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Cardiothoracic Surgery in the Elderly: Evidence Based Practice is an important and timely book that reflects the thoughtful work of pioneers in geriatric surgery. It encompasses their knowledge related to geriatric surgery, and their reflections and guidance on the rapidly accumulating knowledge related to improving the health and surgical care of seniors. This book provides a scholarly review of the constantly expanding knowledge base about cardiovascular and thoracic surgery in seniors. The book follows a logical sequence covering general aspects of care, cardiac surgery and thoracic surgery. Chapters are focused on common, devastating and often missed complications of surgical care in the seniors. These include delirium, depression, pressure sores, functional losses, incontinence, volume depletion and asymptomatic or atypical complications -myocardial infarction, post-operative diarrhea, urinary track infections and pneumonia. Each is expertly reviewed. Strategies to help the surgeons and the surgical team anticipate, recognize and effectively prevent or manage such problems are discussed and the evidence basis for such strategies is provided. Cardiothoracic Surgery in the Elderly: Evidence Based Practice is particularly timely and the first to review the substantial body of knowledge that has been developed in recent years related to geriatric cardiothoracic surgical problems. It catalogs well the expanding knowledge basis for achieving successful surgical outcomes in the very old. It provides a most useful resources for cardiovascular thoracic surgeons in training and those already in practice.
Increasingly, we hear of more and more elders falling victim to financial exploitation. Although this form of elder abuse has been recognized for years, its incidence, prevalence, and impact on the common individual has been only more recently brought to the spotlight. Despite these circumstances, recognition of risk factors and indicators of financial exploitation are not widely disseminated. Additionally, once situations are identified and confronted, the knowledge of what to do next is lacking. These gaps are present within the medical community, law-enforcement, and the finance community areas where opportunities for recognition and intervention are common. Our elders often have no idea of what to do when they see their own risk or when they fall victim. "Aging and Money: Reducing Risk of Financial Exploitation and Protecting Financial Resources "helps clinicians to integrate identification of such indicators of abuse into their geriatric assessment as well as guide them in performing an assessment of an individuals financial decision making capacity when appropriate.
"Aging and Money: Reducing Risk of Financial Exploitation and Protecting Financial Resources" is an essential new text that provides the practicing clinician with information on identifying risk factors and clinical clues associated with financial exploitation and how to incorporate these steps into their practice."
Oxidative Stress in Aging: From Model Systems to Human Diseases discusses the role of free radicals in aging in different animal models, as well as the relevance of free radicals on age-related diseases and pathological conditions in humans (following an introduction section of the basics and theory of free radicals). Human aging is a complex phenomenon - not everyone gets the same diseases and dies from the same cause. Accumulating reports implicate the connection between free radicals and various diseases and age-related pathological conditions. Although the causal relationships have not been established, it is necessary to discuss how free radicals are involved in each situation. In addition, the major interventions trials of antioxidant supplements in age-related disease, cancer and so forth are reviewed and discussed.
Indications for central venous cannulation in critically ill patients have increased dramatically in recent years owing to the use of more complex therapies unsuitable for delivery via peripheral veins. The main drawbacks of central venous access are morbidity and the growing scarcity of experienced operators. Ultrasound-guided peripheral venous access offers a solution, in that it reduces morbidity and can be performed by a dedicated nursing team. The aim of this book is to teach the fundamentals of this emerging technique. Advice is provided on the choice of materials and on vein selection. The advantages and disadvantages of peripherally inserted central venous catheters (PICC) in relation to other types of central venous catheter are discussed, and the principles of use and practical applications of ultrasound for venipuncture are explained. Maneuvers for PICC positioning, techniques for the evaluation of PICC tip placement, and the prevention, diagnosis, and management of complications are all described in detail. Advice is also provided on the organization of a dedicated PICC team within a hospital or a supportive care program, and psychological, legal, and economic issues are considered. Peripherally Inserted Central Venous Catheters will be of interest to a wide range of professionals, including nutritionists, oncologists, anesthesiologists, surgeons, registered nurses, nurse practitioners, physicians, physician assistants, and radiologists.
The ageing process changes body composition and thus nutritional status changes as one gets older. At the same time the body becomes more susceptible to diseases and diet becomes an even more significant or at least visibly significant than in earlier years. Moreover, there is frequently socio-economic downward drifting in this age group making nutritious foods more difficult to afford. This new book presents leading-edge research from around the world.
Caring for people with disabilities often becomes an all-encompassing responsibility for one or more family members. To manage the multifaceted demands, caregivers must possess strong multitasking skills, including the ability to assist with daily life tasks; provide emotional support; help with financial affairs; mediate and advocate with health care providers. Maintaining balance within their own lives can become incredibly challenging for caregivers. More often than not, providing care for family members or loved ones occurs at the expense of the caregivers' well-being. And for caregivers who themselves have disabilities, it further complicates matters. Multiple Dimensions of Caregiving and Disability addresses concerns that have been long familiar to the caregiver population and examines the current state of family care for individuals with disabilities. With a lifespan perspective, this concise reference reviews the literature on specific problems of caregivers and explores which care strategies are effective, promising, or lacking in available resources and support interventions. Contributors also explore the more fluid and subjective aspects of caregiving, such as feelings, spirituality, and family roles. Suggestions for future policy improvements, particularly within the public health sector, are discussed as well. Topics covered include: * Family dynamics and caregiving for people with disabilities. * Parent caregiving of children with disabilities. * Race, ethnicity, socioeconomic status, and caregiving. * Educational, training, and support programs for caregivers. * Emerging technologies to aid caregivers. * Developing partnerships between caregivers and health care providers. Multiple Dimensions of Caregiving and Disability is a must-have resource for researchers, scientist-practitioners, policy makers, and graduate students across such disciplines as clinical psychology, nursing, social work, public health, medicine, and social and education policy.
Disaster Preparedness for Seniors: A Comprehensive Guide for Healthcare Professionals outlines specific disaster scenarios for homebound, community, hospitalized, long term care, homeless and aged veterans. Chapters are written by a diverse group of authors, all of whom offer insight and expertise in training healthcare professionals in preparing for disasters. Topics include myths and realities of natural disasters and disaster preparedness for special populations of elders-the acute care elderly, the community-dwelling elderly, home based primary care senior veterans, the immune-compromised elderly, those with multiple and co morbid illnesses, the long-term care elderly, those elderly at the end of life and the effects of disaster on caregivers. A significant portion of the book is also devoted to training, competencies, literacy, cultural competency and resilience in disaster preparedness as well as the role of the academic medical center. The volume concludes with coverage of the management of behavioral, medical and psychological consequences of disasters. Disaster Preparedness for Seniors: A Comprehensive Guide for Healthcare Professionals is an important new volume and will serve as a guide for the development of programs, policies and procedures for evacuation of seniors during various disaster scenarios.
This volume collects the foundation papers in the discipline of Geriatric medicine. The book begins with a chapter on those papers that established the field. It then goes on to provide a long overdue review of the important "classic" papers in geriatric medicine and includes information on the development of health systems which support the care of older patients. Each chapter begins with a commentary by a faculty member with special interest or expertise in that area.
Human immunosenescence contributes to morbidity and mortality in later life. The age-associated increasing incidence of cancer and cardiovascular disease plateaus at around 80 years of age in industrialised countries, but death due to infectious disease continues to increase up to 100 years of age and beyond. Understanding the reasons for age-associated alterations to protective immunity in the elderly would facilitate the development of interventions to reconstitute appropriate immune function, increase responsiveness to vaccination and extend healthspan. The majority of the papers collected in this volume therefore address not only the mechanisms responsible for immune ageing in humans but consider what might be accomplished to redress the erosion of immune competence with age. The first problem facing the gerontologist investigating human ageing is their longevity: most studies are conducted in a cross-sectional manner, in which parameters of interest in elderly cohorts are compared to young controls. However, the ageing trajectories of people now 80 years old, born at the beginning of the 20th century, will have been very different in mostly unidentifiable ways from those born towards the end of that century. These differences include population genetics, nutrition, stress, disease, and of course, medical treatment, all of which make these two populations hardly comparable.
Geriatric urology represents one of the largest overall sectors of care provided within the specialty of urology. As the incidence and prevalence of many clinical urologic conditions increase significantly in older adults, the practice of urology involves a need for advanced knowledge of the basic principles of geriatrics. Geriatric Urology outlines important topics in the care of elderly urology patients. The first section covers the biology of aging, changes in the genitourinary system, and common diseases including urologic conditions that may serve as warning signs of other disorders. Section two covers geriatric syndromes and implications for urologic care including frailty, polypharmacy, dementia, and wound healing. Urologic conditions in older adults are explored in detail including urinary incontinence, pelvic organ prolapse, urinary tract infection, nocturia, and benign prostate diseases. Other topics covered include obtaining informed consent, development of advance directives, palliative medicine and care of the dying patient. Geriatric Urology is of great value to urologists, geriatricians, internists, residents and family practitioners.
This volume discusses the current state of research findings related to healthy brain aging by integrating human clinical studies and translational research in animal models. Several chapters offer a unique overview of successful aging, age-related cognitive decline and its associated structural and functional brain changes, as well as how these changes are influenced by reproductive aging. Insights provided by preclinical studies in mouse models and advanced neuroimaging techniques in humans are also presented."
Population growth slowed across the world in the last decades of the 20th century, changing substantially our view of the future. The 21st century is likely to see the end to world population growth and become the century of population aging, marked by low fertility and ever-increasing life expectancy. These trends have prompted many to predict a gloomy future caused by an unprecedented economic burden of population aging. In response, industrialized nations will need to implement effective social and economic policies and programs.
This is the final volume in a series of three. The papers included explore many examples and strengthen the basis for effective economic and social policies by investigating the economic, social, and demographic consequences of the transformations in the structures of population and family. These consequences include changes in economic behavior, both in labor and financial markets, and with regard to saving and consumption, and intergenerational transfers of money and care.
As the population ages, clinicians are facing an increasing number of elderly patients with colorectal cancer. These patients pose unique challenges as they have more comorbidities and lower functional reserves. In addition, the treatment goals may differ from those in younger patients. This book discusses in depth the different aspects of management of colorectal cancer in the elderly. After the provision of pertinent background information on the normal physiology of aging, screening and diagnosis are discussed. Subsequent chapters focus on a range of issues associated with the surgical and perioperative care of these patients and with adjuvant treatment and palliative care. Each chapter provides helpful take-home messages in bullet point form, and numerous informative figures and tables are also included. The authors are surgeons, physicians, anesthetists, geriatricians, oncologists, and allied health professionals with extensive experience in the field.
Some of the most serious consequences of aging are its effects on skeletal muscle. Sarcopenia', the progressive age-related loss of muscle mass and associated muscle weakness, renders frail elders susceptible to serious injury from sudden falls and fractures and at risk for losing their functional independence. Not surprisingly, sarcopenia is a significant public health problem throughout the developed world. There is an urgent need to better understand the neuromuscular mechanisms underlying age-related muscle wasting and to develop therapeutic strategies that can attenuate, prevent, or ultimately reverse sarcopenia. Significant research and development in academic and research institutions and in pharmaceutical companies is being directed to sarcopenia and to related health issues in order to develop and evaluate novel therapeutics. This book provides the latest information on sarcopenia from leading international researchers studying the cellular and molecular mechanisms underlying age-related changes in skeletal muscle and identifies strategies to combat sarcopenia and related muscle wasting conditions and neuromuscular disorders. The book provides a vital resource for researchers and practitioners alike, with information relevant to gerontologists, geriatricians, sports medicine physicians, physiologists, neuroscientists, cell biologists, endocrinologists, physical therapists, allied health and musculoskeletal practitioners, strength and conditioning specialists, athletic trainers, and students of the medical and biomedical sciences.
This book focuses on extrapyramidal signs and symptoms of all types of dementia, and addresses the issue of the artificial boundary between dementias and Parkinsonism, which represent the two most common symptoms found in degenerative central nervous system diseases. In Movement Disorders in Dementias, movement disorder specialists from around the world write on topics generally restricted to dementia experts. Important motor issues related to either medication in demented patients (drug-induced movement disorders) or manifestations common to all forms of dementia, regardless of underlying cause (gait disorders, falls, fear of falling), is followed by analysis of the relationship between motor and cognitive symptoms, from their common pathogenesis to specific medical treatments. Movement Disorders in Dementias is aimed at general neurologists, dementia specialists, movement disorders specialists, neuropsychologists and geriatricians.
This book is a study of the neurobiology of Alzheimer's disease. The authors critically review the established and accepted culprit in Alzheimer's disease, the amyloid, the main molecular factor of neurodegeneration in this disease. This book provides a synopsis of current information about ischemic cellular and molecular mediators involved in Alzheimer's neuropathology as well as interactions between these mediators that influence pathology. Current knowledge on the relation between ischemia-reperfusion factors and Alzhemier's-type demential are reviewed as well as the linking of B-amyloid deposition to neuronal damage and clinical disease.
Alzheimer's disease (AD), the most common type of neurodegenerative disorder in the aging population, is characterised pathologically by extracellular amyloid plaques and intracellular neurofibrillary tangles, pathophysiologically by synaptic dysfunction, and clinically by a progressive dementia. The rapid progress in the research fields of AD and dementia continues since the publication of the first book volume with the same title. This second book volume contains 14 chapters, bringing together a presentation of research frontiers in current AD/dementia research. The topics range from defining deregulation of amyloid precursor protein (APP) processing and neurotransmitter and signal molecules involved in regulation of APP processing, transgenic AD mouse models and their relevance to AD research, amyloid -peptide (A) immunisation, cerebral inflammation, myelin breakdown, roles of deregulation of cell cycle in AD pathology, relationship between cholesterol and AD, A binding to cholesterol and cholesterol oxidation, A-binding alcohol dehydrogenase and roles in AD pathogenesis, sex steroids, oestrogen therapy for AD prevention, behavioural and psychological symptoms of AD, memantine for AD therapy, enoxaparin as a therapeutic agent for AD, to molecular links between AD and traumatic brain injury. The prospects for developing effective therapeutic agents that target memory-relevant AD pathogenesis, as shown in these chapters written by world-wide leaders in the fields, are more encouraging. The book will be highly valuable to students and scientists world-wide who are interested in the scientific research progress in AD and dementia.
With the aging of the baby boomers and medical advances that promote longevity, older adults are rapidly becoming the fastest growing segment of the population. As the population ages, so does the incidence of age related disorders. Many predict that 15% - 20% of the baby-boomer generation will develop some form of cognitive decline over the course of their lifetime, with estimates escalating to up to 50% in those achieving advanced age. Although much attention has been directed at Alzheimer's disease, the most common form of dementia, it is estimated that nearly one third of those cases of cognitive decline result from other neuropathological mechanisms. In fact, many patients diagnosed with Alzheimer's disease likely have co-morbid disorders that can also influence cognition (i.e., vascular cognitive impairment), suggesting mixed dementias are grossly under diagnosed. The Clinical Handbook on the Neuropsychology of Aging and Dementia is a unique work that provides clinicians with expert guidance and a hands-on approach to neuropsychological practice with older adults. The book will be divided into two sections, the first addressing special considerations for the evaluation of older adults, and the second half focusing on common referral questions likely to be encountered when working with this age group. The authors of the chapters are experts and are recognized by their peers as opinion leaders in their chosen chapter topics. The field of neuropsychology has played a critical role in developing methods for early identification of late life cognitive disorders as well as the differential diagnosis of dementia. Neuropsychological assessment provides valuable clinical information regarding the nature and severity of cognitive symptoms associated with dementia. Each chapter will reinforce the notion that neuropsychological measures provide the clinician with sensitive tools to differentiate normal age-related cognitive decline from disease-associated impairment, aid in differential diagnosis of cognitive dysfunction in older adults, as well as identify cognitive deficits most likely to translate into functional impairments in everyday life.
Best of Five MCQs for the Geriatric Medicine SCE is the first revision guide designed specifically for this new high-stakes exam. It contains 300 best of five questions with explanatory answers, each accurately reflecting the layout of questions in the exam. The book is divided into three exams for trainees to test themselves on, providing a thorough assessment of the candidate's geriatric medicine knowledge and covering all the main themes of the exam, for example, falls, dementia and delirium, palliative care, nutrition, and stroke. The explanatory answers include references to guidelines and other sources to enable candidates' further reading and study. Ideal for Geriatric Medicine Specialty Registrars, trainees revising for the Geriatric Medicine Specialty Certificate Examination or the Diploma in geriatric medicine.
Dementia is a brain disorder that seriously affects a person's ability to carry out daily activities. The most common form of dementia among older people is Alzheimer's Disease (AD), which involves the parts of the brain that control memory, thought and language. Age is the most important known risk factor for AD. The number of people with the disease doubles every 5 years beyond the age of 65. AD is a slow disease, starting with mild memory loss and ending with severe brain damage. The course the disease takes and how fast changes occur vary from person to person. On average, AD patients live from 8 to 10 years after they are diagnosed, though the disease can last for as many as 20 years. Current research is aimed at understanding why AD occurs and who is at greatest risk for developing it, improving the accuracy of diagnosis and ability to identify who is at risk, developing, discovering and testing new treatments for behavioural problems in patients with AD. This new book gathers state-of-the-art research from leading scientists throughout the world which offers important information on understanding the underlying causes and discovering the most effective treatments for Alzheimer's Disease.
The rapidity of scientific progress over the last few years guarantees the utility of a new collection of state-of-the-art reviews on the immunology of ageing. The aim of this authoritative book is to summarize current knowledge on the cellular and molecular aspects of the ageing immune system and their clinical relevance. The book is a result of extensive collaboration of more than sixty of the greatest thinkers and scholars in the field, in cooperation with a number of junior colleagues. Immunology of Aging presents the most up-to-date information on the scientific issues addressed by research into ageing of the immune system, providing insights into the effects of this process on susceptibilities to those diseases which are most common among elders. The retrieval strategies used to slow down the decline in the immune system in the elderly are another subject detailed extensively. By providing a broad overview of immunosenescence and its consequences, as well as their potential modulation, this book will fill a gap in a timely manner. It will be of value to all immunologists, whether novice or experienced, as well as geriatricians and epidemiologists.
Old age is associated with a number of medico-social problems such as: hypertension, diabetes mellitus, thyroid disorders, osteoarthritis, tremor, pain, gait and balance impairment, incontinence, urinary tract infection, sarcopenia, osteoporosis, polypharmacy, pressure ulcers, sleeping problems, cardiocerebrovascular disorders, fluid and electrolyte disturbance, nutritional disorders, immunisation and disease prevention rehabilitation and care. The management of these problems differs significantly between younger and older adults. All of these problems are evaluated in this book in two parts with the contributions of experienced clinicians and researchers. In addition, cellular aging, comprehensive geriatric assessments, and medicolegal and ethical principles in geriatric medicine are also evaluated. This book will be a valuable tool for all clinicians involved in the management of elderly people.
Vascular dementia is one of the most common forms of mental deterioration for the elderly, second only to Alzheimer's disease. It should not be defined as a single disease, but rather as a group of syndromes that relate to different vascular mechanisms. This is one of the first books to be solely dedicated to the specific class of vascular dementia known as subcortical vascular dementia. The strict focus of the chapters give an depth review that will clarify many different aspects and give an unprecedented amount of detail about this clinical problem. Considering that vascular dementia can be prevented with early diagnosis, the research presented in this book will be important for both students and specialists of this important field.
Effective, meaningful caregiving requires a well-coordinated and informed effort guided by various highly skilled specialists across several interrelated professions, including psychologists, social workers, and occupational therapists. Multidisciplinary Coordinated Caregiving addresses the information needs of these interrelated professionals, contributing to the direct care of individuals and serving as an essential resource for those who ultimately create collaborative approaches to contemporary caregiving plans. In addition, the volume provides a wealth of evidence-based research findings to facilitate ongoing dialogue about multidisciplinary and interdisciplinary perspectives on and interventions for the complex challenge of caregiving in America. Key areas of coverage include: * The status of professional caregiving in the United States. * Nursing perspectives on the state of family caregiving. * Psychological aspects of caregiving. * A human development, lifespan perspective on caregiving during late life. * Public health contributions to caregiving. Multidisciplinary Coordinated Caregiving offers a wealth of insights for those researchers, practitioners, and graduate students who seek to optimize the care of individuals across such fields as psychology, social work, public health, geriatrics and gerontology, and medicine as well as public and educational policy making.
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