Awareness regarding healthy human reproduction is of utmost importance. It has been emphasized by different health authorities like The Centers for Disease Control and Prevention of the United States and World Health Organization that infertility poses serious and considerable public health consequences. Among these, psychological distress, marital problems and stigmatization should be highlighted. Moreover, fertility treatments are costly and not always result in a take-home baby as oftentimes several cycles of assisted reproductive techniques are needed. This results in added psychological and economic strain for the couple who may already be struggling in their relationship.

Most of the time, the hopes and responsibility of a successful ART cycle are put onto the physician´s and laboratory´s shoulders, but science is proving that patients can, and should, do their part. Lifestyle intervention seems to be able to have a positive effect on the outcome of these techniques. In fact, it may have an effect on the psychoemotional status of patients, which can further modulate such outcomes. Research has shed light also on how the emotional status of the mother to be can affect the embryo/fetus. It is clear how physical and chromosomal anomalies are passed on, but very little importance has been given to how the emotional status of the mother could affect the baby´s wellbeing. Now it seems evident that even our emotional experiences are somehow passed on through epigenetic mechanisms. By means of lifestyle interventions, including mind-body protocols, fertility may be improved, and maybe it can even have an effect on the future newborn. What seems to make sense is that… healthy gametes make healthy babies.

Highlighted book Fertility, Pregnancy, and Wellness

Senior Editor – Diana Vaamonde

Post-Doc: Endometriosis (female reproductive pathology)

Main area of research: Exercise and Human Reproduction. Lifestyle and mind-body interventions for fertility and pregnancy.

Human Anatomy and Embryology Professor since Dec 2004 (Degrees of: Medicine, Nursing, Physical Therapy). Professor of Master’s Degree in Assisted Reproductive Techniques. Clinical embryologist. Pre-congress course coordinator of the PCC8 Andrology of the 32nd Annual Meeting of European Society for Human Reproduction and Embryology (ESHRE). Helsinki, Finland. July 2^nd, 2016 (title: “The impact of exercise, sport and doping on human fertility”). Invited sessions on the effect of exercise and lifestyles on gamete quality (Helsinki, Istanbul, Barcelona, etc).

Director of three Ph.D. theses on the effect of exercise on reproduction (animal model) and antioxidant therapy. Director of end of degree dissertations on the areas of fertility and exercise and lifestyle and fertility (titles: “The role of the nurse in assisted reproduction”; “Effect of physical exercise during pregnancy”; “The impact of women´s emotional status on assisted reproduction”; “Effect of physical exercise on the outcome of an assisted reproduction cycle”; “Use of complementary and alternative therapies in fertility”)

Author of books and research articles on fertility and human reproduction and the effects of exercise and lifestyles on both male and female fertility. 

Editor – Anthony C. Hackney, Professor, University of North Carolina, Chapel Hill, NC, USA

B.A. – Health & Human Performance

M.A. – Exercise Science & Sports Medicine

Ph.D. – Exercise Physiology/Nutrition

D.Sc. – Sports Physiology

Dr. Hackney’s research focus is CENTERS on endocrine and metabolic responses to physical stress (e.g., exercise). He HAS directed research for the Department of Defense into the human endocrine and metabolic adaptations associated with chronic cold exposure in humans. He conducts research on how reproductive steroid hormones are modulated by the stress of physical exercise. He is the author of more than 100 publications in the endocrinology and exercise physiology area. Dr. Hackney teaches undergraduate and graduate courses in basic human physiology and exercise physiology. He lectures in the medical school on biochemistry and endocrinology. Dr. Hackney is a member of Sigma Xi, American College of Sports Medicine, Southeast American College of Sports Medicine and Triangle Consortium for Reproductive Biology. Currently, he is an external reviewer for the U.S. Department of Agriculture, Human Nutrition division, the National Academy of Sciences-Institute of Medicine and the U.S. Army, Department of Defense. Dr. Hackney is a two-time recipient of Fulbright Scholar awards, one in Medical Sciences (in Lithuania) and one in Public Health (in Poland). He currently serves as the Assistant Chairman of the Department of Exercise & Sport Science.

Editor – Juan Manuel García-Manso, Professor, University of Las Palmas de Gran Canaria, Canary Island, Spain

B.A. – Exercise Science

M.A. – Elite Sports Performance

Ph.D. – Sports Sciences

Author of twenty-eight books in sports training and over 100 research articles, some versing on the effects of exercise on both male and female fertility.

HOW THE BOOK CAME TO BE

Years ago, the seed of this book was engendered from dedicated practice and study in the fields of human fertility, human-assisted reproduction, and exercise sciences. After gaining understanding on the numerous factors that modulate fertility and the chances of conceiving and carrying a baby to term, I NOTICED THAT the unchartered space REGARDING matters of lifestyle interventions for improving pregnancy rates deserved closer attention.

In the beginning, my own beliefs were aligned to a more physical realm, focusing on exercise and nutrition, but as new experiences unfolded, I came to the realization that there was much more to reproduction than just a physicality. My focus and interest started shifting and embracing more integrative approaches due to a deeper understanding and empathy ON how much pressure, stress, and anxiety sub-fertile couples could experience. Moreover, the so-called idiopathic infertility (unknown cause) has always been a challenge, given that, despite no apparent blockages to fertility, these couples do not achieve pregnancy. Over time, gradually, more studies began to add the scientific evidence of how emotional status affects fertility and also how fertility issues affect the emotional landscape; what a vicious cycle that can become! Having worked in clinical in vitro fertilization, I had witnessed many women challenging their physical, mental, emotional, and economic boundaries with the desire to have a baby. All expectations and efforts were put onto science, but amazingly few recognized they could help science by taking care of their body and mind. Accordingly, this VOLUME covers a large spectrum of topics from physiological to behavioral to psychological.

It is essential to highlight and acknowledge the vital role of my coeditors during the writing process. Their belief in the project from its inception has been matched along the way with continuous support and invaluable insights. They have shared an incredible amount of experience in the field of sport sciences and incalculable wisdom from years of practice, thereby allowing this project to take shape. A practical and effective convergence of study, research, knowledge, practice, and many twists and turns of life have brought this book to fruition.

This book, Fertility, Pregnancy, and Wellness has been created with much enthusiasm and purposefulness in hoping that the reader will greatly benefit from a vast amount of information and years of experience on a variety of related topics. Enjoy reading it!

–Diana Vaarmonde

Fertility, Pregnancy, and Wellness is designed to bridge science and a more holistic approach to health and wellness, in particular, dealing with female-male fertility and the gestational process. Couples seeking to solve fertility issues for different reasons, whether failed assisted reproductive techniques or the impact of emotional, economic, or moral reasons they may entail, are demanding more natural ways of improving fertility. This unique resource fills that gap. As healthcare-medicine develops, it is becoming clearer that health is not only a physical matter but also has to do with the emotions and psychology of any individual. Recently, society has witnessed a shift in paradigm from just using medications which, in the reproductive field, can be very expensive and not accessible to the entire population, to using lifestyle modifications and emotional support as adjunctive medicine therapies. This encompasses a wide, diverse audience that needs concise, evidence-based research.

Professionals dealing with infertility issues, pregnancy, and overall health and wellness need critical information of “what is known,” “what is not known,” and how science and research are going moving forward. This reference nicely brings together the current knowledge – highlighting the gaps – and delivers an important resource for numerous specialists and practitioners.

Chapter 8, Microbiome and Pediatric Obesity, malnutrition, and nutrition  

Gregory C.Valentine, ¹Amy B.Hair,²Camilia R.Martin³⁴

Within each individual reside trillions of microorganisms composing the human microbiome. Approximately 3.8×10¹³ bacteria are living among an estimated 0.3×10¹³ nucleated human cells—a 10:1 ratio of bacteria to nucleated human cells [1]. Bacteria composing our human enteric microbiota can serve as commensals, promoting significant health benefits including vitamin and metabolite production and promotion of a healthy intestinal barrier to prevent infection. Conversely, dysbiosis of the enteric microbiome contributes to the pathogenesis of intestinal and systemic diseases. Thus the human microbiome plays an integral role in promoting or impeding a state of healthy living.

Chapter 3 Power to the people: local ownership of infectious disease control

Sebastian Kevany,

In the post-colonial era, the concept of country ownership and local ownership of infectious disease or other global health programs has increased in prominence and importance. While in many settings this is related to the transfer of funding and resourcing to local actors in order to reduce dependence on aid, from the barefoot diplomacy perspective it is also critical that local ownership engenders a sense of community investment—of pride in the program. This, in turn, relates to questions of sustainability and transferability of health responsibilities to local actors—all of which need to be managed with the principles of diplomacy and international relations in mind. The techniques by which this can be achieved—ranging from the development of local community advisory boards, to the certification of local ownership of programs, to the solicitation of other sources of local advice and expertise on what program will function best in each setting—are explored here.

Chapter 10: Cancer Immunology

Jeffrey K. Actor

To investigate natural (effective) responses to tumor development and formulate how immune components function to eliminate potentially dangerous precancerous events. This will be followed by a discussion of challenges faced when protective responses fail and tumors develop. Categories of tumor antigens will be described, related to their impact on self-recognition. A review of effector mechanisms in tumor immunity will be given, and there will be information on cancers of the immune system when the protective cells themselves become the cause of tumorigenic activity. Finally, aspects of immunodiagnosis and immunoprophylaxis will be addressed.

The field of cancer immunology investigates interactions between the immune system and tumors or malignancies. At the heart of this is the specific recognition of cancerous cells and the antigens they express. In essence, this is the concept of natural immunosurveillance, proposed in 1957 by F.M. Burnet and L. Thomas. They suggested that lymphocytes act as sentinels to recognize and eliminate continuously arising and nascent transformed cells. A stepwise immunosurveillance process ensues, beginning with the recognition and elimination of dysregulated cells; both innate and adaptive immune cells recognize and kill tumors at early stages during development. A balanced state of equilibrium can be assumed, representing the control of cellular and tissue growth. In time, there is the potential for cellular escape from naturally protective responses, resulting in tumor pathogenesis.

Encyclopedia of Biomedical Gerontology

Pages 210-222, Health and Social Care Services Organization for Older Adults

Natalie McNeela, Amit Arora, Peter Crome

Geriatric medicine is a complex speciality treating any condition experienced in the over 65s. With the changing demographic of older age and increasing life expectancy, it has evolved into a speciality of multimorbidity; treating chronic disease and frailty, while attempting to prevent deconditioning. The Comprehensive Geriatric Assessment remains gold standard treatment, improving life expectancy and reducing risk of progression to a care home in those who receive the complete assessment.

In addition, social care has also adapted with increased focus on community care and facilitation of independent living. Personalized care plans and named care coordinators are now standard to ensure the older adult receives the care they need along with a plan for expected deteriorations.

However both the health and social sectors are under increasing strain both financially and from increased numbers. Coordinated health and social care integration is the only solution to this problem and pilots are in place assessing the viability of this. Technology can also help and companies are developing assistance aids through robotics and artificial intelligence. By complete integration and implementation of the above each older person can receive the gold standard health and social care.

Mycotoxins and Mycotoxigenic Fungi: Risk and Management. A Challenge for Future Global Food Safety and Security

 Claudio Altomare, Antonio F. Logrieco, Antonia Gallo

Food safety is a priority for humanity. A major menace for food safety is represented by mycotoxins, toxic secondary metabolites produced by molds that infect field crops and which contaminate raw agricultural commodities as well as processed foods and feeds. These fungal toxins exhibit a number of adverse health effects in animals, even at very low concentrations, and have been associated to cases of acute and chronic poisoning of humans and farm animals since historical times. Mycotoxins not only jeopardize the health of consumers and livestock, but they are also a concern for international trading and an important issue for national and international regulatory bodies, which have to cope with the necessity to set limits for mycotoxin content in foods and feeds and harmonize standards throughout the world taking into account both consumers’ safety and social and economic impact of regulatory measures. Mycotoxin occurrence cannot be completely avoided, but a number of measures aiming at minimizing mycotoxin levels and mycotoxin exposure can be implemented at multiple point in the food and feed chains. These include pre-harvest and post-harvest strategies, guidelines for crop production, storage and processing, enforcement of guidance and regulatory maximum levels for some mycotoxins, surveillance programs and, finally, dietary interventions. This article offers an overview on the main mycotoxins and the relevant producing molds, including their economic and health impact, epidemiology, biosynthesis and genetics, regulation and management. The cutting-edge challenges posed by emerging and masked mycotoxins, the co-occurrence of multiple mycotoxins and the prospects of mycotoxin outbreaks in a world climate change scenario are also discussed.

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