The decision to treat elderly patients with cancer aged 70 years or older with chemotherapy is generally based on clinical judgment of the clinician, in combination with the evidence obtained from... Show moreThe decision to treat elderly patients with cancer aged 70 years or older with chemotherapy is generally based on clinical judgment of the clinician, in combination with the evidence obtained from clinical studies performed in younger age groups. The instrument GA might be helpful to detect hidden shortcomings and may aid clinical decision making with regard to the feasibility of treatment with chemotherapy and prediction of survival in the elderly patients with cancer. The following questionnaires and tests were considered appropriate to obtain a practical GA: MNA, GFI, IQCODE, MMSE, and laboratory values of albumin, creatinine, lactate dehydrogenase and hemoglobin. The main questions we tried to answer were firstly to assess the predictive value prior to the start of chemotherapy of the chosen GA with respect to the probability to complete the planned chemotherapy and overall survival and secondly to analyze and determine which elements of the chosen GA were independently predictive to complete chemotherapy and which elements predicted early mortality.This thesis is the result of clinical research on certain elements of GA that might be useful for routine daily oncology practice, in order to select the proper patients and improve the outcome of treatment with chemotherapy. Show less
Long-term trends, such as the aging of the population, the increased life-expectancy, and the consequences of the recent financial crisis, have raised concerns about the sustainability of pension... Show moreLong-term trends, such as the aging of the population, the increased life-expectancy, and the consequences of the recent financial crisis, have raised concerns about the sustainability of pension systems. Consequently, many OECD countries have proposed and implemented reforms to alleviate the pension system from the pressure of demographic aging and to create sustainable pension systems for the future. Many of the reforms implemented are related to increasing both the statutory and effective retirement age, making pension benefits less generous and increasing contributions. As a consequence, the proposed and implemented reforms have raised a lot of discussion about the financial position of current and future retirees. This thesis collects five studies regarding Pensions, Retirement, and the Financial Position of the Elderly and aims to understand the effects of aging on people’s retirement behavior and the adequacy of their (future) pensions. The thesis focuses on the role of selfemployment and part-time employment in retirement behavior and the financial resources available at retirement. Show less
Part I describes the prognostic effect and interactions of the immune system in breast cancer patients. Part II of the thesis describes the prognostic effect of these prognostic immune parameters... Show morePart I describes the prognostic effect and interactions of the immune system in breast cancer patients. Part II of the thesis describes the prognostic effect of these prognostic immune parameters and biomarkers molecular subtypes and stem cell marker ALDH-1, which are known to be strong breast cancer prognostic factors, in elderly breast cancer patients compared to their younger counterparts. Show less
Akintola, Abimbola A.; Jansen, Steffy W.; Bodegom, David van; Grond, Jeroen van der; Westendorp, Rudi G.; Craen, Anton J.M. de; Heemst, Diana van 2015
