In the network of cardiologists within the European Society of Cardiology Working Group on Cardiac Rehabilitation and Exercise Physiology there is a strong view that the time indeed is right to publish definitively on the methods involved in cardiovascular prevention and rehabilitation. We are facing a transition from conventional cardiac rehabilitation to a phase of combined preventive and rehabilitative efforts, as witnessed in the recent Joint Task Force Guidelines on Preventive Cardiology. For this revision of our clinical routines we lack a practical textbook, based upon the conditions and resources of European health care. This textbook is designed to fill that gap.
primary goal of all forms of therapy is not just prolonging life, but improving the quality of life, has forced analysis of what constitutes quality of life, a concept whose structure pervades all walks of life and eludes definition. Global well being, happiness, morale, vitality, fullness of social life, and satisfaction must be integrated and assessed for the effects of the disease and the therapy, in the context of specific personality traits, attitudes to life, family situation, and socio-economic and political freedom. A growing inter est in research on this subject has led to a clearer understanding of the components which come to determine quality of a patient's life, and how they can be measured in a reproducible manner so that valid comparisons can be made. Keeping these recommendations of analysing quality of life within the context of patients who have undergone open heart surgery, it seemed appro priate to me to separate the influence of various forms of open heart surgery into five aspects of life which can comprehensively reflect the quality of life outcome of the operation. These five 'components' are (1) Physiological state, which summarises the traditionally reported incidence of operative mortality and morbidity, objectively and subjectively measured physical ca pacity, and the residual symptoms, treatment and long-term survival. (2) Intellectual functioning relates to the psychoneurolgocial deficit in memory, reasoning or judgement because of cerebral microembolism and hypo perfusion during cardiopulmonary bypass.
This volume offers a comprehensive and conceptually integrated overview of the changing biological, psychological, and social/environmental influences on health and illness from the prenatal period through infancy, childhood, adolescence, and adulthood. Based on the premise that protective and risk factors vary with life stage, several chapters examine the development of major biological systems and the changing role of genetics and environment over time. In addition, they provide information on environmental influences during the prenatal period and early childhood, chronic illness in childhood, and health and health risks in adolescence. Chapters on adulthood give special emphasis to mid-life transitions in health, resiliency in later life, and the impact of caregiving on health. Final chapters focus on death and dying and on an integrative model of health and illness across the life span.
Coronary artery bypass surgery in the elderly: Too often or too seldom? It is a testimony to scientific advances that raising a simple inquiry today, such as whether coronary artery bypass surgery is done too often or too seldom in elderlypatients, requiresanexplorationofwhatviewsonemightholdonseveral medical as well as non-medical issues. Unlike earlier years when doctors were clinically free to decide what should be done with a patient, health has become an expensive human right, decisions about which also involve the patient, the epidemiologist, the health policy administrator, politicians, the exchequer, and the philosopher. In its broadest definition health has come to mean the core of well-being and, therefore, the goal ofany socio-economic system. Until only a decade ago, medical opinion regarding how often coronary artery bypass surgery (CABG) was indicated or useful was unclear. Becauseof multi-organ senescence, the elderly were expected to have a higher rate operative morbidity and mortality and, having crossed an advanced life span, might not live very long after the operation. Decision making on medical grounds first depends on knowing if a patient can survive an operation compared to how long they would survive without it, i. e.
The ability to see deeply affects how human beings perceive and interpret the world around them. For most people, eyesight is part of everyday communication, social activities, educational and professional pursuits, the care of others, and the maintenance of personal health, independence, and mobility. Functioning eyes and vision system can reduce an adult's risk of chronic health conditions, death, falls and injuries, social isolation, depression, and other psychological problems. In children, properly maintained eye and vision health contributes to a child's social development, academic achievement, and better health across the lifespan. The public generally recognizes its reliance on sight and fears its loss, but emphasis on eye and vision health, in general, has not been integrated into daily life to the same extent as other health promotion activities, such as teeth brushing; hand washing; physical and mental exercise; and various injury prevention behaviors. A larger population health approach is needed to engage a wide range of stakeholders in coordinated efforts that can sustain the scope of behavior change. The shaping of socioeconomic environments can eventually lead to new social norms that promote eye and vision health. Making Eye Health a Population Health Imperative: Vision for Tomorrow proposes a new population-centered framework to guide action and coordination among various, and sometimes competing, stakeholders in pursuit of improved eye and vision health and health equity in the United States. Building on the momentum of previous public health efforts, this report also introduces a model for action that highlights different levels of prevention activities across a range of stakeholders and provides specific examples of how population health strategies can be translated into cohesive areas for action at federal, state, and local levels.
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.
A favorite among residents and pulmonary fellows, this text provides all the information needed to evaluate and manage respiratory diseases and critically ill patients and to pass the American Board of Internal Medicine's subspecialty exam in pulmonary medicine. The Fifth Edition includes new information on ARDS, sedation of critically ill patients, rehabilitation for COPD, care of elderly patients, genetic testing for asthma, CTA and other diagnostic techniques for pulmonary thromboembolism, new antifungal drugs without renal toxicity, new treatment guidelines for pneumothorax, and ventilators and noninvasive ventilation for respiratory failure. This edition also includes more algorithms and differential diagnosis tables.
The fourth edition of the highly acclaimed Principles and Practice of Geriatric Medicine provides an account of the fundamental changes associated with ageing, which are essential to our understanding and management of the elderly sick population. The title has been extensively revised and updates to reflect the enormous changes in treatment options and medical conditions emerged since publication of the third edition. Written by worldwide experts of international repute, this is the most up-to-date and comprehensive single reference source currently available. Principles & Practice of Geriatric Medicine, Fourth Edition incorporates: More than 30 new chapters, including: Preventive geriatrics, Anorexia of Aging, Managements of Weight Loss, Dehydration, Vitamins and Minerals in the Elderly, Cancer and Aging, Mild Cognitive Impairment, Treatment of Behavioral Disorders, The Older Patient with Down's Syndrome, Drug Abuse in Older People, Breast Cancer, Women's health A truly global perspective, including new chapter on: Care of the elderly in Israel: old age in a young land, Geriatric Medicine in China, Geriatric medicine education in Europe, Geriatrics from the European Union Perspective, India, Day Hospitals, Perspectives from Latin America The title will be indispensable for all those involved in the treatment of older patients: Gerontologists to keep up-to-date with the latest developments in the field General practitioners and specialists in health policy and community care, who increasingly have to deal with a significant number of older people. Academic researchers in geriatric medicine, who are in need for an all encompassing reference work Medical registrars (UK) / residents (US) in order to pass their exams Teachers of Geriatric Medicine Hospital libraries with increasing budgets to spend on much needed resource in this growing field. Professionals within the pharmaceutical industry in order to monitor treatment options and new prescription developments.
