This book aims to provide an up-to-date review of the literature in each of the major areas relating to the management of older gynecological cancer patients, and makes recommendations for best practice and future research. The authors come from a broad geographic spread including the UK, mainland Europe and North America to ensure a worldwide relevance.

Assisting someone with Alzheimer's disease or another illness that causes dementia is incredibly demanding and stressful for the family. Like many disabling conditions, Alzheimer's disease leads to difficulty or inability to carry out common activities of daily life, and so family members take over a variety of tasks ranging from managing the person's finances to helping with intimate activities such as bathing and dressing. Key coverage in Caregiving for Alzheimer's Disease and Related Disorders includes: Early diagnosis and family dynamics Emotional needs of caregivers Developmentally appropriate long-term care for people with Alzheimer's Family caregivers as members of the Alzheimer's treatment Team Legal and ethical issues for caregivers Faith and spirituality The economics of caring for individuals with Alzheimer's disease Cultural, racial, ethnic, and socioeconomic issues of minority caregivers Advances in Alzheimer's disease research Caregiving for Alzheimer's Disease and Related Disorders offers a wealth of insights and ideas for researchers, practitioners, and graduate students across the caregiving fields, including psychology, social work, public health, geriatrics and gerontology, and medicine as well as public and education policy makers.

Drug-related problems in the elderly is intended to serve as a source of information and clinical support in geriatric pharmacotherapy for students as well as all health care professionals, e.g. physicians, nurses and pharmacists. Pharmacotherapy is of great importance to all mankind. Drugs are however powerful and must be handled appropriately. This is especially important for elderly patients. Drug-related problem is not a major subject in most university programmes in medicine or pharmacy. When there is no speci c course, there is often no book covering the topic. In our view, as teachers at various university courses, there has been a shortage of literature that re ects the most important aspects of drug-related problems in the elderly. Medical practitioners, nurses and pharmacists, need to have this knowledge to be able to serve their patients in the best way. This book covers most aspects of drug-related problems in the elderly. With b- ter knowledge of drug-related dif culties and risks we hope that elderly will have fewer drug-related problems and bene t more from their pharmacotherapy.

That precursors of adult coronary artery disease, hypertension, and type II diabetes begin in childhood have been clearly established by the Bogalusa Heart Study. This unique research program has been able to follow a biracial (black/white) population over 35 years from childhood through mid-adulthood to provide perspectives on the natural history of adult heart diseases. Not only do these observations describe trajectories of cardio-metabolic risk variables leading to these diseases but provide a rationale for the need to begin prevention beginning in childhood. The trajectories of the burden of cardio-metabolic risk variables in the context of their fetal origin and chromosome telomere dynamics provide some insight into the metabolic imprinting in utero and aging process. The observed racial contrasts on cardio-metabolic risk variables implicate various biologic pathways interacting with environment contributing to the high morbidity and mortality from related diseases in our population. To address the seriousness of the onset of cardiovascular disease in youth, approaches to primordial prevention are described focussing on childhood health education as an important aspect of Preventive Cardiology.

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.

Healthcare Changes Reach Main Street: A Call to Action for Physicians provides guidance, examples, and information on processes and time lines for physicians based on the implementation of The Affordable Care Act (ACA) that was established in 2010. This volume focuses on how geriatricians and other healthcare professionals can be engaged in responding to the roll-out of the ACA in their communities, and through this engagement assume leadership roles in local hospitals, healthcare organizations, and medical societies to advance quality improvement and new models of care for older adults. In-depth chapters provide an update on quality improvement efforts at the state level, as well as changes in Medicaid financing and the significant impact this will have for older adults, particularly dual-eligibles. Many elements of the ACA are yet to be rolled out and many healthcare decisions are yet to be made. Healthcare Changes Reach Main Street: A Call to Action for Physicians will guide healthcare decision makers and help them to play a leadership role in advancing quality care for older adults in our changing healthcare environment.

Due to improvements in health and healthcare, the elderly population is expanding rapidly within the developed world. However, more and more elderly people require some form of psychological support at some point in their later years. The types of problems faced by this population are quite distinct and often more complex than those faced by younger adults, and throw up many new challenges - in both assessment and treatment. Though there are books available that focus individually on assessment or treatment, few have combined the two into a single framework. Within this book Knight and Pachana argue that psychological assessment needs to be more tightly integrated with therapy, especially with older adult clients. Using the Contextual Adult Lifespan Theory for Adapting Psychotherapy (CALTAP) as a framework for applying our knowledge about developmental, social contextual, and cohort/generational factors that influence age differences in response to psychological assessment and therapy, they present an integrated framework for psychological assessment and therapy with older adults. This text is valuable for practitioners looking for a solid theoretical basis for the practice of assessment and therapy with older clients, students in graduate courses looking at later lifespan issues, and educators looking for material to enhance generalist psychotherapy courses with a lifespan perspective.

People are living longer and the population over the age of 60 is burgeoning, with repercussions for health services and healthcare expenditure in developed countries. Crucially, disease aetiology, diagnosis, and treatment in older people differ from the general adult population. Older people often have complicated co-morbidities and respond to treatment in different ways compared to younger people. Evidence of efficacy of different treatments is often lacking because older people are under-represented in clinical trials, and the specific needs of older people are rarely discussed specifically in more general texts. Geriatric medicine: an evidence based approach is a clinical reference for health care professionals who manage older patients, and summarizes up-to-date research literature in a style that can be directly applied by busy healthcare professionals and provide a useful resource for reference.

This book investigates the experiences of older people who remain at home with care. It examines the transition points for the important life changes faced by family members who take on a greater care-giving role. The book draws on demographic analyses and qualitative fieldwork to explore the shift from independence to increasing dependence, and suggests that this transition constitutes movement into a new stage of life, that of an Age of Supported Independence. Applying the anthropological concept of rites of passage in their analysis, the authors focus on the changes in everyday living within the spatial environment of the home, the temporal organization of daily life, and the reshaping of relationships. They suggest that many older people - as well as the family members who become carers - remain in a state of 'liminality': unable to make sense of their new situation and experience and, despite assumptions that ageing-in-place sustains social connectedness, excluded from their communities.

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.

This book provides a comprehensive but practical understanding of the clinical approach to evaluating and caring for older people with bipolar disorder. Aspects of aging that impact the diagnosis, clinical course, and management of bipolar disorder are explained; in particular, attention is drawn to the implications of comorbidities and medical complexity for the psychiatric care of older individuals with the disorder. On the other hand, similarities to treatment in younger patients are also identified. The coverage includes thorough review of current research in the field. Clinical case vignettes are used throughout to highlight practical points, and each chapter includes "clinical pearls" that summarize key points for the clinician. The book closes by examining anticipated research directions and the future needs of this patient population. Bipolar Disorder in Older Age Patients will be an ideal update for the practicing community or geriatric psychiatrist working with older patients with bipolar disorder.

It has been ten years since the National Hormone and Pituitary Program (then called the National Pituitary Agency) sponsored a symposium on human growth hormone (hGH). Numerous advances have occurred during this period. This book does not attempt to summarize past achievements. Rather, it deals with the contemporary issues in hGH research. A discussion of the present state of the art, of necessity, includes a review of the past. Some of the topics herein discussed include the following: 1. Growth hormone releasing factor (GRF). In 1973, the growth hormone inhibitory factor (somatostatin) had recently been discovered. The search for a releasing factor in humans led to its discovery not in the pituitary but in a pancreatic tumor that secreted growth hormone. The advances are discussed in this book. The current hope is that GRF will eventually become an effective therapeutic agent for idiopathic hypopituitarism in childhood and adolescence. 2. Biosynthesis of hGR by recombinant DNA technology. Current advances are discussed. Although hGH is not yet an approved drug, it will eventually become one. This will broaden our horizons in terms of hGH effectiveness in disorders other than hypopituitary dwarfism. The current experience with this type of hGH in both the Vnited States and Europe is reviewed by several authors.

Measurement of Wound Healing will update the knowledge base and promote the use of measurements in order to improve both understanding of wounds and their management. This book will feature well used vascular measurements, pathological measurements, imaging measurements and so on. There will be chapters on techniques/measurements that have much promise. This book is led by 3 experienced clinician scientists from different backgrounds who have successfully worked together on projects.

The growing geriatric population in the United States has created an increasing need for palliative medicine services across the range of medical and surgical specialties. Yet, palliative medicine lacks the resources to carry such a workload itself. Geriatric Palliative Care addresses this need by encouraging individual specialties to "own" the management of elderly with the same vigor as they "own" other key management competencies within their specialty. This clinically focused and highly practical handbook, which compliments the more comprehensive text Geriatric Palliative Care by Sean Morrison and Diane Meier (Oxford University Press, 2003), encourages this process of learning and ownership across many medical specialties. Designed to be readable and easily accessible to a range of health care providers, Geriatric Palliative Care outlines specific strategies for caring for specific palliative care issues common in elderly patients. The handbook also provides evidence based advice for helping patients, relatives, and staff cope with such issues as polypharmacy, dementia and consent, multiple pathologies, home care, elderly caregivers, and supporting the elderly in the place where they would like to be.

Aging is one of the most serious and costly health problems in the Western world. A disproportionate amount of the available health care capability is devoted to the health care of the aged and the cost of this care is soaring. Viewed in wide perspective, aging presents two problems for the researcher's consideration. First is that of providing the most efficacious therapeutic regi mens and the best possible care for those already in their latter years. The second is to determine the cause or causes for senes cence and all its attendant problems in order to decrease the im pact of senescence on general health and well being. This volume is aimed at examining possible relationships be tween biological time structure and aging and ways by which these interrelationships might be examined in terms of both the causes of senescence and the management of health problems of the elderly. The purpose of the volume is to stir the interests of chronobiolo gists in gerontology and those of gerontologists and geriatricians in chronobiology."

1h The 5 International Conference on the Progress in Alzheimer's Disease and Parkinson's 51 1 Disease took place from March 31 to April 5 \ 2001 in Kroto, Japan. This international 1 conference was organized as a joint Congress with the 9 International Catecholamine Symposium. A total of 1258 clinicians and researchers participated in this joint congress 1h from 38 countries in the world. This book represents the proceedings of the 5 Conference on Alzheimer's and Parkinson's disease. The International Conference on the Progress in Alzheimer's and Parkinson's disease was first launched by Professor Abraham Fisher of Israel and Professor Israel Hanin of USA. The first conference was held in Eilat, Israel in 1985. The second conference was organized in Kyoto, Japan in 1989; the third one in Chicago, USA, in 1993, and the fourth one in Eilat, Israel in 1997. The International Catecholamine Symposium (ICS) is an international meeting devoted to the development of basic as well as clinical research on catecholamines. The first Catecholamine Symposium was held in Bethesda, USA in 1958. Since then this symposium has occurred every 5 years. Professor Toshiharu Nagatsu was appointed as 1h the president of the 9 International Catecholamine Symposium, which was to be held in 200 I also in Japan. Therefore, we decided to organize a joint congress of the two meetings, because there is much overlap in research between Alzheimer's disease, Parkinson's disease, and catecholamines. We thank Professor Nagatsu very much for agreeing to organizing this joint congress.

For some time now, the study of cognitive development has been far and away the most active discipline within developmental psychology. Although there would be much disagreement as to the exact proportion of papers published in developmental journals that could be considered cognitive, 50% seems like a conservative estimate. Hence, a series of scholarly books to be devoted to work in cognitive development is especially appropriate at this time. The Springer Series in Cognitive Development contains two basic types of books, namely, edited collections of original chapters by several authors, and original volumes written by one author or a small group of authors. The flagship for the Springer Series is a serial publication of the "advances" type, carrying the subtitle Progress in Cognitive Development Research. Volumes in the Progress sequence are strongly thematic, in that each is limited to some well-defined domain of cognitive-developmental research (e. g. , logical and mathematical development, semantic development). All Progress volumes are edited collections. Editors of such books, upon consultation with the Series Editor, may elect to have their works published either as contributions to the Progress sequence or as separate volumes. All books written by one author or a small group of authors will be published as separate volumes within the series. A fairly broad definition of cognitive development is being used in the selection of books for this series.

Features that characterize the aging process include the gradual accumulation of cell damage after prolonged exposure to oxidative and inflammatory events over a lifetime. In addition to the accretion of lesions, the intrinsic levels of pro-oxidant and aberrant immune responses are elevated with age. These adverse events are often further enhanced by the chronic and slow progressing diseases that characterize the senescent brain and cardiovascular system. The incidence of some disorders such as Alzheimer's disease and vascular diseases are sufficiently prevalent in the extreme elderly that these disorders can arguably be considered "normal". Aging and Aging-Related Disorders examines the interface between normal and pathological aging, and illustrates how this border can sometimes be diffuse. It explores and illustrates the processes underlying the means by which aging becomes increasingly associated with inappropriate levels of free radical activity and how this can serve as a platform for the progression of age-related diseases. The book provides chapters that examine the interactive relationship between systems in the body that can enhance or sometimes even limit cellular longevity. In addition, specific redox mechanisms in cells are discussed. Another important aspect for aging discussed here is the close relationship between the systems of the body and exposure to environmental influences of oxidative stress that can affect both cellular senescence and a cell's nuclear DNA. What may be even more interesting to note is that these external stressors are not simply confined to illnesses usually associated with aging, but can be evident in maturing and young individuals. A broad range of internationally recognized experts have contributed to this book. Their aim is to successfully highlight emerging knowledge and therapy for the understanding of the basis and development of aging-related disorders.

The master tool of logic is the syllogism. If A> Band B> C, then it must follow as the night the day that A > C. If the major and minor premises are true or scientifically correct by current knowledge, the conclusion is true or at least scientifically correct by current knowledge. The demographer of today beams a clear message, which if not true is at least scientifically correct by current knowledge. In the first 80 years of the Twentieth Century, the 'over-65' population of Americans increased eight fold. By century's end it will have increased 12-fold and shortly thereafter will include one in five Americans. While initially a fact of the developed world, the pace of similar graying is accelerating even more rapidly in the Second and Third Worlds. This gray delta constitutes about 35 million living Americans, who may use one-half or more of the health care resources. A would have to be a lot more foolish than B if they failed to recognize that in the coming decade the causation, case-mix, and area of the gray delta demands a change from early, mid-or even later-century medicine. If Homer Smith was right in saying, "We are what we are because we have the kind of kidneys we have" and "The kidneys make the stuff of philosophy", then the who, what, where, when, and why the gray delta will be cared for must focus on the stuff of geriatric nephrology.

nly two things are certain in life, one is that all of us will inevita Obly grow older, the other is that at some point during or at the end of this process we shall die. Inherent to the passage of time is a deterio ration in the structural and functional integrity of our bodies, this pro gressing to such an extent that one or more organ systems will eventu ally begin to fail with the continued health and well-being of the individual coming under threat. Age-associated deficiencies in the musculo-skeletal, cardiovascular, or endocrine systems producing arthri tis, hypertension, stroke or diabetes are all too apparent in our elderly population yet internally caused failures in the function of the nervous system provide the common, and mostly intractable, problems of memory and intellect or locomotion that face and frustrate clinicians. Perhaps the most important factor which can decide the outcome of research studies professing to examine the effects of the passage of time (i. e. the 'process of aging') on the function of the nervous system, or indeed any other organ system, is the selection of appropriate or repre sentative subjects for investigation. The heart of this problem lies in defining what might be considered as 'normal' aging as distinct from age-associated disease; setting the 'goal posts of normality' continues to 1 be a matter of considerable debate.

The survival of the human species has improved significantly in modern times. During the last century, the mean survival of human populations in developed countries has increased more than during the preceding 5000 years. This improvement in survival was accompanied by an increase in the number of active years. In other words, the increase in mean life span was accompanied by an increase in health span. This is now accentuated by progress in medicine reducing the impact of physiologic events such as menopause and of patho logical processes such as atherosclerosis. Up to now, research on aging, whether theoretical or experimental, has not contributed to improvement in human survival. Actually, there is a striking contrast between these significant modifications in survival and the present knowledge of the mechanisms of human aging. Revealed by this state of affairs are the profound disagreements between gerontologists in regard to the way oflooking at the aging process. The definition of aging itself is difficult to begin with because of the variability of how it occurs in different organisms."

Part exploration, part knowledge building, and part narration, Work and the Older Person: Increasing Longevity and Well-Being draws on the latest research from a variety of disciplines and resources to paint a complete picture of productivity in old age. Dr. Linda A. Hunt and Caroline E. Wolverson, along with 11 contributors, discuss the relationship between work and aging and highlight the importance of working into old age. Each chapter of Work and the Older Person focuses on narratives from older workers that support the evidence presented with personal stories. These stories illustrate the opportunities, challenges, frustrations, and choices that older people face in maintaining a productive lifestyle. Simultaneously, the text highlights current events and the economy largely within Western societies and discusses the struggle some countries have supplying the financial benefits paid to retirees. Overall, the text shows how working into old age can contribute to longevity and greater quality of life. Occupational therapists, occupational therapy assistants, gerontologists, social workers, psychologists, and those working with older people in the health and social care sector will appreciate the inspiring accounts from older workers discussing how work contributes to their self-identity, quality of life, health, and well-being. Work and the Older Person: Increasing Longevity and Well-Being shows how engaging in occupations brings purpose to people’s lives. The text will be of value to all professionals working with older adults, as well as older adults themselves looking to maintain a productive lifestyle.

The preparation of Aging, Immunity, and Infection has been a "labor of labor. " When we began, there existed a huge literature-but manage able, we thought, given our years of experience in the area often referred to as immunogerontology. However, in the time that we have been at work, the new relevant literature has increased at a prodigious rate. The more we read and tried to assimilate, the farther we fell behind. In order to have any hope of completing a book on this rapidly evolving topic, we have been forced to become increasingly selective in covering new and re cent publications. We dare to hope that many read ers will find the book useful and only a few will dweIl on the inevitable inadequacies. We consider the book a work in progress, and welcome suggestions for future editions. Five chapters cover several aspects of infection and the decline of immunity with age. The first chapter "Human Aging: Present and Future," is devoted to demographics and theories of senescence. Chap ter 2 outlines the gradual breakdown of resistance to infection in the aged individual. Chapters 3 and 4 cover changes in innate and acquired immunity. The final chapter, "Nutrition, Longevity, and Integrity of the Immune System," discusses such provocative ideas as life-span exten sion and nutritional intervention for the delay of immunosenescence.

''Full of valuable definitions, descriptions, discussion and succinct summaries....the volume forms an interesting, up-to-date reservoir of information on 'preparation for aging'. As a source of specific insights and alternative perspectives it is a welcome addition to the literature.'' -Aging and Society