This book presents results of lifespan prolongation studies obtained from experimental animal models and clinical and epidemiological human investigations. Modern theories, experimental models, and mathematical models of aging are described, as well as factors identified in lifespan prolongation, such as reduced body temperature, calorie- and protein-restricted diets, antioxidants, enterosorption, motor activity, modulators of genome expression, ionizing radiation, vitamins, microelements, and revitalizers. Gerontologists, physiologists, biochemists, and physicians active in the field of aging will find this book to be an interesting addition to their reference library.
There is an Inca incantation which stated said roughly: "Lord, give me spiritual peace so that I can acquiesce to what I cannot change, give me courage so that I can change what I can change, and give me wisdom so that I can distinguish one from the other. " Obviously, this incantation can be regularly repeated by any gerontologist, since it is very difficult to distinguish aging from the processes which enhance the organism's viability, aging from diseases, and the mechanisms of aging in various species of animals. According to N. Shock, who compiled a valuable bibliography of the works on aging, more than 43,000 works on gerontology have been published in the last decade. Why do we continue to disagree with one another and hold that the most important mechanisms are still largely unknown to us in spite of that flow of information and an enormous number of facts? What is it that we do not know? Could it be that we do not know the sole sacramental fact which can explain everything, such as the hormone of aging, the programmed triggering of a suicide gene, the appearance of a special toxic agent in the axoplasmic flow of substances, and so forth? Goethe once wrote that a scientist most often holds certain parts, but unfortunately he lacks their sacred link.
What should happen when doctors and parents disagree about what would be best for a child? When should courts become involved? Should life support be stopped against parents' wishes? The case of Charlie Gard, reached global attention in 2017. It led to widespread debate about the ethics of disagreements between doctors and parents, about the place of the law in such disputes, and about the variation in approach between different parts of the world. In this book, medical ethicists Dominic Wilkinson and Julian Savulescu critically examine the ethical questions at the heart of disputes about medical treatment for children. They use the Gard case as a springboard to a wider discussion about the rights of parents, the harms of treatment, and the vital issue of limited resources. They discuss other prominent UK and international cases of disagreement and conflict. From opposite sides of the debate Wilkinson and Savulescu provocatively outline the strongest arguments in favour of and against treatment. They analyse some of the distinctive and challenging features of treatment disputes in the 21st century and argue that disagreement about controversial ethical questions is both inevitable and desirable. They outline a series of lessons from the Gard case and propose a radical new 'dissensus' framework for future cases of disagreement. - This new book critically examines the core ethical questions at the heart of disputes about medical treatment for children. - The contents review prominent cases of disagreement from the UK and internationally and analyse some of the distinctive and challenging features around treatment disputes in the 21st century. - The book proposes a radical new framework for future cases of disagreement around the care of gravely ill people.
When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."
A NEW YORK TIMES BESTSELLER “Brilliant and enthralling.” —The Wall Street Journal A paradigm-shifting book from an acclaimed Harvard Medical School scientist and one of Time’s most influential people. It’s a seemingly undeniable truth that aging is inevitable. But what if everything we’ve been taught to believe about aging is wrong? What if we could choose our lifespan? In this groundbreaking book, Dr. David Sinclair, leading world authority on genetics and longevity, reveals a bold new theory for why we age. As he writes: “Aging is a disease, and that disease is treatable.” This eye-opening and provocative work takes us to the frontlines of research that is pushing the boundaries on our perceived scientific limitations, revealing incredible breakthroughs—many from Dr. David Sinclair’s own lab at Harvard—that demonstrate how we can slow down, or even reverse, aging. The key is activating newly discovered vitality genes, the descendants of an ancient genetic survival circuit that is both the cause of aging and the key to reversing it. Recent experiments in genetic reprogramming suggest that in the near future we may not just be able to feel younger, but actually become younger. Through a page-turning narrative, Dr. Sinclair invites you into the process of scientific discovery and reveals the emerging technologies and simple lifestyle changes—such as intermittent fasting, cold exposure, exercising with the right intensity, and eating less meat—that have been shown to help us live younger and healthier for longer. At once a roadmap for taking charge of our own health destiny and a bold new vision for the future of humankind, Lifespan will forever change the way we think about why we age and what we can do about it.
Getting the right diagnosis is a key aspect of health care - it provides an explanation of a patient's health problem and informs subsequent health care decisions. The diagnostic process is a complex, collaborative activity that involves clinical reasoning and information gathering to determine a patient's health problem. According to Improving Diagnosis in Health Care, diagnostic errors-inaccurate or delayed diagnoses-persist throughout all settings of care and continue to harm an unacceptable number of patients. It is likely that most people will experience at least one diagnostic error in their lifetime, sometimes with devastating consequences. Diagnostic errors may cause harm to patients by preventing or delaying appropriate treatment, providing unnecessary or harmful treatment, or resulting in psychological or financial repercussions. The committee concluded that improving the diagnostic process is not only possible, but also represents a moral, professional, and public health imperative. Improving Diagnosis in Health Care, a continuation of the landmark Institute of Medicine reports To Err Is Human (2000) and Crossing the Quality Chasm (2001), finds that diagnosis-and, in particular, the occurrence of diagnostic errorsâ€"has been largely unappreciated in efforts to improve the quality and safety of health care. Without a dedicated focus on improving diagnosis, diagnostic errors will likely worsen as the delivery of health care and the diagnostic process continue to increase in complexity. Just as the diagnostic process is a collaborative activity, improving diagnosis will require collaboration and a widespread commitment to change among health care professionals, health care organizations, patients and their families, researchers, and policy makers. The recommendations of Improving Diagnosis in Health Care contribute to the growing momentum for change in this crucial area of health care quality and safety.
Among the many studies of aging and the aged, there is comparatively little material in which the aged speak for themselves. In this compelling study, Sharon Kaufman encourages just such expression, recording and presenting the voices of a number of old Americans. Her informants tell their life stories and relate their most personal feelings about becoming old. Each story is unique, and yet, presented together, they inevitable weave a clear pattern, one that clashes sharply with much current gerontological thought. With this book, Sharon Kaufman allows us to understand the experience of the aging by listening to the aged themselves. Kaufman, while maintaining objectivity, is able to draw an intimate portrait of her subjects. We come to know these people as individuals and we become involved with their lives. Through their words, we find that the aging process is not merely a period of sensory, functional, economic, and social decline. Old people continue to participate in society, and--more important--continue to interpret their participation in the social world. Through themes constructed from these stories, we can see how the old not only cope with losses, but how they create new meaning as they reformulate and build viable selves. Creating identity, Kaufman stresses, is a lifelong process. Sharon Kaufman's book will be of interest and value not only to students of gerontology and life span development, and to professionals in the field of aging, but to everyone who is concerned with the aging process itself. As Sharon Kaufman says, "If we can find the sources of meaning held by the elderly and see how individuals put it all together, we will go a long way toward appreciating the complexity of human aging and the ultimate reality of coming to terms with one's whole life."
Most of us want and expect medicine’s miracles to extend our lives. In today’s aging society, however, the line between life-giving therapies and too much treatment is hard to see—it’s being obscured by a perfect storm created by the pharmaceutical and biomedical industries, along with insurance companies. In Ordinary Medicine Sharon R. Kaufman investigates what drives that storm’s “more is better” approach to medicine: a nearly invisible chain of social, economic, and bureaucratic forces that has made once-extraordinary treatments seem ordinary, necessary, and desirable. Since 2002 Kaufman has listened to hundreds of older patients, their physicians and family members express their hopes, fears, and reasoning as they faced the line between enough and too much intervention. Their stories anchor Ordinary Medicine. Today’s medicine, Kaufman contends, shapes nearly every American’s experience of growing older, and ultimately medicine is undermining its own ability to function as a social good. Kaufman’s careful mapping of the sources of our health care dilemmas should make it far easier to rethink and renew medicine’s goals.
