older primiparous women. They had a higher number of days with sick leave and hospitalization in the year before and after their delivery date. This might reflect higher health risks during pregnancy and childbirth among older women; however, social factors and reverse causation might also be influential.


2020 ◽  
Author(s):  
Qizhen Zheng ◽  
Hongzhan Zhang ◽  
Shiru Xu ◽  
Shan Xiao ◽  
Xuejin Wang ◽  
...  

Abstract Background: It is paramount to consider the appropriate preparation of the endometrium to receive the transferred embryos as the amount of frozen embryo transfer (FET) cycles is increasing worldwide. However, there remains lack of evidence about what is the most optimal protocol of endometrial preparation regarding pregnancy outcomes in different subgroup of infertile women. This retrospective cohort study was aim to explore the best endometrial preparation protocols among different maternal age groups.Methods: A total of 16870 FET cycles were categorized into three groups based on endometrial preparation protocols: Natural cycle (NC n=3893), artificial cycles (AC, n=11459) and AC with pretreatment with GnRH-a (AC+GnRH-a, n=1518). Logistic regression was performed to investigate the independent effect of endometrial preparation protocols on IVF pregnancy outcomes. Subgroup analyses were conducted to evaluate the most optimal endometrial preparation protocols for different maternal age groups.Results: In overall populations, after controlling for potential confounders, the incidence of live birth (NC as reference; AC: adjusted odds ratio (aOR) =0.840, 95%CI 0.774-0.912; AC+GnRHa: aOR=0.907, 95%CI 0.795-1.034) in NC was significantly higher than that of AC, while comparable to that of AC+GnRH-a. The early miscarriage rate (AC: aOR=1.413, 95%CI 1.220-1.638; AC+GnRHa: aOR=1.537, 95%CI 1.232-1.919) was significantly lower in NC compared to either AC group. In younger women, the live birth rates (AC: aOR=0.894, 95%CI 0.799-1.001; AC+GnRHa: aOR=1.111, 95%CI 0.923-1.337) were comparable between the three groups, with a slightly higher in AC+GnRH-a. Early miscarriage rate was only significantly lower in NC compared to that of AC without GnRH-a (aOR=1.452, 95%CI 1.159-1.820). While in older women, the incidence of live birth (AC: aOR=0.811, 95%CI 0.718-0.916; AC+GnRHa: aOR=0.760, 95%CI 0.626-0.923) was significantly higher, and early miscarriage (AC: aOR=1.358, 95%CI 1.114-1.655; AC+GnRHa: aOR=1.717, 95%CI 1.279-2.305) was significantly lower in NC compared to those of two AC groups.Conclusions: NC protocol is associated with lower early miscarriage late in overall IVF population. There is a mild favor of AC+GnRH-a in younger women, while the priority of NC is remarkable in older women. Maternal age should be a considerable factor when determine endometrial preparation method for FET.


2021 ◽  
Vol 9 (2) ◽  
pp. 374-394
Author(s):  
Denis N. Maslyuzhenko ◽  

Research objectives: To detect sources and stages for the formation of the concept of the “Siberian Tsardom” in the Russian chronicles and ambassadorial documents from the second half of the sixteenth century. Research materials: This work was carried out on the basis of the analysis of the published sources (chronicles, ambassadorial documents, charters and contracts, travelers’ notes, cartographic data). Results and novelty of the research: In the native historiography, the Shibanid states in the territory of Western Siberia are traditionally referred to as the “Siberian khanate”, terminology which dates back to the famous “Siberian Tsardom” in the Russian sources. An analysis of the written sources and cartography shows that during the fifteenth and first half of the sixteenth century, this notion was not used in any documents in relation to the Shibanids’ possessions. Such terms were most often connected with Tura or East Turan or Tyumen by the Russian authors. As the political interests of the Muscovite rulers expanded east of the Urals, the name “Siberian land” appears in the corresponding sources, which was quite clearly differentiated from neighboring Tyumen for a long time. Only in 1563, during tripartite negotiations of the representatives of the Shibanids, Taibugids, and Ruirikovichi in Moscow, did Siberia start to be connected with the tsardom. This, as well, demonstrates the enlargement of the possessions of Tyumen khans to the east, something which was recognized in the Muscovite State. Afterwards, other names of the Shibanids’ possessions were forgotten and in some cases the concept of the “Siberian Tsardom” or “Siberian Khan” came to refer to some earlier time and to be used for the Tyumen khans, Ibrahim and Kutluk. This reference to the past was created from historical examples which could be used to justify the notion of original Russian possession of the Siberian land. The concept of the “Siberian Tsardom” obviously reflected the interests of particular Muscovite political circles, because it allowed for the consideration of Kuchum Khan as a separatist who seized the throne which was previously in vassal dependence on Moscow, and likewise did not admit his dependence. This latter act legalized and justified the resulting military activities. This concept, elaborated by Moscow diplomats, justified the Siberian khanate being tied into a single category alongside the Kazan and Astrakhan khanates. Their accession could be considered not so much as an unjustified, illegal military aggression, but as an exercise of the right to establish an acceptable form of government for Moscow. The annexation of the Siberian khanate began to be seen as the return of original “fiefdoms” of the Russian sovereign, a right which he received from the old Russian dukes. However, we must understand that the idea of the longstanding tradition of this power was itself developed in Moscow no earlier than the 1570s. Thus, the choice of the name of the “Siberian Khanate (Tsardom)” to define the Shibanid states in the south of Western Siberia reflects the ideology of the Muscovite State from a historic point of view. It had little to do with how its rulers, the representatives of other post-Horde states, and the resident population would call it; for them, the concept of the “Tyumen Khanate” was much closer.


Sexual Health ◽  
2007 ◽  
Vol 4 (4) ◽  
pp. 312
Author(s):  
R. W. Jones

The incidence of vulval cancer is increasing especially in women under 50 years where the proportion of cases has doubled in the past 25 years. There are two forms of vulval cancer. The first is seen in younger women and is associated with high risk HPV infection (vulval intraepithelial neoplasia, VIN) and has many similarities with cervical cancer. The second is non-HPV related, seen in older women with chronic skin scarring, most commonly in long standing lichen sclerosus. The changing prevalence, clinical features, natural history and the influence of treatment on the precursor lesions will be presented.


1955 ◽  
Vol 6 (1) ◽  
pp. 1-17 ◽  
Author(s):  
Brian Tierney

‘Because of the obedience by which I am bound to the Apostolic See…filially and obediently, I do not obey, I oppose, I rebel.’ The more we learn of Robert Grosseteste's achievements as theologian and scientist the less likely does it seem that he will be remembered in the future—as he used to be in the past—principally for this letter of defiance concerning papal provisions in the diocese of Lincoln. Yet the letter itself remains something of an enigma in spite of all the attention it has received from a long line of scholars. It may seem an unprofitable task to go gleaning in a field where workers like Maitland and Sir Maurice Powicke have helped with the harvest, but we would suggest that Grosseteste's direct refusal to obey an unambiguous papal command has never been adequately analysed from one obvious point of view—as an extreme instance of a classical problem of political theory, the right to resist an unjust command of a divinely ordained power.


1999 ◽  
Vol 79 (9) ◽  
pp. 827-838 ◽  
Author(s):  
Richard L Gajdosik ◽  
Darl W Vander Linden ◽  
Ann K Williams

Abstract Background and Purpose. Therapeutic stretching of the calf muscle-tendon unit is used to increase its length and to ameliorate decreased dorsiflexion range of motion (ROM), but the influence of age on the passive properties of the calf muscle-tendon unit has not been studied adequately. The purpose of this study was to examine the influence of age on length and passive elastic stiffness (PES) characteristics of the calf muscle-tendon unit when stretched through the full, available dorsiflexion ROM. Subjects. Twenty-four younger women (aged 20–39 years), 24 middle-aged women (aged 40–59 years), and 33 older women (aged 60–84 years) participated. Methods. An isokinetic dynamometer was used to passively stretch the right calf muscle-tendon unit from relaxed plantar flexion to the maximal angle of available dorsiflexion at 5°·s−1. The maximal passive resistive torque was measured, and passive angle-torque curves were constructed for a full ROM from an initial angle of passive resistive torque to the maximal dorsiflexion angle. The full ROM represented length extensibility. The average PES was calculated for this full stretch ROM and for the first half and the last half of this stretch ROM. The maximal passive dorsiflexion angle, maximal passive resistive torque, angular change for the full stretch ROM, and average PES for the full stretch ROM and the first half and the last half of the full stretch ROM were examined for group differences and their relationships with age. Results. The maximal passive dorsiflexion angle, maximal passive resistive torque, angular change for the full stretch ROM, and average PES within the last half of the full stretch ROM were less for the older women than for the younger women. Age was negatively associated with these variables. Conclusion and Discussion. Decreased maximal passive dorsiflexion ROM in older women was associated with decreased maximal passive resistive torque, decreased calf muscle-tendon unit length extensibility, and decreased average PES within the last half of their available passive dorsiflexion ROM.


2016 ◽  
Vol 3 (4) ◽  
Author(s):  
Manju

Success in marriage is much more than finding the right person; it is a matter of being the right person. Husbands and wives relationship with each other affect the adjustment and mental health of couples. Marital happiness is very strongly linked to mental health. Marital dissatisfaction increases the problem of mental health of married couples. Depression is one of the most prevalent mental health problems. It can be caused by several factors, including interpersonal relationships. In keeping all these views in mind the present study was conducted on 200 women (100 younger and 100 old) in Haryana state. In results, Depression was negatively correlated with marital adjustment. Marital duration affects the marital adjustment. Younger women (less than five years of marriage) are more adjusted in comparison to the older women (more than 5 years of marriage).


Author(s):  
Oleksandr Kondratiuk

Coverage of the past requires, first of all, researcher’s understanding of the essence of the historical knowledge, skills on the principles of epistemology and historical science, using necessary scientific methods, objective reconstruction of the course of events. That is, he must know the ways of research and the ways of learning the past, in other words, he must be knowledgeable about the methodology of the historical science. The modern methodology of history is characterized by diverse, sometimes opposite approaches to the study of the historical past due to, first of all, differences in historians’ worldview and their understanding of a historical reality. All this leads to the formation of a polyvariant, pluralistic, nonlinear methodology. Starting a research, a historian must understand what theoretical principles he will rely on, from which point of view he will consider events and phenomena. At the same time, each researcher has the right to choose his own methodological foundations for comprehension of historical existence, to use logical constructions, principles and methods which, in his opinion, are most optimal for solving a specific scientific problem. Investigating the development of shipbuilding in the South of Ukraine in 1945–1991, the author supports the dialectical understanding of history, believing that dialectics captures (reflects) the most characteristic features of the development. Choosing dialectics and the theory of modernization as the main philosophical approaches, the principles of objectivity, historicism, systematicity, pluralism and modern methodological tools makes it possible to solve the tasks and achieve the goal of a concrete historical research of the development of shipbuilding in the South of Ukraine in 1945–1991.


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