In recent years ideas about the influence of psychological status on physical health have been elevated from intuition and clinical lore to a legitimate area of scientific study. Mechanisms of influence are, indubitably, diverse. Some of this influence is indirect, accounted for simply by the instrumental help that social engagement, associated with good mental health, affords people; for example, psychologically "healthy" people are probably more likely to comply with medication regimens and engage in other healthful behaviors to a greater extent than those who are socially withdrawn or psychologically unstable. But recent studies suggest that while the importance of these more obvious factors cannot be denied, the complete picture includes factors that are much more subtle and complex. A body of research is beginning to accumulate that suggests that all three major regulatory systems -- the central nervous system, the endocrine system, and the immune system -- are affected by cognitions, emotions and behavior. There is no doubt that a relationship between mental and physical health exists, but very little is known about the specific mechanisms by which such influence occurs. At least in part, empirical research in this area has been limited by the inherent need for an interdisciplinary approach and synthesis of collected data. Recently, a few researchers in a number of different disciplines have begun to study directly the linkage between psychological and emotional well being and health."

Throughout my clinical training and practice, I have been surprised by the number of times that sexual issues have emerged as an unexpectedly central feature in my work with older adults. I can vividly remember my own internal reaction on hearing one of my elderly female patients tell me that she was date raped a few years after the death of her elderly husband-when she was 68 years old. I can see in my mind's eye the blood splattered on the floor of an inpatient unit from an elderly man who smashed his arm through a window, furious that his antidepressant medication made it impossible to climax through masturbation. On a much less dramatic but equally important note, I think about the elderly amputee who told me softly about his fears of resuming sexual activity with his wife of 25 years. I also think about the elderly woman whose inability to take herself shopping to find fashionable, comfortable clothes to fit over her hunched shoulders and large breasts helped precipitate a serious depression. In sum, I learned early on that elderly sexuality is not just about how many times a week someone makes love. It is my hope that sharing these experiences and introducing the related theories, research, and interventions will assist other clinicians in dealing with these often challenging and clinically demanding situations. Without my patients, this text would not have been possible.

A distinguished team of contributors from the fields of medicine, philosophy and law address some of the issues which arise over the provision of care for dependent elderly patients. Some of the chapters are concerned with the challenge of achieving good quality medical care, the chronic inadequacies of policy making in the UK context, and the prospects for improvement in the medium term. Other chapters look at some of the threats to dependent elderly patients posed by longer-term social and ideological trends which find expression in proposals for age-limits to health care, advocacy of living wills and euthanasia, arguments for withdrawing tube-feeding from certain categories of patient, and certain proposals for resource allocation. This interdisciplinary volume will have a wide appeal to those involved in care of the dependent elderly, to health policy analysts and health care economists, and to bioethicists.

This volume brings together leading researchers on quality of life in old age to focus on one of the most important issues in both gerontology and quality of life studies. Quality of life is a holistic construct and assessed from many different perspectives and by many disciplines. Moreover, the concept of quality of life can be applied to practically all important domains of life. Thus, quality of life research has to include social, environmental, structural, and health related aspects and be approached from an interdisciplinary perspective. Recently research in gerontology has begun to systematically study quality of life - following the WHO dictum 'years have been added to life and now the challenge is to add life to years' - however there are very few texts available on this topic and none of an international and multi-disciplinary nature. Quality of life studies have neglected older people and, given the size and growth of this population, it is time to publish a volume on this topic that systematically pursues a comprehensive perspective and includes theoretical approaches and empirical findings with respect to the most important components of quality of life in old age. For these reasons and the high quality of the authors we have assembled, this will be a seminal text for both gerontology and quality of life researchers.

In this third volume on longevity Fondation Ipsen has again collected the most recent results in research on genes and diet in the evolution of human longevity, educational level and longevity, cognitive impairment and survival at older age and other contributions. The preponderance of relatively short - compared to long-lived organisms suggests that morphogenesis is easier to accomplish than is maintenace of soma, whereas the broad range of longevities of organisms demonstrates that maintaining soma for extended periods of time is possible. The underlying assumption of "disposable soma" theory of aging is that the expense of maintaining somatic cells depends on their contribution to the welfare of the germ cells.

Aging is an almost universal process within biological systems, one which leads to a decline in functional capacity, disease onset, and eventually death. There has been much interest in recent years to elucidate the molecular mec- nisms that underlie the aging process. Many theories have been proposed since the last century that aim to explain the causes of aging. There is no one theory that completely satisfies the phenotype of aging, but genetics and environm- tal factors play an important role in the etiology of age-related pathologies and the aging process. However, there is still much to be learned about the aging process which has been termed one of the last great frontiers in biology. De- graphic changes worldwide are leading to increased average life expectancies within our populations. These changes in population characteristics will impact upon the economies of the supporting society, with increasing healthcare and infrastructural costs arising from the prevalence of age-related pathologies and other physical disabilities associated with advancing years. Many researchers worldwide are working in the attempt to identify key cellular processes through which it might one day be possible to slow down the aging process and thus increase the health span of humans. Numerous research projects-from the cellular through to tissue, organ, and whole organism studies-are currently underway to investigate the mul- factorial aging process.

For centuries people have puzzled over the inevitability of human aging. At the end of the 20th century a remarkable scientific discovery emerged, based on a series of important interconnected insights over quite a long period of time. The aim of this book is to dispel ignorance by explaining in non-technical language what are the reasons for aging and the myth of excessive prolongation of life.

In comparison to Husserl and Heidegger, Max Scheler's philosophy of time as first presented here, is considerably wider in scope. Using posthumous manuscripts, Frings shows that Scheler conceived the origin of time in the self-activating center of individual and universal life as threefold "absolute" time of a four-dimensional expanse. This serves as a basis for establishing the phenomenon of objective time in multiple steps of constitutionality, including the physical field theory and theory of relativity.
For Scheler, objective time, even though anchored in absolute time, deserves "maximum attention" in a technological society. Frings focuses here with Scheler on time experience of values and among social groups, time experiences in the mind-set of capitalism, in politics and morals, in population dynamics, and time experiences in the process of aging, all of which were signposts in Scheler's thought before his early demise.

In this volume the authors examine some of the medical social and psychological conditions which affect the way we die. Important topics covered include attitudes toward death; suicide, assisted suicide and euthanasia; hospice and pain management. This volume will be of interest to all who work with terminally ill patients.

This textbook addresses the best way of evaluating patients with rectal prolapse, the underlying pathophysiology, the different surgical approaches, the expected functional results after surgery and the management of complex clinical conditions associated with this condition. It is an essential book that attempts to draw together material that could be of vital importance to surgeons around the world. The pathophysiology of rectal prolapse is still uncertain and its clinical and instrumental diagnostic assessment needs to be clarified.

Whereas chronic stress has well known harmful effects, recent research shows that intermittent exposure of cells and organisms to mild stress can improve various biological parameters. This book brings together some of the world leaders in this area of research who present a critical analysis of the ongoing research with respect to the effects and mechanisms of action of various types of mild stress. Novel approaches to improving health and longevity are introduced.

Presents both current and future aspects of diagnosis and treatment.

Presents evidence-based knowledge of pressure ulcer aetiology.

Contains over 90 illustrations.

Explores the possiblities of tissue repair using new tissue engineering strategies.

This book analyzes the challenges, benefits, coping strategies, problems, and accomplishments associated with the midlife experience of women. Ten chapters present the state of research (and correct longstanding myths) regarding significant aspects of middle-aged women's lives. The book bridges a major knowledge gap in the feminist-psychology literature. It balances optimism and realism about older women 's lives and younger women 's futures.

It is with great pride that the Psychologists in Long Term Care (PLTC) have sponsored The Professional Educational Long-Term Care Training Manual, and now its second iteration, Geropsychology and Long Term Care: A Practitioner's Guide. Education of psychologists working in long-term care settings is consistent with PLTC's mission to assure the provision of high-quality psychological services for a neglected sector of the population, i.e., residents in nursing homes and assisted-living communities. To this end, direct training of generalist psychologists in the nuances of psychological care delivery in long-term care settings has been a major priority. It is a tribute to the accelerating nature of research in long-term care settings that a revision is now necessary. After all, the Professional Educational Training Manual's initial publication date was only in 2001. However, in the intervening years, much progress has been made in addressing assessment and intervention strategies tailored to the needs of this frail but quite diverse population. It is so gratifying to be able to say that there is now a corpus of scientific knowledge to guide long-term care service delivery in long-term care settings.

It 's a core issue at the heart of elder care: while best-practice data exist for long-term care, quality of life as a concept, measure and standard for care outcomes remains elusive. The result of an ambitious European research initiative, the Care Keys Project addresses quality of life issues among frail, care-dependent seniors, taking their social as well as health needs into account. This resulting volume explains the theory behind Care Keys, its methodology, empirical findings, and practical considerations in promoting effective, efficient elder care aimed at social and emotional well-being and including disabled and cognitively impaired patients.

This book offers a broad-ranging assessment of current efforts of the molecular, cellular, hormonal, nutritional and lifestyle strategies being tested and applied by biogerontologists in the search for effective means of intervention, prevention and treatment of age-related diseases, and for achieving healthy old age. Employing a semi-academic style, the book presents data from experimental systems, while focusing primarily on their applications to humans in the prevention and treatment of age-related impairments.

In the past 25 years, the frontal lobes have dominated human neuroscience research. Functional neuroimaging studies have revealed their importance to brain networks involved in nearly every aspect of mental and cognitive functioning. Studies of patients with focal brain lesions have expanded on early case study evidence of behavioral, emotional, and cognitive changes associated with frontal lobe brain damage. The role of frontal lobe function and dysfunction in human development (in both children and older adults), psychiatric disorders, the dementias, and other brain diseases has also received rapidly increasing attention. In this useful text, 14 leading frontal lobe researchers review and synthesize the current state of knowledge on frontal lobe function, including structural and functional brain imaging, brain network analysis, aging and dementia, traumatic brain injury, rehabilitation, attention, memory, and consciousness. The book therefore provides a state-of-the-art account of research in this exciting area, and also highlights a number of new findings by some of the world's top researchers.

Geriatric anesthesia is a rapidly growing and evolving field. The last few years have seen significant advancements in and important new modalities for addressing the needs of an aging population. The editors of Geriatric Anesthesiology's second edition are uniquely situated to put together a text highlighting both essential knowledge and recent breakthroughs of importance to any who work with the elderly. For the second edition, the editors have introduced a streamlined chapter format and have assembled a selection of chapters intended to deepen the understanding of anesthesic management of the geriatric patient.

The analysis of intra-group correlations between LS and BW at representative intervals yields no consistent support for the hypothesis that lower BW is associated with longer LS. Indeed, among male Wistar rats and C57BL/6J and A/J mice followed since weaning on AL diets, the data suggested that relatively higher BW across the adult LS was generally associated with longer life. Even when the diet was restricted by EOD or RES regimens, this pattern of positive correlations between LS and BW persisted for the C57BL/6J and A/J strains when relative ages were analyzed. However, when BW at absolute ages were correlated with LS, support for the positive relationship between BW and LS was not as forthcoming. When AL groups were assessed beginning at later ages (> 10 months), the pattern of positive correlations was very evident for the Wistar rats--heavier rats tended to liver longer. This pattern was also evident among AL-fed C57BL/6J mice followed since 6 months, but was lost in the 10-month group in this strain. Among A/J mice on AL diets, the pattern became somewhat negative when followed at 6 and 10 months of age. However, among both C57BL/6J and A/J mice placed on EOD diets at 6 and 10 months of age, the pattern clearly tended toward the positive.

The significance of hormone action in psychiatry has long been studied, but only recently has this study included the psychiatric effects of hormones on the aging process. Hormones influence a wide scope of states and conditions, ranging from pain tolerance and anorexia to attention, mood, immunity, cardiovascular and cognitive function, schizophrenia, and Alzheimer's disease. Written by an eminent team of psychiatrists, psychologists, geriatricians, and neuropharmacologists, this pioneering clinical reference addresses the hormonal basis of mental disorders in older people. This book brings together established information and recent findings in four sections:

• An overview of the basic science of neurosteroids
• Sex difference and the roles that cortisol, thyroid hormone, and the sex steroids estrogen, progesterone, dehydroepiandrosterone and testosterone play in common mental disorders and pain sensitivity
• Psychoneuroimmunology in relation to age
• Sex differences and hormones in psychotropic drug metabolism in the elderly.

Public health and antiseptic measures, vaccination and antibiotics, have all contributed to the reduction in the incidence and impact of diseases due to infections in younger age groups. Unfortunately, however, infections remain a very important cause of both morbidity and mortality in the elderly. The reasons for the continued effect of infection on the older person are multifactorial. Firstly, the immune response alters with age and may result in opportunistic infections. Secondly, while the diagnosis and management of some infections in the elderly can present little problem, altered signs and symptoms in other older patients, especially the old elderly, can cause considerable diagnostic difficulties with resulting delays in definitive treat ment. Thirdly, a degree of complacency can develop because some infec tions are seldom seen and, consequently, may not be considered in the differential diagnosis. The presence of other, more common, diseases serve only to distract attention and confuse the diagnosis. Since the number of elderly people is increasing, the need for continued high standard of skill in diagnosis and management is emphasized. These factors are considered in this book by contributors who are experi enced in their fields. The altered immune response with age, the appropriate use of antibiotics in older people and the latest developments of therapy are reviewed. Infections in various body systems are considered, with emphasis on differing presentations and diagnostic difficulties, ways of improving diagnostic skills as well as management and treatment."

As people live longer and health care costs continue to rise and fewer doctors choose to specialize in geriatrics, how prepared is the United States to care for its sick and elderly? According to veteran psychologist Seymour Sarason's eloquent and compelling new book, the answer is: inadequately at best. And rarely discussed among the grim statistics is the psychosocial price paid by nursing home patients, from loneliness and isolation to depression and dependency.

In "Centers for Ending," Dr. Sarason uses his firsthand experience as both practitioner and patient in senior facilities to reveal wide-ranging professional and moral issues affecting this seemingly familiar terrain. Insensitive medical personnel, poorly trained nurses and aides, indifferent administrators, and a prevailing culture content with treating "bodies" instead of human beings are identified as contributing factors. Drawing on America's rich history of large-scale solutions to social problems, Dr. Sarason offers penetrating insights and bold suggestions in such areas as:

The widening care gap between haves and have-nots.Why professional caregivers fail to understand patients.The nursing home resident as immigrant.Why previous reform efforts have not worked.The need for a Presidential commission for the elderly.The scenario if conditions are allowed to remain as they are or worsen.

This concise volume is essential reading for researchers, graduate students, professionals, practitioners, and policy makers across such fields as geriatric medicine, health psychology, social work, public health, and public policy. "Centers for Ending "is a clarion call to be ignored at great cost to our elders and ourselves. "

This book arises from a conference held in November 1996 designed to examine how competence can be improved in the different stages ofthe lifespan. To this end, we brought together eminent researchers in different areas of human development-infancy, childhood, and adulthood, including the late adult years. The conference was based on the premise that discussion arising from the interfaces of research and practice would increase our knowledge of and stimulate the further application of effective interventions designed to improve competence. The editors wish to acknowledge the contributions of Concordia University and the Fonds pour la Formation de Chercheurs et l'Aide a la Recherche (FCAR) in providing funding and other assistance toward the conference "Improving Competence Across the Lifespan" and toward the publication of this book. Finally, we wish to express our gratitude to the numerous students associated with our Centre for their help and to Gail Pitts and Lesley Husband of the Centre for Research in Human Development for their assistance. We are especially grateful to Donna Craven, Centre for Research in Human Development, for her heroic work on both the conference and the present volume. We could not have met our goals without you.

This excellent new work confronts two important oral health policy concerns in the United States: the disparities in the oral disease burden and the inability of certain segments of the population to access oral health care. The book examines in depth this crucial yet frequently overlooked indicator of seniors' quality of life. It provides an invaluable set of recommendations to the clinical, research, and administrative communities that will serve the elderly population.

Covers the whole range of potential complications of PCI

Only book exclusively dedicated to the risks of PCI

Complements available texts that detail interventional cardiology

Supports physicians in improving care by anticipating or recognizing problems

Appeals to cardiologists or interventional radiologists

Addresses cardiac arrest, legal matters and adverse event reporting

Essential information is easily accessible in useful tables

Text is logically organized and richly illustrated with 184 illustrations on 210 pages