This book analyzes the development of medical big data projects in Japan.Japan is experiencing unprecedented population aging, and labor productivity has decreased accordingly. Big data analysis of the Japanese medical real-world database (RWD) has the potential to tackle this issue.To allow readers to gain an understanding of Japanese medical big data analysis, the book discusses the original Japanese system that generates medical RWDs in the hospital medical records system, the nationwide standardized health checkup system, and the public medical insurance system in Japan.After introducing four major big data projects in the healthcare-medical field in Japan, the book explains the importance of creating information standards to maintain data quality and to analyze medical big data. It enables readers to analyze which standards are installed in which RWDs, how the standards are maintained, and which issues are prevalent in Japan.This book also describes the ethical processes involved in big data projects involving medical RWDs in Japan.

Almost a decade has passed since the first edition of this book was published and the explosion of new research in stroke is very apparent. Several important themes have coloured medicine during this time: the development of evidence based health care, new optimism for acute drug treatments for stroke, the growth of new information about the human genome, a dramatic increase in the number of stroke clinicians and researchers world-wide, and the establishment of the Cochrane Collaboration. All of these trends are relevant in revising a book of this nature. Clinical epidemiology remains an essential foundation for the practice of evidence-based healthcare. The enthusiasm of the pharmaceutical industry has resulted in a large number of new trials, often too small to detect clinically important differences, and have increased the number of clinicians actively engaged in stroke research. It is even more important that these clinicians should have a good understanding of the design of trials, the rationale for randomisation and blinding, and the importance of selecting the most appropriate outcomes. Surprisingly, little of practical importance has resulted from the decade of exploration of the human genome - the best indication of a person's risk remains their phenotype and not their genotype. The impetus to organise stroke medicine into a defined speciality, with emphasis on acute stroke, is even stronger - but it is essential to bear in mind the importance of interdisciplinary working, the value of primary care, geriatric medicine, psychiatry and rehabilitation in the prevention, treatment rehabilitation and long-term care of stroke patients. The Cochrane Collaboration is currently grappling with a task of enormous size - the compression of tens of thousands of randomised control trials -and other scientific evidence- into systematic reviews of the effects of interventions. Citations to this work are made in the section on management. In this edition, there is an extra opening section entitled Epidemiology which comprises the nuts and bolts of the subject and reviews the purposes of health care for stroke patients. The remaining sections follow the format of the first edition: Diagnosis, Management, and Prognosis. All chapters have been substantially updated. The book retains its focus on epidemiology that is relevant to the clinician and attempts to use examples from stroke to illustrate many aspects of epidemiological thinking. The book aims to stimulate readers to think about their own practice, the nature of scientific evidence and the vast areas of clinical uncertainty that remain the target for research over the coming decades.

This book focuses on the nutrients and nutraceuticals that promote active and healthy ageing - recently defined by the WHO as the process of development and maintenance of functional capacity that allows well-being at an advanced stage of life. There has been a rapid rise in the use of nutritional interventions as well as specific nutraceuticals in the management of multifactorial aspects of clinical health outcomes. Written by leading experts this book comprehensively discusses the various ageing phenotypes and age-related diseases. It also assesses the nutritional status of the elderly and the various epidemiological factors that influence it. It reviews the role of dietary fiber in disease-free and fully functional ageing. Further, the book explores the benefits of polyphenols, which are secondary plant metabolites, in protecting against cancer, cardiovascular diseases, and various neurodegenerative diseases.

With an increasing global ageing population, the psychiatry of old age has become increasingly important. This revised second edition remains a succinct manual on the practice of psychiatry of old age, providing an up-to-date summary of existing knowledge, best practice and future challenges for the specialty, from a global perspective. Written by four leading clinicians, teachers and researchers, the book offers a much-needed international focus and is designed for use in a wide variety of countries and settings. Chapters are presented in a clear and practical way, enhanced by current and comprehensive further reading sections as well as tables and diagrams for quick assimilation and reference. The new edition is updated to incorporate new developments in assessment, investigation, classification, treatment and care since the publication of the first edition, including the ICD-11 and DSM-5. Essential reading for practising psychiatrists and geriatricians, as well as trainees, nurses and medical students.

This book addresses key questions about the need for palliative care, the current provision of services and the evidence for the effectiveness of a range of alternative models of organisation in palliative care. A broad approach is taken to include the needs of both cancer patients and patients with other terminal diseases and the relationship between palliative care and other aspects of health care services. The book is based on a comprehensive and detailed review of the international scientific literature on evaluation of palliative care, providing an essential evidence base for policy decisions.

Organised services for those with memory disorders are growing. This growth is stimulated by an increase in the number of people with memory problems and by an increased appreciation of the complexity of the needs of such patients. Further growth is likely, especially now that we appear to have crossed the threshold of effective treatment for many patients with dementia. With these advances has come the recognition of the necessity for an interdisciplinary approach to management. Diagnosis and Management of Dementia: A Manual for Memory Disorders Teams is an edited volume covering all aspects of the operation of a memory disorders team. It is aimed at all those working in the dementia or memory disorders team, whether in a clinic or a community setting. The book is divided into three sections. Section one takes the reader through the practical details of setting up and organising a clinic, from timetabling, through managing information, to the assessments needed and the opportunities such a service provides. Section two deals with the diagnostic process; and section three addresses management issues, from carer support, pharmacological and physiological interventions, through managing common problems, to the role of the primary care physician. An Appendix contains the results of a survey to the memory disorder services. This survey provides the reader with examples of other services and demonstrates the wide variation in how these services operate. The Manual is unique in that it combines up to date thinking on diagnosis and management with practical and helpful ideas on how to run a dementia or memory disorders service.

When the first edition of this book (Terminal Care Support Teams: the hospital-hospice interface, 1990) was written, there were only a few advisory palliative care teams working in hospitals. Since then the number of teams has grown rapidly. The concept of these teams in now widely accepted but there is an increased need for information about setting up a team, how they work and how effective they are. This book looks at the need for hospital- based palliative care teams and the challenges of bringing palliative care into the acute hospital setting. It reviews the needs of patients, their families and their professional carers, and also looks at the theoretical and practical problems which may be encountered. For example there is practical advice on setting up hospital-based palliative care teams, the selection of team members as well as coverage of team dynamics, and the role of the pain clinic and palliation oncology.

Seven in ten Americans over the age of age of sixty who require medical decisions in the final days of their life lack the capacity to make them. For many of us, our biggest, life-and-death decisions—literally—will therefore be made by someone else. They will decide whether we live or die; between long life and quality of life; whether we receive heroic interventions in our final hours; and whether we die in a hospital or at home. They will determine whether our wishes are honored and choose between fidelity to our interests and what is best for themselves or others. Yet despite their critical role, we know remarkably little about how our loved ones decide for us. Speaking for the Dying tells their story, drawing on daily observations over more than two years in two intensive care units in a diverse urban hospital. From bedsides, hallways, and conference rooms, you will hear, in their own words, how physicians really talk to families and how they respond. You will see how decision makers are selected, the interventions they weigh in on, the information they seek and evaluate, the values and memories they draw on, the criteria they weigh, the outcomes they choose, the conflicts they become embroiled in, and the challenges they face. Observations also provide insight into why some decision makers authorize one aggressive intervention after the next while others do not—even on behalf of patients with similar problems and prospects. And they expose the limited role of advance directives in structuring the process decision makers follow or the outcomes that result. Research has consistently found that choosing life or death for another is one of the most difficult decisions anyone can face, sometimes haunting families for decades. This book shines a bright light on a role few of us will escape and offers steps that patients and loved ones, health care providers, lawyers, and policymakers could undertake before it is too late.

Although very little can be done to alter the course of dementia, much can be done to maximize the quality of life of people with the condition. Research as well as practical experience suggest that behavior management, especially through programs that provide meaningful and constructive activity, is currently the most effective treatment.

In "Keeping Busy," James Dowling describes a variety of activities designed to bring meaning and enjoyment to the lives of persons with dementia. The activities are organized by general categories such as music, exercise, horticulture, pets, humor, and social events. The largest section deals with communication and includes word games that help people strengthen their remaining verbal skills. The description of each activity includes step-by-step instructions, as well as tips on how to adapt it for small or large groups, for individuals at home or in an organization, or people who are bedridden.

Globally, EDs face new challenges as the world's population ages. Visits from older people are predicted to rise for the next 20 years. This practical and accessible book provides essential guidance on assessing the ED care of older patients - and improving it. It assists ED teams to implement changes tailored to their unique environments, providing guidance across all settings regardless of size, location or resources. Experience- and evidence-based elements combine to guide best practices for older patient flow, staff and patient satisfaction, and improving patient health outcomes. The book features proven ideas for creating a geriatric ED such as specific staff training, modifying job roles, implementing new care processes, and adapting physical spaces. An invaluable resource for practising ED clinicians, leaders, administrators, educators, and system change leaders.

This book addresses the practical aspects of vibration exercise and vibration therapy. In addition, it describes the technical and physiological background, providing applied scientists and doctors with a deeper understanding of the therapeutic potential that vibration exercise holds. Having first emerged two decades ago, vibration exercise has since established itself as a widespread form of physical exercise, used in all rehabilitation areas. The goal of this book is to close the gap between scientific knowledge and practice.Given that occupational exposure to vibration leads to well-known unfavorable effects, the book is also dedicated to potential risks, hazards and contra-indications and of course, the application of vibration therapy in a number of specific conditions is presented in a clinically usable fashion. Given its breadth of coverage, this book will be of interest to physiotherapists and exercise scientists, but also to a wider range of physicians working in the field of rehabilitation.

The growing proportion of older people in Western countries means that the proper provision of suitable care facilities is of increasing importance. This timely new book is based on solid practical research carried out over 12 years in over 300 different establishments, and offers a conceptual framework for evaluating group residences for older adults, and new procedures for measuring their quality. It also proposes guidelines for designing new facilities as well as improving existing facilities.

Your best tool to optimize patient care by minimizing restraint use Frontline nurses face fraught decisions every day about whether and how to use restraints in dementia care. They need to consider many complicated issues: legislation governing the use of restraints, the policies of health-care facilities, the expectations of families, and--most importantly--the well-being, dignity, and safety of patients and care providers. Frontline nurses need the right support to navigate decisions about restraint use. Dr. Atul Sunny Luthra and his colleagues have developed an algorithm to provide that support. Their work comes from focus-group consultations with frontline staff, a review of current literature on restraint use, and a clear summary of key legislation. The algorithm's systematic approach ensures restraints are a last-resort measure, and puts the right steps in place when restraints are necessary. This short guide includes: A review of nurses' perspectives on restraint use. Alternatives to restraints in patient management and assessment of clinical indicators for restraint use. Procedures to ensure informed consent when restraints are necessary. A reference on appropriate and inappropriate restraint use in everyday clinical situations.

This book covers current controversies in women's health care. It takes a broad interdisciplinary approach to the subject. With topics ranging from the controversies in breast and cervical cancer screening, through osteoporosis and the menopause, to the relationships of older women with their doctors, it provides a well-rounded view of health care for older women. Each chapter has been written by an authority in that field and includes issues of current debate. The book is suitable both for students new to the area and for specialists wishing to read about the work of others in related fields, as well as being a useful source of information for general practitioners about the provision of women's health care from a primary care perspective.

Aging is an inevitable part of life and is becoming a worldwide social, economic and health problem. This is mainly due to the fact that the increasing proportion of individuals in the advanced age category have a higher probability of developing age-related disorders, such as type II diabetes mellitus, cardiovascular disorders, sarcopenia, and neurodegenerative conditions. New therapeutic approaches are still needed to decrease or slow the effects of such diseases. Advances in -omic technologies, such as genomics, transcriptomics, proteomics and metabolomics, have significantly advanced our understanding of disease in multiple medical areas, as the analysis of multiple molecular networks has simultaneously provided a more integrated view of disease pathways. It is hoped that emerging hits from these analyses might be prioritized for further screening as potential novel drug targets for increasing the human healthspan in line with the lifespan. In turn, this will lead to new therapeutic strategies as well as drug development projects by the pharmaceutical industry. This book presents a series of reviews describing studies that have resulted in identification of new potential drug targets for age-related disorders. Much of this information has come from -omic comparisons of healthy and disease states or from testing the effects of new therapeutic approaches. Authored by experts from around the globe, each chapter is presented in the context of specific chronic diseases or therapeutic strategies. This book is designed for researchers in the areas of aging and chronic disease, as well as clinical scientists, physicians and stakeholders in major drug companies.

This book summarizes findings from the National Health and Nutrition Survey Epidemiologic Follow-up Study (NHEFS) for persons 55 years of age and older at initial examination. This is the first prospective study of health and health-related behaviour in a representative sample of the US population.Included in the follow-up study approximately 10 years later were all 14,407 participants who were examined at baseline in 1971-1974 (National Health and Nutrition Survey I-NHANES I). This book reports on the 5,215 individuals who were 55-74 years of age at baseline and who could be traced for further examination.The prospective nature of this research permits the authors to estimate the incidence of new disease, to examine changes in health related behaviour over time, and to access the probability of subsequent disease, given the presence of risk factors at baseline. Their analyses provide new insights into disease causation and outcome in an aging population in the US.

This book examines the worldwide growth of elderly populations and its consequences for future care, and the associated costs for this sector of the population. Living a longer life does not necessarily imply an improvement in the quality of life. Important issues concerning the overall quality of additional years gained through increase in life expectancy are addressed in this book. Progress in specific dimensions of wellbeing are described. Recent gains in knowledge are reviewed, together with advances in our understanding of falls, sensory disorders, mental health in old age, osteoporosis, incontinence, drug therapy and iatrogenic disorders. The book extends outside medical care to encompass the family, which is the key issue in developing countries, community care, nursing home and hospice care; health care services that are particularly appreciated by older people are described. It will provide readers with a knowledge base for developing policies and programs that will advance the wellbeing of the elderly people of the world.

Aufgrund der demographischen und oekonomischen Entwicklung erlangt die Behandlung geriatrischer Patienten steigende Bedeutung. Am Beispiel der Zentralen Notfallaufnahme am Klinikum Klagenfurt wird ein Modell fur eine spezifische geriatrische Notfallversorgung prasentiert, die hochbetagten multimorbiden Patienten gerecht wird. Das Buch spannt den Bogen von der hausarztlichen Akut- uber die intrahospitale Notfallversorgung bis zur Pflegeheimmedizin. Im medizinischen Bereich werden Schnittstellen zwischen eindimensionaler und geriatrischer Sicht beleuchtet. Weitere erfolgreiche Projekte aus D, A und CH, in denen durch organisatorische Veranderungen eine massive Auswirkung auf Patientenstroeme aus Pflegeheimen gezeigt wurde, vervollstandigen das Werk. Es richtet sich an Fuhrungskrafte mit gesundheitsoekonomischer Ausrichtung im Gesundheitswesen, an Pflegedienstleitungen, Mediziner (Geriater, Notfallmediziner und Hausarzte) und Studierende der Gesundheitsoekonomie/-management, Pflegewissenschaft und Public Health.

The growing number of older adults in the United States poses a significant challenge to families, healthcare systems, mental health services, and many other caregiving groups. Using the Grand Challenges for Social Work initiative as a framework, this text evaluates critical policies and issues pertaining to older adults, identifying both the overall systemic inequalities currently working against older adults as well as specific areas that require updated policies and interventions. It calls for active attention to the implementation of science-based research, policy, and practices to promote health and well-being. Among the topics addressed: Family violence against older adults Disaster planning and preparedness Building financial capability for aging families Health needs of incarcerated older adults Closing the gap in healthcare services for older adults Social isolation and its effects on mental health and well-being A useful gerontology resource for students, social work scholars, and practitioners, Gerontological Social Work and the Grand Challenges advocates for justice and equal opportunity for older adults, and highlights important social issues that must be urgently addressed in the near future.

This book covers the latest advances in non-muscle invasive bladder cancer care. It provides a review of the available evidence base for the efficacy of a range of therapeutic techniques, diagnostic procedures and risk factors. Management of Non-Muscle Invasive Bladder Cancer features detailed guidance in uniformly formatted chapters on how to properly apply a range of available therapeutic treatments relevant for patient care. It is a valuable resource for all trainee and practising medical professionals who treat these patients.

This timely volume provides an up-to-date and comprehensive summary about what is known about aging and work and addresses the challenges and opportunities confronting older workers and organizations. The authors describe current and emerging topics related to work and aging adults such as working in teams, the increasing diversity of the labor force, work and caregiving, the implications of technology for an aging workforce, and health and wellness issues. The authorship is international; the authors are renowned for their respective work in the topical areas and represent a broad range of disciplines within academia, as well as offer perspectives from government and policy. Jobs, organizations, the labor market, and the workforce are experiencing dramatic change. Workers of all ages, including older workers, need to interact with the wide variety of ubiquitous technologies that are reshaping work processes, job content, work settings, communication strategies, and the delivery of training, and this book aims to update readers on the particular issues facing today's aging adults in the workplace. The chapters' broad and inclusive scope encompasses: Workplace aging and jobs in the 21st century The retirement income security outlook for older workers Population aging, age discrimination, and age discrimination protections Older workers and the contemporary labor market The role of aging, age diversity, and age heterogeneity within teams The intersection of family caregiving and work Current and Emerging Trends in Aging and Work is relevant to a broad audience of academic researchers, practitioners, and students in psychology, sociology, management, engineering (industrial and human factors), the health sciences, gerontology/geriatrics, and public health. It is also a useful resource for government and policy leaders, as well as workers and managers in the public and private sectors.

This open access book takes a multidisciplinary approach to provide a holistic understanding of late old age, and situates the aged person within the context of family, caregivers, clinical and other institutions. All through the book, the author discusses preparedness for an aging individual as well as the society in the Indian context. The book highlights inevitable but mostly neglected health issues like depression, dementia, fall, and frailty and provides detailed analyses of solutions that are practicable in low resource settings. It also brings up intergenerational differences and harmony in the context of holistic care of older Indians. Alongside clinical perspectives, the book uses narratives of elderly patients to dwell on the myriad of problems and issues that constitute old age healthcare. Demonstrating cases that range from the most influential to the most underprivileged elderly in India, the book enlightens multiple caregivers-doctors, nurses, and professional caregivers as well as family members-about the dynamic approach required in dealing with complex issues related to late old age. The narratives make the book relatable and interesting to non-academic readers, with important lessons for gerontological and geriatric caregiving. It is also of use to older adults in preparing for active aging.

Die Pflege hat eine zentrale Rolle in der Versorgung alter Menschen. Sie tragt dazu bei, dass alte Menschen trotz Einschrankungen, z.B. in der Selbststandigkeit, ein Leben in Wurde und Selbstbestimmung fuhren koennen. Renommierte Autorinnen und Autoren konkretisieren, welches genau das Ziel der Pflege von alten Menschen sein soll und wie die Qualitat in der Langzeitpflege weiterentwickelt und gemessen werden kann. Weitere Beitrage thematisieren Herausforderungen und Konzepte in der spirituellen Begleitung von zu pflegenden Menschen und hinsichtlich des Einsatzes von digitalen Technologien. Schliesslich werden rechtliche und qualifikatorische Rahmenbedingungen diskutiert sowie Chancen und Desiderata von Pflegeforschung herausgearbeitet.

This book focuses on centenarians - people aged 100 and over - one of the fastest growing segments of the population in most developed countries. Drawing on official international and national data, it describes the longevity phenomenon and profiles socio-demographic, health and living conditions of long-lived people in 28 European countries. By comparing and synthesizing current information according to country, the book helps fill the knowledge gap regarding Europe's centenarian population. Providing insights to help stakeholders better predict, plan for and respond to the challenges of extreme longevity, it is a valuable resource for students and academics in the field of population aging, gerontology and geriatrics, as well as social scientists and policymakers.