MEDICINE

MEDICINE AND CARE OF THE DYING. Milton J. Lewis. Oxford University Press.

MEDICINAL CHEMISTRY : A MOLECULAR AND BIOCHEMICAL APPROACH. Thomas Nogrady. Donald F. Weaver. Oxford University Press.

By John Aiello

PATHOLOGY OF THE OVARY. Jaime Prat. Saunders.

AlCAMO’S FUNDAMENTALS OF MICROBIOLOGY. Jeffrey C. Pommerville. Jones and Bartlett.

COLOR ATLAS OF COSMETIC OCULOFACIAL SURGERY. William PD Chen. Jemshed A. Khan. Clinton D. McCord Jr. Butterworth Heinemann.

This text sets the standard in the field of Oculofacial Surgery, addressing this burgeoning field in comprehensive terms.

In Color Atlas, Chen and his co-authors (each recognized authorities) have put together a benchmark text on the subject of facial surgery. Beginning with clear direction on how to approach the preliminary examination of the patient, the authors deftly move into the anatomical structure of the eyelid. At this point, the reader begins exploration of topics such as preoperative preparation and safely anesthetizing the patient.

PUBLISHER SPOTLIGHT

JONES AND BARTLETT NURSING & MEDICAL

Winter2006 Spotlight

By John Aiello

NURSE AS EDUCATOR. Second Edition. Susan B. Bastable. Jones and Bartlett.

Now in its second edition, this text marks a radical change in the medical profession’s traditional view of nurses. In the past, nurses we were seen only as support for the physician -- individuals whose mission was to deliver medication and monitor patients until the doctor returned.

However, that perception of the nurse is actually many decades old; now, nurses perform myriad duties in multiple settings, serving as key components in the American health care system charged with maintaining patient comfort and safety. Here, Bastable (State University of New York) presents to us a textbook with the primary focus of outlining the breadth of the nurse’s present role -- a role that includes not only patient care, but also patient education.

In this ever-changing landscape of the world, the responsibility of maintaining individual health has shifted from the medical professional back to the patient. Consequently, nurses are now on the frontlines and are expected to help guide patients through the intricate process of learning about their health. Now, the nurse is not only a giver of care, but also a teacher who must be able to show patients how to investigate their bodies.

In Nurse As Educator, Bastable has constructed a manual that looks to show both students and practicing nurses how to impart information and educate patients -- further demonstrating that in order to educate, one must first understand how people learn (speaking to the individual’s specific traits and predilections). Topics covered here are vast, beginning with an overview of the meaning behind nurse as educator, before moving into a complete examination of the methods used to assess to the learner’s needs and learning styles; analysis of the developmental stages of learning; and direction on how to compensate for differing levels of literacy among the patient population. In addition, Bastable takes a significant journey into technology’s role in patient education and the ways that the internet can be used to broaden the general populous’ understanding of the human body.

At its finest moments, Nurse As Educator not only covers a remarkable number of subjects, it carefully stresses the fact that nurses are central to the health care system itself. In the modern day structure, nurses serve not only as conduits responsible for guiding patients to information about maintaining their health, they are also the teachers who must insure that we are capable of comprehending the data in front of us.

This new volume from Jones and Bartlett is a key companion to Bastable’s text stressing the foundational aspects of the learning experience as it relates to the student nurse. In light of the pace of 21st-Century hospital care, it is imperative for nurses to be able to use critical thinking skills in order to properly assess patient needs and then provide care in varied environments. Basically, nurses must be able to note subtle changes in patients and then understand what these changes mean; in effect, the nurse is the doctor’s eyes and ears when the doctor is not present. Accordingly, Critical Thinking stresses ways that nurses should go about training their minds in order to think critically and beyond the perimeters of the obvious, teaching traits that ultimately serve as the cornerstone of the profession.

Recommended to instructors of advanced courses teaching nurses how to think through complex situations.

In light of the Terri Schiavo case that captivated and divided the nation for months, this textbook cannot be ignored; bluntly, it should be required reading in every single nursing program throughout the United States. Palliative Ethic examines the role the health care provider should play in tending to the dying patient, in turn opening up detailed introspection on how to best make the terminally ill comfortable as they confront the ultimate test of moving from the living state into death. Even more than doctors, nurses bear the primary responsibility for comforting both the gravely ill patient and their family as this difficult process naturally moves forward. In his work, Fins (Cornell University) does an exemplary job of looking at both the myriad ethical and clinical questions that doctor, nurse and patient will come upon together. In essence, the idea here is to be able to provide humane care for the patient, addressing both physical and psychological pain in direct and compassionate terms.

Recommended as a primary text in courses that address care for the terminally ill. Further recommended to Health Science libraries as a general reference text exploring medical, sociological and philosophical issues of patient care.

PANCREATIC CANCER. Daniel D. Von Hoff. Douglas B. Evans Ralph H. Hruban. Jones and Bartlett.

Pancreatic cancer is one of the most pernicious and swiftestmoving of all cancers that afflict the human body (and currently ranked asthe 4th leading cause of cancer-death in America). In addition to these startling numbers, researchers presume that in the next decade the incidence of pancreatic cancer will continue to increase more rapidly than other forms of malignancy, in turn causing greater patient mortality.

In this volume, the unique perspectives of three different kinds of specialist (oncologist, cancer surgeon, pathologist) have been stitched together to build a one-of-a-kind text that serves as the comprehensive authority on cancers of the pancreatic system.

Accordingly, the unique wedding of these specialists allows the reader to peer into the labyrinth of this disease from every conceivable angle. For example, by studying the pathology of these cancers, a physician might better understand how the disease attacks the chain of organ systems and invades the cell structure. At this point, both surgical and medical-management options can be evaluated and the best course of treatment for an individual patient ascertained.

As this text carefully point outs, pancreatic cancer is a very real threat to the populous, and it will take a huge toll on America in terms of human life over the next several decades. Yet, from a practical standpoint, research into invasion of the pancreas by a neoplasm has paled in comparison to the energy and dollars we’ve invested into the exploration of prostate and breast cancers.

However, this volume by Von Hoff and his co-writers seeks to reverse this trend -- its primary mission to develop a keener interest in this specific area of the body so that deeper scientific research can take place into ways to better treat patients stricken with the disease (thus naturally enriching life in terms of quality and duration).

As previously noted, the authors cover every aspect of the disease, from genetic predisposition to symptom analysis to a comprehensive summary of treatment options, presenting internist and oncologist alike with a step-by-step manual that promotes thoughtful patient care.

Simply, if we are to effectively combat this disease, the medical community as a whole must flow together to investigate the ways that cancer over-takes the pancreatic system. The goal is for science to ultimately move toward prevention. And this text provides a natural starting point.

BREAST CANCER ANSWERS. Understanding and Fighting Breast Cancer. Bruce A. Feinberg. Jones and Bartlett.

Jones and Bartlett’s "100 Questions Answered Series" (which we’ve touched upon on these pages before) is the ultimate patient resource addressing complex health topics in a way that the lay reader can readily understand.

Breast Cancer Answers by Dr. Feinberg (Georgia Cancer Specialists) continues this specialized editorial focus, offering a well-developed analysis of breast cancer that has been written from the point-of-view of the patient who is swimming in fear and questions, looking for straight-forward and unadorned answers.

Any diagnosis of cancer comes with a lifetime of baggage -- patients just diagnosed must feel as if they’ve received a death sentence from the judge with no hope of reprieve. Unfortunately, physicians don’t have enough time to hand-hold and provide deep comfort. Like it or not, the patient is many times left to help themselves and find their own way.

But where do you go?

If you’re a woman and you’ve just received the horrible news that there’s a tumor in your breast, this book is an affordable resource that touches on every layer of the disease (priced at only $19.95 it’s the equivalent of a library on the subject).

In addition to discussion of the clinical aspects of the disease (symptoms, treatment options, long-term management), Breast Cancer Answers also tells the story of a breast cancer patient and her husband. The personalized tone of this segment is meant to tell the reader that they indeed are not alone: the lesson here is that many others have been in your place and triumphed over their burden.

Breast Cancer Answers marks a wonderful consumer resource and should be recommended by oncologists to their patients upon diagnosis. Nurse Practitioners assisting in treatment should also make recommendations to patients about this book. Finally, pharmacies that feature counter-top book racks of useful consumer titles should include this title in their inventory: it offers straight-forward discussion of a common problem and it will naturally provide comfort to the reader/patient.

100 QUESTIONS AND ANSWERS ABOUT BREAST SURGERY. Joseph J. Disa. Marie Czenko Kuechel. Jones and Bartlett.

Any woman going through breast surgery (either for therapeutic or cosmetic reasons) will benefit from reading this title (which is part of the acclaimed Jones and Bartlett consumer series). About Breast Surgery discusses the topic of surgical invasion of the breast in broad detail (including types of surgery, precautionary measures for the patient to consider, how to locate a competent surgeon and psychological issues of which to be aware). The fact that American women are under such societal pressures to look a certain way means that the psychological ramifications that accompany breast surgery must not be ignored. Readers will find this discussion invaluable to their complete comprehension of the subject as the authors strive to help you understand - and accept - any procedure you might undertake.

THE NURSE PRACTITIONER’S BUSINESS PRACTICE AND LEGAL GUIDE. Second Edition. Carolyn Buppert. Jones and Bartlett.

This text revised in its second edition is one of the most unique medical reference books we have seen this year. However, it’s probably not that unusual that it showed up under the J&B umbrella, since Jones and Bartlett (along with Thomson) is the most editorially creative of all the academic giants, with every aspect of their list quality-driven and chock full of interesting texts that simply aren’t found elsewhere.

And Ms. Buppert’s book is no exception.

Here, Buppert (St. John’s College) has come up with a legal guide/outline of general business practices dedicated exclusively to the work of nurse practitioners. As Buppert’s study infers, many nurse practitioners enter the field without the necessary business savvy to forestall problems that fall out of the immediate purview of scientific study:

"Risk management is what one does to avoid problems later. Compare risk management to preventive medicine; risk management is preventive law. Nurse Practitioners (NPs) are at risk for two categories of professional mishap: clinical mishap and business mishap [and] There can be great overlap between clinical and business problems; that is, a clinical problem can turn into a business problem and then into a legal problem..."

(At page -- 249)

This book is comprised of information that NPs need to keep in their minds at all times. Buppert is obviously a veteran writer and knows the fields of medicine and law equally well (she is a lawyer and also Director of Student Health Services at St. John’s). Consequently, Buppert is able to lend her personal experience to the subject matter, intensifying it with sharp and incisive insight that lets her readers know that this is indeed serious business that requires all NPs to remain vigilant in the daily activities of their practice in order to avoid ending up in court.

Many in depth chapters command immediate attention on the part of the reader, but the sections on Negligence/Malpractice and Risk Management seem especially relevant, as this material is directly related to helping the medical professional dodge legal proceedings. In addition, Buppert has provided a state-by-state breakdown of law as it relates to the scope of authority of the professional NP (including the rules that govern professional practice). Also included are tidy case examples that offer cogent comment on how to avoid malpractice suits -- advice that shouldn’t be discounted given Buppert’s background as a seasoned attorney.

It’s unfortunate to say, but today’s society is driven by the concept of "get even" lawsuits, and the medical professional is the veritablesitting duck. However, Buppert’s text provides a well-written road map which gives the NP serious counsel on the marriage of law and medicine. If you’re a NP, reading this text might actually save you a day in court.

Recommended to all practicing NPs for the reasons previously outlined in this review. Would further serve as a useful teaching text in all nursing programs dedicated to the study of the business practices of the NP. Finally, it is recommended to all Health Science libraries as a general reference text.

Varney’s marks the authority in the field of midwifery, and the 4th edition is notable for over 400 pages of new material that has been added in order to keep the practicing midwife current with changing demands in the field. Varney-Burst (Yale University) is the resident expert on midwifery, and this text is indeed a formidable effort. Here, the reader is greeted with a full and in depth analysis of the course of care for women from pre-puberty to old age -- a definitive resource that has not been approached by any other author in the discipline. The author begins with a nice series of chapters detailing the history of the profession before moving through the basics of primary care as it relates to the female patient (with specific analysis of different organ systems, preconception care, care for the newborn, pharmacology, in addition to a wonderful segment on nutrition for women). The nutrition data is especially pertinent, as many women today are battling weight concerns and eating inappropriately because of work and family obligations.

CANCER SYMPTOM MANAGEMENT. Third Edition. Connie Henke Yarbro. Margaret Hansen Frogge. Michelle Goodman. Jones and Bartlett.

This selection focuses on the professional oncology nurse and ways these care-givers can mitigate the suffering of the cancer patient. There are many titles out there that intersect this subject matter, but what sets Yarbro (University of Missouri- Columbia) and her co-writers’ effort apart is in its organization and formatting. The reader will be especially impressed with the clear and logical way the chapters are delineated, with nurses counseled on symptom management/ assessment, matters of pathophysiology, patient self care and various treatment therapies. For example, there are specific chapters dedicated to Arthralgias/Myalgias, Dyspnea, fatigue, pain, and sleep disturbances. The material on patient self-care is particularly important: people are often stunned by a diagnosis of cancer and that shock often manifests itself in an unwillingness to want to care for themselves. This text does not ignore this pattern, but instead, strives to motivate nurses to teach these patients techniques of self-sufficiency. In addition to assisting with issues of daily life, this allows the cancer-sick patient to redevelop vital self-esteem.

Of Related Interest

ONCOLOGY NURSING DRUG HANDBOOK. Gail M. Wilkes. Margaret Barton-Burke. Jones and Bartlett.

This selection serves as a vital companion to the Yarbo text (reviewed above), outlining in complete terms the steps nurses should take to administer medication to the cancer-sick patient. Believe me -- everything is here, including discussion of nursing diagnoses, patient assessment, symptom evaluation, mechanism of action, dosing/metabolism, administration, as well as signs of toxicity (and side effects). Noted for its in-depth coverage on medicating the oncology patient, as well as for its inclusion of new and cutting-edge drugs (such as Abarelix).

MEDICAL AND PSYCHOLOGICAL ASPECTS OF CHRONIC ILLNESS AND DISABILITY. Third Edition. Donna Falvo. Jones and Bartlett.

Too many times, doctors and care-givers, over-stressed and under-staffed, fail to truly realize the psychological obstacles a person in the throes of chronic illness is trying to overcome. In this regard, Falvo’s text is ground-breaking: In addition to detailing the medical aspects of illness/disability, Falvo is careful to cover the mental impact of disease on the individual -- reminding the reader that the mind and body do, indeed, go together.

In chapter four, the author writes on vision impairments, noting:

"Vision loss often precipitates a sense of fear and reduced personal competence, which may result in isolation and social withdrawal....Adjustment to loss of vision depends on many factors, including the degree of loss and the age at which the individual becomes visually impaired. Those who are not congenitally blind, for example, have not had the opportunity to learn concepts such as distance, depth, proportion, and color....."

(At page -- 138)

The lesson here is to encourage the care-giver to understand that, beyond the physical manifestations of illness, there is a second wall to penetrate -- the wall of the mind. A person who has fallen sick is often bitter, angry and, many times, resistant to treatment. Therefore, it is the obligation of the health care provider to take steps to approach a treatment plan only after this factor has been duly considered.

ARRHYTHMIA RECOGNITION. The Art of Interpretation. Tomas B. Garcia. Geoffrey T. Miller. Jones and Bartlett.

One of the most vital aspects to competent emergency medical care is for the health care provider to be able to recognize a heart arrhythmia and then provide quick and effective treatment. But that’s all much easier said then done -- for this skill is one of the most difficult to master.

Arrhythmia by Garcia and Miller explores the subject in its entirety, offering clear and well-focused discussion on how the physician or cardiac-care nurse should approach the study of the heart’s rhythm and ways to detect life-threatening abnormalities.

The authors begin by introducing the material through an over-view of anatomy and physiology, then move quickly into analysis of the heart’s electrical system, including rhythm strips, calculating heart rate, arrhythmia recognition and electrocardiography. From here, we move into the different rhythm patterns of the heart, with in-depth investigation of Sinus rhythms, Atrial rhythms, Junctional rhythms, Ventricular rhythms, and heart block.

Garcia and Miller have done a comprehensive job in detailing the topic, discussing how and why the heart loses its ability to beat properly in addition to ways the health care professional should approach identification of the affliction. Notable for its full color graphic illustrations that assist in understanding the text descriptions, as well as for the hundreds of real-life rhythm strips that are included here as a seamless way to force the reader to immediately apply the lessons being learned.

Recommended to instructors in nursing courses dedicated to cardiac-care/intensive care nursing. Would also be highly useful to instructors teaching one of the cornerstones of paramedic/emergency-response care. Finally, recommended to Emergency Room physicians as a valuable ‘on-the-job’ resource that provides clear instruction on the interpretation of rhythm strips.

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THE THOMSON-DELMAR- LEARNINGHEALTH CORNER

FOUNDATIONS OF NURSING. 2^nd Edition. Lois White. Thomson/Delmar-Learning.

Reviewed by Karen C. Bagatelos, M.S.N.; N.P.

Lois White’s Foundations Of Nursing, now in its second edition, serves as a comprehensive summary of the nursing process and an excellent over-all resource with multiple focal points. Here, White (former faculty and chairperson, Department of Vocational Nurse Education, Del Mar College) has built Foundations Of Nursing into a practical nursing text which can also easily double as an on the job reference book for use by the practicing nurse.

Over the past twenty years, the nurse's responsibilities have increased tremendously, with myriad expectations awaiting both the novice and experienced nursing professional.Consequently, success in the field requires any student-nurse to command a thorough understanding of both medical diagnoses and treatment.

Accordingly, White’s texts provides an in depth review of disease processes (with focus on medical, surgical and pharmacologic treatments) – topics that are often overlooked in that annals of nursing literature which has, in the past, concentrated deeply on nursing diagnoses and intervention.

The Foundations of Nursing (in its second edition) is divided into three primary sections: Basic Nursing; Adult Health Nursing; and Maternal/Pediatric Nursing. White has gone to great lengths to insure that this text be well organized and careful to cover a multitude of information crucial to the day-to-day nursing practice.

In addition, the text includes analysis on holistic care; the history of the nursing profession; legal and ethical responsibilities pertinent to nursing care; a guide to infection control; a review of fundamental nursing procedures; guidelines on how to care for the patient with various physiologic disorders; and tips on meeting the needs of the childbearing patient. The highlighted boxes which frame each chapter further serve to stimulate critical thinking, providing useful professional tips (such as making sure to take a patient’s cultural background into consideration in the course oftreatment) – hints that should make the nurse’s day-to-day experience in the hospital a little bit easier.

To the experienced nurse, a lot of this might seem ‘old hat;’ however, White’s treatise is meant to give the novice nurse basic instruction on disease processes, in addition to guidance on the medical, surgical and pharmacologic management of various pathophysiologic conditions.

In essence, Foundations of Nursing teaches both experienced and novice nurses to piece together the whole picture of the patient instead of merely focusing on the nursing process and intervention. And for the present-day student of nursing, success in the field will mean mastery of these concepts.

White’s Foundations of Nursing would serve as an excellent choice for use in courses that teach the basics of nursing, noted for its comprehensive tone and the author’s unique ability to speak on myriad intellectual levels. Further, the text is full of well-placed diagrams that are both pleasing to the eye as well as vital to the information being presented. Basically, Lois White has created a user-friendly textbook that provides the novice nurse with an excellent review of disease processes and medical, surgical and pharmacologic treatment options necessary to maximize patient care, covering all the important aspects of nursing assessment, planning and intervention.

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© Karen C. Bagatelos. 2006. All rights reserved. Karen C. Bagatelos andThe Electric Review.

Karen C. Bagatelos holds a Masters of Science degree in Nursing, serving as both a Nurse Practitioner in Gastroenterology and Assistant Clinical Professor of Community Health Systems at the nationally ranked University of California, San Francisco Medical Center. Reach her through The Electric Review.

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THE CONTINUUM OF LONG-TERM CARE (Third Edition). Connie J. Evashwick. Thomson/Delmar Learning.

Reviewed By Frank Aiello

Thomson/Delmar Learning’s "Series in Health Services" is intended to provide high quality educational materials to the health administration and to myriad public education fields. As part of that series, this excellent text by Connie J. Evashwick focuses on the ever-increasing problems that plague individuals with functional disabilities who require some form of assistance for an extended period (usually 90 days or longer and known as "Long-Term Care").

Functional disabilities are determined by an individual’s ability (or inability) to perform the Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs). Examples of ADLs include bathing; dressing; eating; and continence control [as] "The abilities to carry out these activities are typically acquired during the first years of life in a definite hierarchical order [with] independence of these skills...often lost in the reverse order; that is, bathing tends to be the first loss of independent functioning, and eating the last." [p. 18.]

Examples of IADLs include the ability to manage money; to shop for groceries; to keep the house; and manage medications. As Evashwick states:

"While ADLs involve use of large motor skills, IADLs are more likely to involve the use of fine motor skills. IADLs tend to require greater cognitive ability. . . Each person’s condition will have a unique progression, so patterns of service may be similar, but not identical. This complex progression and potential variation in service use makes designing payment systems for long-term care challenging to structure and costly to insure." [pp. 19-20.]

As the Baby-Boom Generation comes upon retirement age, there will be no shortage of patients requiring long-term care. In The Continuum of Long-Term Care, Evashwick points out that the elderly population will double by the year 2030, rising to 70 million, the majority of which will likely have one or more chronic conditions (these may range from life threatening illnesses, such as heart disease, to conditions which produce functional disabilities).

Moreover, as these seniors age into their seventies and eighties, the need for all types of health services will increase dramatically, with the need for long-term care for those who can no longer perform the basic activities of daily living increasing as well. However, despite their physical shortcomings, the majority of these individuals will continue to reside in their communities, often under the care of informal caregivers with little or no training in attending elderly patients beset by a multitude of chronic afflictions (and without adequate financial resources to care for their disabled family members).

The following statistics foretell the severity of the situation:

"Informal caregivers are the major providers of long-term care to the millions of people with functional disabilities and chronic conditions who live outside of institutions. About one-quarter of all U.S. families report being engaged in caregiving activities and the estimated numbers of caregivers to disabled persons of all ages is 52 million. Caregivers are typically immediate family members, with nearly two-thirds being spouses or adult children. Between 59% and 75% of all caregivers are women, who often have to manage multiple roles as spouse, parent, and employee in addition to their caregiving responsibilities." [pp.42-43.] (Emphasis added in bold italics).

These figures are truly astounding, and it is not surprising that a health care crisis looms on the horizon as one comes to absorb the fact that one out of four families are presently engaged in the daily care of a loved one, with such caregivers spending thousands of hours of unpaid work time carrying out their responsibilities. In addition, as a by-product of the enormous stress that accompanies these circumstances, many caregivers suffer from depression, loss of leisure time, and conflicts within families.

Although non-profit hospitals outnumber for-profit hospitals by a 3 to 1 margin, it is nonetheless readily evident that the ability of the patient to pay is the over-riding factor impacting just who these hospitals will choose to help and what programs will be made available to the needy consumer. Furthermore, the quality of such hospital treatment cannot be guaranteed; as Evashwick points out, medical errors in hospitals reportedly account for as many as 98,000 deaths annually in the United States:

"Each day of hospitalization is estimated to increase a patient’s chances of experiencing an adverse event by 6 percent (Kohn, Corrigan & Donaldson, 1999). Adverse patient events also include approximately 2 million nosocomial (hospital-acquired) infections annually, according to the Centers for Disease Control. (CDC, 1992)." [p. 63.]

It is clear, after reviewing Evashwick’s chapter on the costs of long-term care, that citizens requiring dedicated assistance will continue to be tended by their immediate family (and, to a limited extent, by social networks), ultimately depleting the resources of both. As Evashwick asserts, there is simply a dearth of social-service programs equipped to faciliate long-term care for the chronically ill:

"Medicaid is not a single program, but a collection of 50 state programs that fall within a range of options determined by the federal government . . .As a result of state variations, people with identical circumstances may be eligible to receive Medicaid benefits in one state but not in another. Even individuals in the same state with similar incomes may not be equally eligible for benefits because of welfare rules." [pp.244-245.]

Thus, despite the morass of state and federal legislation enacted subsequent to the creation of Medicare in 1966, basic health insurance and a rational managed care program for all citizens remains a distant dream.

Accordingly, Connie Evashwick’s treatise on the subject makes it clear to both practicing health care professionals and to students entering the field that this question is still the most pressing social concern America faces.Unfortunately, after more than 40 years, we still have no real answer to the question of how to best meet the needs of our elderly after they become disabled.

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OF RELATED INTEREST

A GUIDE TO HEALTH INSURANCE BILLING (Second Edition). Marie A. Moisio. Thomson Delmar Learning.

Reviewed by Frank Aiello

This text from Thomson/Delmar, together with other Thomson publications [1], are reviewed with a future eye fixed on exploring both the ever-worsening health care crisis and scandals involving non-profit hospitals [2] (institutions which presently provide the majority of health care services that are available in the United States).

However, some basic background is first necessary in order to educate the reader on these topics.

The Federal Medicare program was established in 1966 to provide basic form of supplementary health insurance to individuals 65 years or older (and to other qualifying individuals). (See 42 U.S.C. Sections 1395c, 1395j). Basically, Medicare gives retirement age individuals the ability to seek medical services under a program that is universally accepted among the nation’s health care providers. Although convenient and easy for the consumer to use, the program itself has become a breeding ground for abuse, as doctors and their billing agents have gained control over a patient-base that has little ability to understand or monitor how services are being billed.

Yet, as Moisio’s book reminds its readers, there are grave consequences to unscrupulous conduct on the part of health care providers. Specifically, it is a felony for a health care provider to intentionally make false statements of a material fact in order to obtain any payment. 42 U.S.C. Sections1320a-7b(a); 42 C.F.R. Section 455.2.

Moreover, a health care provider found to have engaged in fraudulent billing is subject to a revocation of its right to treat Medicare beneficiaries. The scope of improper billing can be seen in statistics complied by the Department of Justice which in 1996 estimated improper payments made by the Government amounted to 23.5 billion dollars: See: http://www.usdoj.gov/dag/pubdoc/hipaa99ar21.htm.

Given the magnitude of the problem and its impact on the quality of health care for every citizen, portions of Marie A. Moisio’s text, specifically her chapter on the legal aspects of insurance billing, are especially relevant to life in 2006. Refreshingly, Moisio has not ignored the overriding issue of insurance fraud/abuse, noting in her chapter on the legal aspects of insurance billing that: "[i]nsurance billing fraud and abuse cost the federal government between 11 and 23 billion dollars per year. In 2002, about 7 % of Medicare’s total expenditures was paid inappropriately. The reasons for this error rate include fraud, abuse and lack of medical documentation related to insurance claims processing." [p. 33.]

Health care fraud is defined differently depending on the federal or state statute involved, but the term often means that "someone is illegally attempting to collect insurance payments from government health insurance programs...Most health insurance billing fraud is targeted at the Medicare program...Health insurance fraud activities fall under three main categories: fraudulent diagnoses, billing for services not rendered, and medical coding errors." [ p. 34.]

In illustration, Moisio provides well-defined examples relating to each category:

Fraudulent diagnoses consist of either intentionally falsifying a diagnosis, misrepresenting the diagnosis, or selecting a diagnosis based on the amount of reimbursement. Billing for services not rendered can consist of scenarios where equipment is never provided to the patient; hospital visits which never occur; or laboratory/diagnostic tests which are never administered. Medical billing errors can include "upcoding" or selecting a diagnostic code based on a greater reimbursement; "leveling" or using the same billing/diagnostic code for all office visits; and "unbundling," or assigning individual medical or office-visit codes to services or diagnoses covered by a single code (note Moisio’s excellent snapshots of such activity).

Unfortunately, identifying fraudulent activity in an ultra-complicated environment is not simple. For example, Medicare reimburses hospitals on a Progressive Payment System (PPS) that was adopted by Congress in 1986 (a system intended to reimburse hospitals for their "reasonable costs" according to PPS methodology which uses both a fee schedule and a cost-base method or a combination of both).

The primary components of this payment system are Medicare Part A, which covers institutional services, and Part B, which covers outpatient services provided by physicians and other professionals (with each segment or "part’ financed differently and offering specific and distinct coverage). Part A provider claims for reimbursement are processed by "fiscal intermediaries," which are generally insurance companies operating under contract with the Secretary of Health and Human Services. Part B provider claims are processed by "carriers" who are also commercial insurance companies.

In actuality, the PPS payment method is a labyrinth of rules and regulations virtually incomprehensible to all but the most determined student, and deep understanding of this material requires access to a two-volume "Provider Reimbursement Manual" which is basically the "bible" of the industry.

Medical reimbursements have created acomplicated system with layered rules that benefit hospitals in myriad ways. Some examples of instances which mandate special attention: payment adjustments may be made to providers who are sole community hospitals or Medicare-dependent small rural hospitals; adjustments may be made if a provider serves a disproportionate share of low-income patients; teaching hospitals can receive additional payments through a variety of indirect medical education adjustments. In addition, there are also different cost-reporting requirements for proprietary facilities, teaching hospitals, doctors providing inpatient medical services, skilled nursing facilities, and home health care facilities (among others).

As a means to illuminate her readers on how health care billing is done, Moisio provides crisp descriptions of the coding systems and the terms commonly used in those systems:

"CPT "Evaluation and Management" section (E/M) (99201-99499) codes are divided into three broad categories of provider services: office visits, hospital visits, and consultations. E/M codes capture information about medical services, as opposed to surgical services. As the name implies, evaluation and management codes are used to report physician or provider activities associated with evaluating an individual’s health status and managing or implementing a plan of care related to that status." [ p184.]

And taking the subject still further:

"Selecting the appropriate evaluation and management CPT code that is the responsibility of the physician or provider. Many providers document the E/M code by circling or checking one of the E/M codes that are preprinted on the encounter form or route slip. Figure 6-7 is a sample encounter form with the E/M and diagnosis codes printed . . . It is important to emphasize that the billing specialist and medical coder do not challenge the clinical judgment of the physician. Rather, the record review is a method to ensure that the documentation in the patient record supports the physician-or provider-selected code. . .Insurance carriers and regulatory agencies monitor E/M codes for upcoding or downcoding . . .Some providers downcode under the mistaken assumption that this prevents insurance carrier or regulatory agency audits. In fact, both upcoding and downcoding can be categorized as insurance fraud or abuse." [pp. 196-197.]

Even though the system itself seems to create paths of abuse, fraudulent manipulation of a patient’s Medicare benefits are not tolerated, with severe administrative, civil and criminal penalties in place should a health care provider be proven to have engaged in insurance fraud. To evince how serious it takes the issue, the Government encourages citizens to come forward to report suspicious patterns of activity. And Moisio writes:

"The Federal False Claims Act provides financial incentives when suspected fraudulent activities are proven true. Any individual who reports the fraud may receive 15%-25% of any judgment." [p.36.]

Although written as a learning aid, A Guide To Health Insurance Billing is one of the few readily obtainable resources which provides a clear understanding of this subject area, including a guide to key terms and abbreviations, descriptions of medical coding, and sample copies of the appropriate forms. Accordingly, it not only serves the goals of the student, but also can assist administrative agencies, auditors and attorneys involved in the examination and prosecution of insurance fraud. We found the short but informative chapter on the intricacies of Medicare billing worth the price of the book alone.

Recommended as a primary classroom text in courses focused on the technical aspects of billing procedures for the health care industry. Further recommended as a research tool for individuals charged with overseeing this industry and enforcing procedural compliance. Finally, recommended to all Health Science libraries as a general reference text.

[1] Future columns in The Electric Review’s Reference section will review several of Thomson/RIA’s manuals on tax requirements for not-for-profit entities.

[2] Mississippi attorney Richard Scruggs, noted for litigating cases against the tobacco industry, recently filed several lawsuits against non-profit hospitals alleging that they were illegally acting as non-profit entities andnot meeting the IRS’ strict standards to maintain thisstatus. Consequently, the evidence Scruggs is presenting in his cases has opened up the entire concept of the not-for-profit hospital to closer scrutiny -- by both the Internal Revenue Service and the American public. ~The Editor

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© Frank Aiello. 2006. All rights reserved. Frank Aiello and The Electric Review.

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Frank Aiello is an attorney who has practiced law in California since the 1970s, including criminal defense, civil and probate work. He holds a History degree from the University of California at Berkeley, and a Law degree from Hastings College of the Law in San Francisco; he has also studied Anthropology, Sociology and Political Science extensively. Reach him via The Electric Review.

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MIRRIAM-WEBSTER’S MEDICAL DESK DICTIONARY. Revised. Thomson/Delmar Learning.

This reference manual (recently released in its revised edition) is the best - and most affordable - general medical dictionary presently on the market. The volume offers over 60,000 entries of terms specifically related to health care; definitions of terms that apply to health-care treatments, medical conditions and commonly used medications are also included. In addition, the reader will find mini-biographies of prominent medical pioneers whose work has influenced the practice of medicine in terms of research and patient care. Webster’s Medical also compiles definitions of oft-used abbreviations, as well as a truncated writing style guide for the practicing health care professional. Quite simply, this title is the definition of reference work, as Webster’s is a name known throughout the world for the creation of timeless dictionaries that have helped students work thorough their fundamental years of education. Here, we have the sure-handed vision of a Webster’s that has been dedicated to illuminating the language specific to the practice of medicine. Although the ‘target’ audience for Webster’s Medical is the health care professional and the medical student, there is also a place for this text in the hands of the patient/‘consumer’ as well. Developed by expert reference writers, the definitions compiled here are presented in a clear and compact style, and they can be readily understood by most detail-driven readers. In light of how many individuals are taking a ‘hands-on’ approach to their own medical care, this dictionary allows us to quickly become familiar with the terms and phrases our doctors are using. In turn, this knowledge will allow patients to develop well-reasoned questions for their health care providers in order to build a better understanding of the medical therapy they are receiving.

Recommended to Health Science libraries for its long-term reference value: as a medical dictionary, this selection sets the standard. In addition, it should be on the desk of all medical professionals as an in-office reference tool that will be referred to on a constant basis. Finally, this book also has value to the consumer for its clear and straight-forward style that never ‘talks down’ to its reader.

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CLINICAL DECISION MAKING: CASE STUDIES IN MATERNITY AND WOMEN’S HEALTH. Diann S. Gregory. Thomson/Delmar Learning.

Newly released from Thomson Delmar, this text (written by Professor of Nursing Diann Gregory; Miami Dade College) is presented with unique focus and delicate precision: A text meant to "bridge the gap" between knowledge and the student’s ability to apply that knowledge.

Nurses, more than any other health care personnel except Emergency Room specialists and trauma surgeons, are on the "front lines": With multiple demands flying at them at once, they must be able to make split second decisions that immediately impact the patient. A very demanding job indeed.

Here, Gregory has structured a text meant to assist nurses in the making of clinical decisions that relate directly to women’s health and to maternity-based cases. In this unique and practical series from Delmar Learning, nurses are summoned to the "front lines" of the classroom and confronted with real life scenarios; the idea is to present a "case" study and then step back while the nurse assembles the myriad information and offers the proper care. The author writes:

"Clinical Decision Making has been developed to provide the student with an opportunity to experience a wide range of clinical encounters in women’s health. The case format provides the opportunity to move from theory to application. It provides instructors with a transitional tool to guide students into practice...[and] gives students the opportunity to utilize the nursing process in order to make decisions based on multiple variables..."

As noted, the text is comprised of real life case studies in various areas of concentration, including Prenatal, Intrapartum, Newborns, Postpartum and Well-Woman health maintenance. In each case study (there are 44 in all), the reader is given a "blueprint" of variables (such as age, gender, pertinent health issues) to assess as they proceed toward appropriate patient care.

By ordering the material in this way, readers (students, nurses) are encouraged to use the knowledge they have learned in the classroom and apply it to a very real clinical situation. Gregory’s ultimate lesson here is to show that the typical classroom is a sterile and completely controlled environment, while the hospital itself is a kinetic and unpredictable stage where anything can happen at any time.

Accordingly, the best nurses think quick on their feet and are attentive to every fact and every last detail. The catch is that the only way for a student to learn these skills and how to adequately manage the needs of the patient is to dive into the fire and offer primary care. Clinical Decision Making by Diann Gregory gives them just that opportunity -- marrying the walls of the classroom to the hospital maternity ward and then demanding the reader initiate an appropriate plan of action.

Recommended to instructors of nursing courses that test the student nurse’s retention of material and the ability to transfer that knowledge to the care of the patient. The text by Gregory also comes in a more compact and streamlined version, one that offers 20 complete case studies rather than the aforementioned 44. The smaller version of the text is appropriate for use as a secondary class text in support of a more generalized manual on all aspects of nursing.

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ANATOMY AND PHYSIOLOGY FOR THE SURGICAL TECHNOLOGIST. Kevin B. Frey. Paul Price. Thomson/Delmar Learning.

Anatomy and Physiology courses form the foundation of the general study of medicine. In addition, these aspects of the curriculum are vital to the emergence of the surgical specialist -- without a thorough understanding of how the body is built and how the organ systems inter-relate, there can be no competent surgical intervention.

In Surgical Anatomy, Price and Frey have constructed a perfectly readable text that surveys the human body in complete terms. The goal of this text is simple: To familiarize the surgical technologist with the human anatomy and its physiology so that medical personnel are able to mitigate the inherent risks that surgery poses to the patient. The authors write:

"In fact, patient outcomes for intraoperative care can be negatively affected by the surgical technologist who does not understand anatomy. It is especially important that the practitioner of intraoperative care understand the distinction between general and surgical anatomy. For the surgical technologist to function effectively in the operating room, an accurate view of the human body is necessary, with emphasis placed on the application of this science to practical surgery."

Moving through the layers of this text, readers are met with well-ordered chapters that build on each other to form a coherent narrative. The book begins with a snapshot of the organization of the human body, and then segues into study of its chemistry and cell structure. From here, we are ready to examine tissues and membranes as they build into this highly sophisticated labyrinth of organ systems (heart, circulatory, nervous, muscular, skeletal, vascular) that governs human life.

In addition, each chapter includes two case studies focused on surgical intervention -- the authors expertly sewing the material together so as to make it meaningful to the practicing health care provider and advanced student. In a crisp, deft and economical style, Frey and Price not only outline the anatomical and physiological aspects of the body, but also show just how the information pertains to the very specific practice of surgery.

For doctors and students alike, the goal is to understand that intervening on an organ via an operation is a delicate and precise event - -an event which requires a certain appreciation for the way the human body is constructed. This text, while detailing the scientific data, also ushers the reader to the threshold of a greater lesson -- a lesson that leaves the surgeon and his staff appreciating the "person" and not just the "patient."

Recommended to instructors of any course centered around preparing medical personnel for work in the operating room -- from anesthesiologists to specialized nurses to surgery-based technicians. To this end, the text is premised on clear and sharp writing that serves a large demographic. Further recommended to Health Science libraries as a general reference text with long-term value.

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RESPIRATORY CARE SCIENCES. An Intergrated Approach. Fourth Edition. William V. Wojciechowski. Thomson-Delmar Learning.

ANATOMY AND PHYSIOLOGY FOR SPEECH, LANGUAGE AND HEARING. Third Edition. J. Anthony Seikel. Douglas W. King. David G. Drumright. Thomson/Delmar Learning.

This text is unique in the market for its specialized exploration into the speech, language and auditory systems of the human framework. Now in its third edition, Seikel (Idaho State University) and his co-authors have developed a textbook focused on topics of speech pathology and audiology - an in depth survey into the anatomy of this region that demonstrates how each of these independent systems is intricately inter-related.

The text begins with a nice overview of anatomy and physiology, including a review of the parts of the body and pertinent terminology. From here, we move into the "building blocks" of life, with discussion of organs, tissues and the systems that govern the body. Once these basics are covered, the authors then begin their focus on the systems that drive our ability to speak and hear.

Many texts devoted to the study of anatomy and physiology tend to leap quickly over this material, and instead will focus on the more popular areas of study (like neurology or the circulatory system). And that is exactly why Seikel’s book stands out: it gives the student a chance to engage in a detailed study of these regions.

As the text moves forward, we are led through the many interlocking systems of the body responsible for speech and hearing. For example, a standout chapter on the anatomy of respiration allows the student to begin to understand that vocalization is a by-product of breath; it simply cannot occur unless a multitude of other interactions are happening simultaneously within the body.

And the same is true for the material that covers the ear. In Anatomy/Physiology, careful consideration is given to the fact that the organ systems of the human body are intricate and inter-related, with many neurological reactions occurring that allow us to process sound and then store it within our minds and memories.

One of the best aspects of this text (in addition to its organization and clearly written passages) is in its ability to make the student aware that the study of one particular organ system must begin with a thorough understanding of the body as a whole. Seikel, King and Drumright have accomplished this in glowing terms.

Recommended as a primary course text in advanced anatomy/physiology and biology courses designed to train Audiologists and Speech-Language Pathologists. Also recommended to Health Science libraries as a general reference text. A truly unique text impeccably designed.

ALSO FROM DELMAR HEALTH

DELMAR’S FUNDAMENTAL AND ADVANCED NURSING SKILLS. Gaylene Altman. Delmar Thomson Learning.

As the title implies, this text examines basic nursing skills and how they build into the ability to complete advanced procedures. Delmar’s Fundamental is note-worthy because it is centered around the day-to-day nursing process: rather than just serving as a classroom tool, the book can be used by nurses in the throes of caring for sick patients - giving the reader immediate and practical value.

In today’s world of medical care, the nurse’s role has expanded greatly. Today, nurses are expected to be able to know and do more, while taking care of many more patients. Accordingly, the stresses which affect their working environments have multiplied. Given these changes in working conditions, nurses must be better prepared to perform their duties and care for the sick.

And that’s where Delmar’s Fundamental comes into play.

In its second edition, the text offers step-by-step instruction for nurses in physical assessment/examination, safety and infection control, patient care, basic care, medication administration, nutrition, elimination, oxygenation, circulation, wound care, immobilization/ support and special procedures as related to nursing care. Within these topics area, Altman (who is an RN and Ph.D. from the University of Washington) expertly augments the basic material by discussing issues such as when a nurse should and shouldn’t delegate tasks to an unlicensed aide. This is very important information because of the legal ramifications which could result from the wrong decision (see: Library Advisory on Industry News Page for a review of the Nurse Practitioner’s Legal Reference). In addition, there is also a nice section on the typical errors nurses make and how these gaffes can be avoided.

Recommended to all nurses as a day-to-day reference. Appropriate as a teaching text for its clarity and exhaustive coverage of the topic areas. Further recommended to all college and university libraries with nursing programs as a general reference text.

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COMPREHENSIVE MEDICAL TERMINOLOGY: A COMPETENCY BASED APPROACH. Betty Davis Jones. Delmar/Thomson.

This souped-up medical dictionary provides an in depth introduction to medical terminology, designed to familiarize the novice with the systems of the human body, thus preparing him to move into more advanced medical science courses.

However, readers shouldn’t be misled, for this is much more than just a glossary of medical terminology. Instead, Jones has done a remarkable job in creating a dictionary that also can be utilized as an tool in the classroom, as one special segment of the text shows specifically how combining word elements creates medical terms. Accordingly, each time a new word is introduced to the reader its components are broken down to show its root.

The design of the text - by body system and specialty area of practice - is beneficial to the young student in that it allows them to learn one system at a time without skipping around from organ to organ. This stylistic trait promotes a more complete understanding of the systems of the human body, encouraging students to note how each of these systems fit together and work in complete balance. Moreover, Jones has developed a special "Do This/Say It" chapter which forces the student to apply what’s been learned before moving to new material. This second edition also includes a section on gerontology meant to familiarize the young student with the unique problems that confront the elderly patient.

Recommended as a teaching text in all nursing courses and in any under-graduate course that begins the foundation for medical school. Further recommended to all college-level and public sector libraries as a general reference text.

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PEDIATRIC NURSING. Skills and Procedures. Barbara L. Mandleco. Thomson/Delmar Learning. This specialty text focuses on nursing care for the child patient. Pediatric is an important book in that it clearly lays out for discussion the fact that child-patients much be approached differently than adults. Here, Mandleco (College of Nursing Brigham Young University) does a comprehensive job in fully addressing what nurses need to know about caring for young patients. Starting from the beginning, Mandleco instructs readers how the nurse is to assess the child-patient’s health (including health history, physical examination, vital signs and assessment of nutritional and developmental deficiencies). From here, the reader is escorted through the proper procedures relating to specimen collection (the blood draw chapter is important since this is very difficult to perform on a child), medication administration, peripheral IV-line insertion (another extremely important segment) and wound care (among a host of other information). As you can see from this summary of major topics, Pediatric covers the whole of the nurse’s duties as they relate to the pre-teen patient. But more than being detailed, well-written and expertly formatted for easy review, the true value is in the book’s ability to teach the student nurse to slow down and realize that all patients are not alike -- especially where children are concerned. This fact cannot be over-emphasized, and accordingly, this selection should be required reading in all nursing programs.

Also recommended to Health Science libraries for its long-term reference value.

HEALTH UNIT COORDINATOR: 21st CENTURY PROFESSIONAL. Donna J. Kuhns. Patricia N. Rice. Linda L. Winslow. Thomson/Delmar Learning. Specifically designed for the community college or nursing administration student, Health Unit reviews the role of the Health Unit Coordinator in the hospital setting. The Health Unit Coordinator position dates back to World War II and basically serves as support for the hospital nursing staff, assisting in the completion of non-clinical duties. However, over the last 60 years (due to technology and research), this position has changed drastically. Accordingly, Kuhns and her co-authors have written a text for the 21st century student meant to help them prepare for the Health Care Unit Coordinator Certificate Exam. Topics covered here include the history of medicine, proper patient care, an overview of the Health Unit Coordinator’s primary functions, an overview of the hospital setting including administration and support services, patient privacy, patient rights, advanced directives, hospital communication systems, and medical transcription. One of the best features to be included is the addition of a study question segment which concludes each chapter -- forcing the reader to immediately test themselves on what they’ve learned/retained.

Recommended to all instructors who teach courses focused on hospital administration. Would also prove to be a useful reference tool for the coordinator of the private physician’s office because of the wealth of information it provides on the behind-the-scenes world of the medical office. Finally, recommended to all Health Science libraries as a general reference text.

DOSAGE CALCULATIONS. 7th Edition. Gloria D. Pickar. Thomson/Delmar Learning. The ability of the health care worker to competently calculate medication dosages is paramount to both patient safety and effective treatment. It is also one of the most difficult and tension-filled of all duties the clinician must master -- for an error on this level often courts lethal consequences. Thus, Gloria Pickar’s Dosage Calculations (now in its 7th edition) is regarded in the profession as one of the most useful reference tools available. In Dosage, Pickar has written a book that attempts to allay some of the anxiety that goes along with calculating medicine dosage, and is specifically written for those individuals who feel uncomfortable with mathematical equations. Pickar helps the reader get over their math anxiety by writing in a clear and effortless way (showing that with practice and focus this skill can be mastered and performed with ease). Topics covered here are varied and vast, and include review of ratios, percents and simple equations; measurement systems and medication orders; and a very detailed examination on deciphering drug labels and bar code symbols. There is also a rich chapter on adult intravenous calculations (including heparin administration). Readers with an understanding of basic arithmetic will gain much from this text.

Recommended to instructors in RN preparatory programs as a supporting text. Also would be a useful daily reference tool for Emergency Room and Intensive Care personnel.

WITH AN EYE ON THE CHILD

THE AMERICAN ACADEMY OF PEDIATRICS

By John Aiello

Any new mother or father is likely to be on information over-load, bombarded with various how-to manuals, in addition to so much motherly advice on the do’s and don’t of raising a child. After awhile, it all must seem daunting -- it’s only a matter of time before these new parents have to scream "Enough!"

That’s where the American Academy of Pediatrics (AAP) comes in. The Academy (comprised of top Pediatricians and pediatric researchers throughout the country) publishes an extensive line of books meant to educate first-time parents on how best to care for their kids.

The AAP’s titles are notable for their long-term reference value and for their deep consumer focus -- these books, written with the parent in mind, are easy to navigate and easy to understand: the key here is that the information is immediately accessible to the lay reader (and thus conducive to retention).

New parents are obviously under a great deal of stress, and few (if any) have extra time to search through a text to find answers to questions about how to best address their infant’s needs. In light of this fact, the AAP list comes together to build an impeccable reference foundation on myriad subjects. Yet, even though their subject matter is vast, the over-all purpose of these books remains singular: to make your child’s early years as healthful as possible.

Standout titles in the AAP catalog include:

YOUR BABY’S FIRST YEAR. Steven P. Shelov, Editor-in-Chief. Bantam Books and the American Academy of Pediatrics. This pocket reference, priced at only $6.99, should be in every new parent’s baby-bag -- a rich and well-detailed resource that escorts the reader through the typical first year of a child’s life. Your Baby’s First includes a comprehensive month-by month guide that tells the parent what to expect, with specifics on growth patterns, behavior scenarios and development cycles. In addition, note the erudite instructions how to confront (and successfully navigate your way through) a pediatric medical emergency. Also, information on vaccination schedules, breast vs bottle-feeding and prevention of accidental poisoning is included. Finally, the segment on basic first-aid care is notable for data on children and choking - with guidance on how to guard against this danger. An absolutely impeccable consumer reference. Version also available in Spanish.

GUIDE TO YOUR CHILD’S SLEEP. George J. Cohen. Editor-in-Chief. Villard Books and the American Academy of Pediatrics. Like the Shelov title noted above, this book is a necessity for the fledgling parent, detailing the things child caretakers need to be aware of as the infant develops its sleeping pattern. Probably the most stressful thing a new parent has to cope with is getting the baby to sleep at regular times, and Cohen provides insightful direction on how a mother/father can help the infant get the rest it requires. In addition to myriad tips on how to survive the ordeal of getting your infant to sleep, this book’s provides pertinent data on Sudden Infant Death Syndrome (SIDS) -- a well-publicized affliction that causes much consternation for new parents. Accordingly, Cohen’s analysis is quick and to the point and should alert a new parent on what to look for and what issues to examine (in dialogues with their pediatrician) so that they don’t fall victim to SIDS.

NEW MOTHER’S GUIDE TO BREASTFEEDING. Joan Younger Meek, Editor- in- Chief. Bantam Books and the American Academy of Pediatrics. There was recently some debate in pediatric wellness circles on whether breastfeeding was as important (and beneficial) to a baby as "old time" pediatricians had thought. But as Dr. Meek’s text so nicely illustrates, breastfeeding is indeed beneficial to the new-born, allowing maximum nutrition for the baby (as well as giving the first-time mother the chance to bond with her child and to get to know its personality and feeding patterns). Beyond this, information provided in this guide shows that breastmilk actually bolsters the infant’s immune system and helps the child fight off opportunistic illness. Among other topics, readers will find examples on how to hold/position the child during feedings, as well as advisement on how to wean a baby from breastfeeding. Version also available in Spanish.

GUIDE TO YOUR CHILD’S ALLERGIES AND ASTHMA. Michael J. Welch, Editor-in-Chief. Villard Books and the American Academy of Pediatrics. According to the most recent statistics, Asthma afflicts 5 million children in the United States, with allergies plaguing a whopping 50 million kids nation-wide. And as staggering as these numbers are, they grow every day, with new variations of mold, mildew and fungal allergies discovered annually. Thus, Dr. Welch’s guide to allergy and asthma as related to the child-patient is particularly relevant. Within this volume, readers will find comprehensive coverage of the triggers which spawn asthmatic and allergic reaction within the adolescent body. In addition to helping parents identify symptoms, triggers, treatment options and potential allergens, there is also valuable direction on how to explain these oft complicated conditions to the young patient. It is important to remember that these afflictions can often deprive children of the enjoyment of engaging in strenuous exercise, separating them from them classmates. With this in mind, Dr. Welch offers pertinent advice on how a parent can discuss these conditions with a child so that the youngster can then play an active role in helping to manage symptoms.

GUIDE TO TOILET TRAINING. Mark L. Wolraich, Editor-in-Chief. Bantam Books and the American Academy of Pediatrics. Dr. Wolraich and his contributors have done a handsome job is detailing this big event in the life of a child. Some psychologists believe that the way a youngster is toilet trained has the potential to impact their mental well-being as an adult. Consequently, it is imperative that parents realize this and take steps to make bathroom training as trauma-free as possible. Guide To Toilet Training is chock full of practical advice on how to help the child through the process. Topics covered include finding the best age to begin toilet training, how to manage accidents, how to approach bedwetting episodes, and ways to initiate toilet training when dealing with a resistant child. Well-written and presented with a delicate hand, this book belongs at every new parent’s (and grandparent’s) fingertips.

Even though we have reviewed these selections with the consumer in mind, we would recommend them to all public sector and community college librarians as well: these books create a true "community resource" and deserve to be readily available to low-income readers via the public library system.

Order from booksmd.com;or go to aap.org/bookstore

ELSEVIER HEALTH SCIENCE

In the wake ofthepublishing season's graduationinto the secondquarter of 2006, Elsevier continues its assault on the medical science market with a bevy of outstanding titles. These books are examples of someof itsvaried-best:

New and Notable

PHYSIOLOGY. 3rd Edition; with Student Consult Access. Linda S. Costanzo. Saunders.

By John Aiello

This text by Linda Costanzo (Professor of Physiology, Virginia Commonwealth University) is an important addition to the canon of medical literature as it investigates human Physiology at both the organ and cellular level. More than anything, what this manual does is offer the primary aspects of Physiology in a clearly defined manner that stresses long-term retention for the student.

Costanzo takes a basic approach to the construction of Physiology, presenting the reader with a firm overview of the body’s cellular labyrinth before moving into the Physiology of particular organ systems (neurological; cardiovascular; respiratory; renal, gastrointestinal; endocrine; reproductive).

In addition. Costanzo devotes an entire chapter to analysis of the dynamics of acid-base Physiology, which often can be a trouble-point for students. Accordingly, inclusion of this information rounds out the face of this text in complete terms, cutting to the core of a topic area that tends to lose many student-readers in its multiple complexities.

Obviously, Costanzo’s background as a veteran instructor has instinctively allowed her to create a book that will satisfy the needs of a broad-based audience:

"Part of the impetus in doing this book was the desire to deepen my own understanding – in writing about physiology, I came to learn it better," notes the author. "The other impetus was in that basic human drive to be useful and to do something new. As a writer, I wanted to build a teaching resource that would be immediately accessible to the student. I based the format on my own learning and teaching experiences – taking care to appreciate what worked for me in the past and what didn’t work so well. The goal was to show students the hierarchy of the subject and then to demonstrate the links between concepts in a logical way. I’ve found that once students see the structure of a subject, they truly begin to own it."

And that just what makes Physiology noteworthy - its accessibility: The tone clear-eyed and straight-forward gives students the information they need in a well-defined and ordered format (as the author combines illustrations with point-by-point explanation in order to draw a complete picture of each topic for the reader). Chapters conclude with succinct summaries which bring students back to key areas of reference (review questions augment these chapter summaries and test the reader’s comprehension of the most relevant data).

Finally, the Clinical Physiology Case Studies presented serve to confront students with patient capsules, confronting young doctors with the myriad forms of "classic disorders" as a means to teach them how to take information from the lecture hall and apply it directly to the examination table.

"I think the key to any textbook is for the author to be courageous – the courage to leave out extraneous details; the courage to show one’s own enthusiasm for the material; and even the courage to point out where the thread of logic may break down," remarks Costanzo. "Textbook authors have an obligation to insure that students do not feel intimidated. The challenge is to break down and organize the material in a way that brings the student to this ordered way of thinking."

Indeed, Costanzo’s real gift is to be able to write medicine in a way that allows it to transfer to the classroom with seamless efficiency. Insofar as foundational Physiology texts go, this one sets the standard in scope and style.

THE OSLER MEDICAL HANDBOOK - 2nd Edition. Handbook with BONUS PocketConsult Handheld Software. By Johns Hopkins Hospital: Jonathan Paul Piccini, MD; Fellow. Kent R. Nilsson, MD; Fellow. Saunders.

This handbook comes to us having been written by experts at Johns Hopkins Hospital, and it focuses on meeting the challenges posed by the daily practice of medicine. Accordingly, Osler’s covers the full spectrum of diseases that afflict the design of the human body, discussing in detail how the medical specialist should approach diagnosis (a carefully orchestrated step-by-step process of testing, observation and evaluation culminating in treatment).

In creating this comprehensive manual, the authors cover myriad organ systems, with acute analysis of Cardiac disorders; Dermatologic issues; diseases of the Gastrointestinal tract; Hematology; and Oncologic emergencies requiring immediate intervention by the hand of the physician. This edition is further noted for the new information it shares, as the authors have included chapters on end-stage liver disease, hematologic malignancies, biotterrorism, tuberculosis, Glomerular Disease and bone marrow failure (the delineation of each providing keys to the most recent thinking on patient care as it relates to these subject areas).

In addition, the completely revamped section on Critical Care Medicine gives both Emergency Room and ICU personnel a refresher course in new approaches to managing the sickest patients (to this end, readers will find new perspective on ventilation therapies -- an extremely important topic given the public’s increased awareness of quality of life issues in the wake of the Terri Schiavo controversy).

Basically, a medical text is deemed worthy of widespread use when it is able to convey cutting-edge data in a clear and cogent manner. And that’s just what the authors and editors of Osler’s have done with this manual -- building an in-office reference that outlines the most common diseases and disorders the clinician is likely to encounter in daily practice.

As Osler’s infers with its carefully ordered analysis of human health, the best doctors know that no case is routine and that no diagnosis is easy. To the contrary, sound patient care takes dedication and a mastering of the fundamentals of the scientific process, this never-ending process of testing and assessment that allows the clinician to alleviate patient suffering. In accordance with this sacred mission, The Osler Medical Handbook is an artful resource with long-lasting value.

A MANUAL OF SYSTEMATIC EYELID SURGERY. Third Edition. J.R.O. Collin. Butterworth-Heinemann.

FUNDAMENTALS OF BODY CT, 3rd Edition. W. Richard Webb. William E. Brant. Nancy Major. Saunders.

Refinement of Computed Tomography (CT) has revolutionized approaches to diagnostic medicine during the past 30 years, as Radiologists working in concert with physicians can literally see through the myriad layers of the body to assess flaws in function.

CT scans use thin beams of light which rotate around the patient to create an image of the body. Once that image is complete, it is then interpreted -- and enhanced -- by computer, thus allowing for multi-dimensional (and cross-sectioned) investigation of various regions of the human anatomy. Accordingly, CT scans are vital for in depth assessment as they give the physician a more complete view of the body as a whole.

Fundamentals of Body by Richard Webb (University of California, San Francisco), William Brant (University of Virginia) and Nancy Major (Duke University Medical Center) is noted throughout the annals of medicine for its clean "no-frills" delineation of how to implement CT scans and then interpret the nuances of the results.

Now in its third edition, the text is noteworthy for its organization and formatting, as the authors have gone to great lengths to strip away extraneous and convoluted analysis, building their study from a foundational perspective. As if teaching a class on paper, Webb and his co-writers speak in a crisp and concrete manner that is delivered in a lecture-like style. Topics covered are vast, including discussion of recent development of CT technique, exploration of "multislice" CT scans to assist in diagnosis of chest and abdominal problems, as well as a detailed breakdown of ways 3D CT agiography can be used to peer into a blood vessel in order to examine its delicate intricacies.

The x-ray department’s role in the practice of medicine cannot be understated, for the Radiologist remains at the center of the diagnostic process, allowing the physician to see the full perimeters of an abnormality and then move toward the best treatment for an individual patient. Fundamentals of Body is an important text that provides a record of the latest developments in the field, examining the topic from a multitude of perspectives (when information on how to properly perform a CT procedure merges into how physicians should approach interpretation of test results a complete picture of the discipline is ultimately created for the reader).

In the end, Webb and his co-witers present their readers with a book that says, quite clearly, that the long-term health of the patient is just as dependent on the skill of the Radiologist as it is on the Pharmacist’s dispensary.

SMITH’S RECOGNIZABLE PATTERNS OF HUMAN MALFORMATION. Sixth Edition. Kenneth Lyons Jones. Saunders.

This text offers a definitive analysis of the patterns of human malformation that originate during the genesis of the fetus. Now in its sixth edition and richly layered in detail, Smith’s Recognizable Patterns is applauded throughout the medical community for its ability to cover its topic in relevant and broad-reaching terms.

Dr. Jones (University of California, San Diego) is a leading expert in the field, and his work with this text will serve generations of physicians to come as they look to unlock the mysteries of genetics and the causes of malformation.

Here, Dr. Jones tackles the topic of birth defects from a classic academic perspective, creating a definitive resource along the way. Accordingly, Dr. Jones offers a complete summary of various Chromosomal Abnormality Syndromes, moving seamlessly from one aspect of the topic to the next, expanding on the data with clear clinical precision.

Among the wealth of information presented, Dr. Jones writes on several common disorders (Short Syndrome; C Syndrome; Lenz Microphthalmia Syndrome; Torriello-Carey Syndrome; Mowat-Wilson Syndrome) as a means to connect thepracticing physician with the latest thinking on the reasons why the normal stages of development come to be altered. The idea here is to educate the clinician so that he absorbs the data in a way that will allow him to help parents cope with the disturbing reality of having to raise a child with birth defects.

Dr. Jones’ vast experience as a physician and professor has enabled him to align the book in a way that will be immediately relevant to other doctors -- with chapters designed to thoroughly describe a given abnormality in terms of its history and etiology in quick and efficient detail. From here, expert use of photographs and illustrations allow the reader to see the abnormality in multiple dimensions so that complete understanding can be attained.

As with other areas of medical research, a scientist must be able to see into the molecular basis of a given disease before precise diagnosis and treatment can ever take place. To this end, Dr. Jones has written a manual that inspires its reader to see beyond the skin to the platform of the cell, writing through the subject of human malformation so as to peel the mystery away from this oft-misunderstood area of study.

Recommended to instructors teaching courses on Genetics, Dysmorphology and Teratology. In addition, the manual would prove useful to physicians who treat patients with birth defects and/or provide counsel to parents. Finally, the text is indispensable to all Health Science libraries as a general reference text.

WALL & MELZACK’S TEXTBOOK OF PAIN. 5th Edition. Stephen McMahon. Martin Koltzenburg. Churchill Livingstone.

Pain Management Centers are now common place at many urban Centers, as health care providers attempt to alleviate suffering through a variety of medications and dedicated treatments.

In this text, McMahon (Center for Neuroscience Research, King's College, London) and Koltzenburg (Institute of Child Health/Institute of Neurology, University College, London) offer the definitive resource on all aspects of the pain process -- including analysis of both neurophysiological and psychological perspectives as related to the "pain syndrome."

In addition to dissecting the neurological basis of pain, the authors carefully summarize treatment options through examination of various pharmacological, surgical, electrostimulative, physiotherapeutic, and psychological alternatives.

In this treatise, McMahon and Koltzenburg have done a masterful job in editing contributions from the leading researchers in the field in order to construct a one-stop manual that is pertinent to instructors, practicing physicians and advanced students on the threshold of exploration into the palliative side of patient care.

Readers of Wall & Melzack will take part in a comprehensive course focused on the phenomenon of pain. High-lights of the revised edition must include mention of the material on medications, as recent research has given rise to the use of a mixed variety of drugs (cannabinoids, antidepressants, muscle relaxants, opioids) in order to lessen the severity of chronic pain patterns. Furthermore, the authors are careful not to side-step the possibility of patient addiction to such narcotics (a problem that is seen all too frequently now in the athletic and entertainment worlds). Also notable is the chapter on headaches (which, along with back/spinal pain complaints, account for millions of doctor visits every year).

Obviously, the subject of pain is paramount to the practice of medicine, since it often the primary reason the patient seeks medical attention in the first place. Here, the authors examine the subject from both physiological and psychological perspectives in an effort to lead physicians to the understanding that this is a complicated matter that requires the medical provider to search for individualized treatments.

Flawlessly written and impeccably researched, with smart use of illustrations to evidence key areas of focus. The best book on the topic we’ve seen, hands down.

Recommended to all pain management specialists for its exhaustive coverage of the subject. Also useful to Anesthesiologists, Neurologists and Sports Medicine specialists (physicians and therapists). Further recommended as a teaching text in any course that delves into ways that the physician should address both acute and chronic pain complaints. Finally, recommended to all Health Science libraries as a general reference text.

GREEN’S OPERATIVE HAND SURGERY. 5th edition. David P. Green. Robert N. Hotchkiss. William C. Pederson. Scott W. Wolfe. Churchill Livingstone.

Green’s is noted as the absolute authority in terms of detailing the intricacies of hand surgery. Now in its 5th edition, Green’s comes to us completely revised from earlier versions, with updated information that’s been framed in a somewhat different face -- the print text bolstered by multimedia capabilities that allow the reader to access a continuously updated website for information on the most recent developments in the discipline.

Green’s is the preferred reference in the field because of the depth of reportage by a long list of expert contributors. The text begins with an overview of the general principles of surgery before moving into specific analysis of this region of the body. Discussion includes the hand (infections, Dupuytren’s Contracture, tendon injury, nails, arthritis); the wrist (carpal instability, Distal Radioulnar Joint, wrist Arthroscopy); elbow and forearm; the nerve system (Comprehensive Neuropathies, Radial Nerve Palsy, repairs and grafting, Cerebral Palsy); congenital disorders; bone and tissue reconstruction; and an overview of disorders related to the upper extremity.

Obviously, this text completely exhausts its subject by presenting the latest perspectives on surgical technique and research as related to the human hand. What sets Green’s apart is its ability to provide a definitive record of all disorders which strike this region. In addition to the routine cases that physicians are likely to see, Green (University of Texas Health Science Center at San Antonio) and his co-authors also address more complicated reconstruction, deformity and neurological issues that tend to be seen somewhat less frequently.

Further to the comprehensive discussion of the hand and its sub-systems, Green has added a series of new chapters on the elbow and forearm (including analysis of Arthroscopy and Arthoplasty procedures as related to the elbow). Additionally, there is a highly refined section on the wrist (which has become an area of increasing concern among Orthopedic specialists who are now seeing an influx of patients with carpal instability issues caused by repetitive stress and computer over-use).

In the end, Green’s real value is cloaked in its authors’ ability to clearly define each hand-related disorder as it escorts the reader into deeper exploration of these subjects. Unlike those typical "how to" references of yesteryear, this book addresses the core of each affliction along with all appropriate surgical-repair options, bringing the physician to a better overall understanding of the upper extremities.

TEXTBOOK OF MEDICAL PHYSIOLOGY. 11TH EDITION. Arthur C. Guyton, MD. John E. Hall, Ph.D. Saunders.

Now in its 11th edition, this world-respected textbook (often referred to by instructors as "Guyton and Hall") has set the standard in physiology classrooms for decades. The 11th edition of Medical Physiology extends the standard of quality that began with the first installment of the text, and should immediately remind instructors, students and academic writers in all disciplines what a textbook should aspire to be.

Beginning with a full overview of physiology as it relates to each human organ system (and the practice of medicine), Guyton and Hall move into deep discussion of how organ systems are inter-related and entwined (creating the amazing labyrinth that is the human body).

The magnificent thing about Homo Sapiens is in their construction -- each organ system functioning with independent precision as it merges seamlessly into the next system in the chain in order to create this multi-dimensional "body." Accordingly, this text does an admirable job at bringing this symbiosis to life, utilizing a full-color format to help students more easily understand the subject matter. In addition to the analysis of medical physiology, the authors have taken the material one step further, actually applying these situations to a clinical stage so that the student-doctor can better link the principles of physiology to the practice of medicine.

Aside from the breadth of coverage afforded the reader by this text, the true "beauty" of this title is in its presentation: Clear and concise writing make the material instantly accessible to the young reader and allow for a more precise understanding of the human body.

It should not forgotten that medical students are often inundated by a never-ending parade of new vocabulary and foreign concepts -- a confusing 'mishmash' of material that sometimes gets lost in the translation. To combat this trend, Guyton and Hall offer their readers an introduction to the study of physiology that is at once insightful and artful and inviting -- inviting a deeper interest in the body as a whole.

ALSO OF NOTE

PREOPERATIVE DRUG MANUAL. Paul F. White. Saunders.

Recent events centered around adverse reactions by patients to various prescription drugs have spawned a renewed interest in the administration of medication -- on the part of both consumer and medical professional.

This manual (formerly titled "Anesthesia Drug Manual") outlines the way preoperative drugs (anesthetics) are likely to interact with other medications that a patient might be taking upon admission to the hospital.

Preoperative is a handy pocket-sized book meant to be carried/used by the Anesthesiologist in the course of patient care. The book marks a thorough examination of both the "pharmacokinetic and pharmacodynamic properties of nearly all drugs listed in the PDR and USP" -- a well-developed compilation of both standard and recently approved medications that sets off an in depth discussion of how these drugs work and how they impact the body.(Also notable for its inclusion of dietary supplements and herbal medicines which are now seeing more wide-spread use).

The key for the Anesthesiologist is to be able to anticipate the likely interactions between pre-operative medications and other drugs (such as Beta-Blockers or Immunomodulators) that many patients are taking in the days and hours before surgery: The idea is for the Anesthesiologist to be able to understand the likely adverse reactions that might occur so that he can take appropriate steps to mitigate a life-threatening event. This well-desinged manual (the format allows for easy access of information as the clearly organized topic headings attest) provides a natural starting point.

ACCIDENT AND EMERGENCY RADIOLOGY. Nigel Raby. Laurence Berman. Gerald de Lacey. Saunders.

Like the subject of the previous review, this selection is written for the practicing health care professional to be used in the direct course of patient treatment. Accident and Emergency is focused on guiding emergency room personnel towards accurately accessing x-rays (and catching hidden conditions that often might be over-looked at first glance).

Now in its second edition (first released in 1995), this handy carry-size manual’s importance cannot be over-stated. Organized according to the radiological anatomy, Accident and Emergency covers all primary points of the body, including the skull, face, shoulder, spine, pelvis, leg and foot.

After moving through the basic principles of radiology (with well-presented data on how to detect a fracture), the reader is taken to each primary region of the body and given a step-by-step tour of ways to detect injury and then assess its severity (with direction on how to avoid common mistakes caused by misreading nuances in radiological studies).

In addition to the clear delineation of the subject matter and precise organization, readers will be further assisted by the "Key Points" and "Subtle Signs Not To Miss" boxes which summarize the most relevant information chapter-by-chapter -- features that provide ER doctors with an extra point of reference as they attempt to accurately identify problems in kinetic environments.

INTERVENTIONAL RADIOLOGY (A Survival Guide). Second Edition. David Kessel. Lain Robertson. Churchill Livingstone. Radiologists might want to consider this text as a companion to the selection reviewed in the previous summary. While the Raby text is dedicated to assessing emergency-type radiological images, this manual is focused on how to proceed with invasive tests so that results can be obtained safely and accurately. Interventional Radiology provides important and detailed analysis of Angiography and Vascular Intervention - procedures that comprise some of the most common studies done in this realm.

Recommended as both an in-hospital reference and as a teaching text in courses which focus on this specialty-area of radiology.

PATHOLOGY OF THE SKIN. 3rd Edition 2-Volume Set with CD-ROMS .
By Phillip H. McKee. J. Eduardo Calonje. Scott R. Granter. Mosby.

Now in its in its 3rd edition, this title is a major contribution to the study of skin pathology. Here, McKee and his co-authors present the reader with full and comprehensive analysis of the diseases which attack the skin.

Expert analysis begins at the onset as the authors first explore the structure and functions of skin (the largest organ within the human body). From this point, we are taken on a complete journey through the many different afflictions which are found at the body’s surface, including full discussion of Acantholytic disorders, inflammatory diseases of the subcutaneous fat, diseases of the oral mucosa, diseases of the genital skin, disorders of pigmentation, and Melanoma (only the short list of the topics covered). The text surveys each of these subjects in complete terms, moving slow and with certainty, with over 5,000 well-developed illustrations augmenting the most critical points of understanding.

These physician-authors done an exemplary job at capturing this material for both the academic and professional reader. Many texts in this field of study tend to be ‘either’ ‘or’ efforts: Either they are written for specialists in the field, or they are written for student-doctors and presented with too much classroom preponderance (and thus unsuitable for a doctor who needs to refer to the material in the quick course of patient treatment).

However, these writers have managed to avert this minefield, deftly creating a resource that is not only a perfect fit for physicians treating diseases of the skin (but is also a valuable teaching tool that can guide fellows seeking certification in the field ). The idea here is to foster a true understanding of a sometimes complicated area of medicine where early diagnosis is so vital to effective treatment.

Moreover, the cutting edge tone of this volume -- comprised of the latest data on the subject -- renders it invaluable to all medical science libraries. Among the many fine attributes of Pathology are the chapters on Melanoma and other cancerous conditions: with a large segment of the populous now reaching retirement age, the incidence of skin cancer is only likely to increase. Thus, is it is imperative for physicians practicing in this sub-specialty to be able to recognize the early signs of disease and pro-actively move toward treatment. Accordingly, this text creates a wonderful resource that will serve Dermatologists and Internists for years to come.

Of Related Interest

SURGERY OF THE SKIN. June K. Robinson. C. William Hanke. Roberta D. Sengelmann. Daniel Mark Siegel. Mosby. A perfect companion to McKee’s Pathology of The Skin, Surgery of the Skin sews together the latest data on the subject of invasive treatment of skin disease into one practical and all-inclusive text. In addition to the up-to-date data presented here, this selection features a bonus DVD-ROM that allows the surgeon to examine different surgical procedures through video clips and various illustrations (a vital tool in that it allows for practical application of the text itself). 95 contributing writers comprise the leading voices on the subject, and the full spectrum of surgical approaches to both common and complicated problems are explored within these pages. Included in this discussion are chapters on skin structure and surgical anatomy, aseptic technique, anesthesia and analgesia, Electrosurgery, Electrocoagulation, Cryosurgery, biopsy techniques, skin grafting, use of botulinum toxin type A in facial rejuvenation, and liposuction (to name but a few of the topics covered). Similar to the previous text, this is an important resource for Dermatologists and skin surgeons who are likely to see many more cases of skin cancer as the elderly population continues to increase over the next decade. Also recommended to all Health Science libraries as a general reference text for its long-term reference value.

Also of Note From Elsevier(Spring Quarter 2005)

DIAGNOSTIC ULTRASOUND. 3rd Edition. 2-Volume Set. Carol M. Rumack. Stephanie R. Wilson. J. William Charboneau. Jo-Ann Johnson. Mosby. This title is the authority in the field of ultrasound diagnosis as it relates to both the adult and child patient (which is exactly why it is used in so many radiology departments at centers throughout the world). This selection covers the subject in broad and definite terms, and boasts many features which has caused it to be first choice among health care providers who use ultrasound to detect disease and instigate treatment. Diagnostic Ultrasound provides a nice over-view of the process of ultrasound itself, and then moves quickly into the core material, which includes in depth analysis of abdominal, pelvic and thoracic sonography; small parts, cartoid artery and peripheral vessel sonography; obstetric and fetal sonography; and a full analysis of pediatric sonography. In addition to discussion of the different disorders inherent to each particular region of the body (as noted), the authors have designed a unique feature that incorporates a series of image collages into the text that depict different ultrasound findings of the same disorder. As medicine continues to evolve and become more high-tech, this feature allows the radiologist to teach himself to look beyond the surface and explore test results with an eye to locating abnormalities which at first might not be obvious. Recommended to hospital radiology departments both big and small as the definitive reference in the field. Also recommended to all Health Science libraries a general reference text.

VASCULAR DIAGNOSIS. M. Ashraf Mansour. Nicos Labropoulos. Saunders. In line with the previous entry, Vascular Diagnosis collects the work of over 50 experts in the field who address the current thinking on non-invasive vascular diagnosis (for cerebrovascular disease, peripheral atherosclerotic occlusive disease, intra-abdominal occlusive disease, venous disorders, and aneurysms). Vascular is formatted for practical application and meant for use by the physician in the course of diagnosis and treatment. Accordingly, the authors have organized the material into three sections (the vascular laboratory and principles of vascular diagnosis; collecting useful images of the different regions of the vascular system; and a well-thought-out series of chapters on miscellaneous topics relating to administrative organization). This text boasts many standout features, including discussion of cerebrovascular color-flow scanning, MR and CT angiography, and vein-graft evaluation. In addition to the up-dated analysis of the most recent thinking in the field, Vascular benefits from the fact that it is written with the practicing physician in mind - the format conducive to quick referral by the practitioner. In short, this text has a singular and well-focused mission: to help escort the radiologist and surgeon and clinical cardiologist through the great labyrinth of the human vascular system. Similar to Rumack’s treatise, this book is recommended to vascular surgeons and radiologists specializing in vascular disease as the definitive reference in the field. Also recommended to all Health Science libraries as a general reference text.

PRINCIPLES AND PRACTICE OF SLEEP MEDICINE. E-edition/4th Edition. Meir H. Kryger. Thomas Roth. William C. Dement. Saunders. The inability to sleep -- along with backache and headache -- is the most common complaint for which patients consult their doctors. This magnificent tome (which comes with an option to engage a continually updated on-line reference data bank) examines all relevant topics related to disorders which both create and exacerbate our inability to sleep properly. After a tidy over-view of the physiology/mechanisms of sleep and the underlying principles of sleep medicine, we are taken on a tour of the etiology of sleep disorders and the many different reasons that can cause a person not to be able to gain the rest they need. In addition to a very interesting and in depth breakdown of circadian rhythms and how genetics impact these internal cycles, the reader gains deep insight into various new paths of thinking as related to the subject of treating/evaluating the sleep deprived patient. Specifically, there is research ongoing that looks to a link between sleep-breathing disorders and Cardiovascular abnormalities -- information that is vital in helping doctors treat patients who might present with sleep apnea and cardiac problems concurrently. Readers will also find invaluable discussion on the effectiveness of sleep medications for treating some insomnias, as well as a full dissection of neurological disorders and sleep (with a nice section on dementia). This selection, published under the Saunders imprint, is a one-stop source for the physician and contains research on the primary causes and treatments for sleep disorders. Accordingly, this would serve as an equally useful in-office reference for the internist, primary care physician and sleep disorders specialist. Also recommended to all Health Science libraries as a general reference text.

CRITICAL CARE TOXICOLOGY. Diagnosis and Management of the Critically Poisoned Patient. Jeffrey Brent. Kevin L. Wallace. Keith K Burkhart. Scott D. Phillips.J. Ward Donovan. Mosby. This specialty reference is dedicated to surveying how the physician should approach assessment and treatment of the patient who presents with symptoms of poisoning. A one-of-its-kind publication, this volume is the first text that we have seen to focus specifically on critical-care toxicology. Given the changing landscape of our world, with so many different chemical compounds being used in myriad ways, the potential for accidental poisoning is greater than it has ever been. Here, Brent and his co-writers have written a thorough exploration of the subject (with the analysis evolving from the point of hospital admission through core-treatment and stabilization/management, up to discharge). As noted, coverage is comprehensive and captures the whole of the topic, including chapters on toxic syndromes, poisoning by medication, drug abuse, poisoning by chemical agents, biological toxins, agents of chemical and biological terrorism (increasingly important given the war-torn fabric of this world), and antidotes used to neutralize toxicity. In addition, discussion includes perspective from various medical toxicologists within their individual areas of expertise. Analysis is also included on individual considerations as related to pediatric, pregnant, and geriatric patients (another reminder that medical professionals must evaluate patients on an individual basis and not based on ‘model’or formulaic treatments). Recommended to Emergency Room physicians as an in-office reference (offering immediate access to a printed Poison Control Center). Further recommended to all Health Science libraries as a general reference text for its obvious long-term value to the student community.

THE REQUISITES IN ANESTHESIOLOGY. Editor: Roberta L. Hines. Mosby. One of the most ignored aspects of surgery by the patient community is the process of administering anesthesia -- the surgeons tend to get all the glory and headlines, but the anesthesiologist is just as vital to the procedure: without his expert administration of the drugs that keep the patient sedated, without his ability to know the patient and anticipate problems, surgeries would be a gamble and constant crap-shoot, with many ending in disaster. In terms of specialty texts that deal with anesthesia topics, Elsevier/Mosby’s The Requisites series is a benchmark, offering vital analysis on how the anesthesiologist should approach his craft.

In The Series

CARDIAC AND VASCULAR ANESTHESIA. Jacqueline M. Leung. Mosby. Leung (University of California, San Francisco) has drafted this text specifically for the anesthesiologist working with patients who have cardiac or vascular disease, and it specifically guides the anesthesiologist on ways to manage care for a cardiac-compromised individual. Topics covered include anesthesia for patients with aortic disease; anesthesia for the patient with valvular heart disease; and anesthesia for the patient with congenital heart disease. Leung is a master at the organization of medical data, and she approaches her subject in truly comprehensive terms, designing her chapters for quick and easy reference. The underlying idea here is for the surgeon and anesthesiologist to come together, striving to increase patient safety/survival while reducing post-operative complications.

REGIONAL ANESTHESIA. James P. Rathmell. Joseph M. Neal. Christopher M. Viscomi. Mosby. Like Leung’s text, this selection offers insightful investigation into specialized anesthesiology, with an examination of the different techniques the anesthesiologist can use for different regions of the body. After an overview of neurophysiology and nueroanatomy, we move into analysis of the effects of anesthesia on different parts of the body (including the head/neck block; spine; and upper extremities).

In addition to their value to the practicing anesthesiologist, these texts are marked by clear and logical organization and have strong classroom value; thus, they should strongly be considered as instructional resources.

Order each from booksmd.com;or go to http://www.us.elsevierhealth.com

Previously Featured Reviews

SAUNDERS MANUAL OF CRITICAL CARE. PDA SOFTWARE. James A. Kruse. Mitchell P. Fink. Richard W. Carlson. W.B. Saunders. This converts the Saunders Manual Of Critical Care to software, thus allowing physicians and nurses in the ICU to consult vital information in the course of treating critically ill patients. The Saunders Manual is renown as a comprehensive catalog of the most common conditions found in patients who present to the Intensive Care Unit. The software version of the manual omits nothing from the printed pages, and even adds some features. Readers will find over 200 chapters of analysis, formatted by organ system, a quick and easy one-stop electronic reference that saves doctors critical time in addressing questions. Topics covered include surgery, trauma, and post-op care, to name but a few. A wonderfully rich pharmacology chapter documents many of the drugs used in ICU wings, with full analysis on side effects, dosing and key action. The software also comes with a built-in calculator that is able to perform 39 different computations -- yet another unique feature to this product that has been designed to save doctors research time, in turn, giving them a better opportunity to save lives.

Recommended to hospitals big and small for use as an ICU supplement. Priced at only $85, this is truly a bargain and will likely pay for itself many times each day.

THE SABISTON TEXTBOOK OF SURGERY: THE BIOLOGICAL BASIS OF MODERN SURGICAL PRACTICE. Courtney M. Townsend. R. Daniel Beauchamp. B. Mark Evers. Kenneth L. Mattox. W.B. Saunders. 17th edition of a text first published in 1936. Known throughout the medical world as the definitive source on surgery, Sabiston covers the principles of surgical technique in a well-written and clear style, guiding surgeons with panache and expertise. The new edition has many new and interesting additions, including analysis of the latest techniques used in the operating room and a CD-ROM comprised of over 2,000 illustrations (and supplements) designed to provide continuing education to the experienced surgeon. There is A LOT of new information here: material on robotics; comment on surgery of the elderly, obese, pregnant and immunosuppressed; and remarks on the use of ultrasound in the operating room give new relevance to this grandfatherly textbook. Medical instructors will note that the data on the CD ROM is easily downloadable to PowerPoint, allowing the information to be used as a classroom tool.

Recommended to surgeons in all sub-specialty areas. Further recommended for use as a classroom text for courses that review the role of surgery in medical care. Would be a welcome addition to any Health Science library as a general reference text.

Of Related Interest

Sabiston Textbook of Surgery -- 17th edition Pocket Companion. Courtney M. Townsend. R. Daniel Beauchamp. Mark Evers. Kenneth Mattox. Elsevier/Saunders. This pocket companion to the Textbook of Surgery (see above) condenses the most vital information from the ‘mother’ volume, building a truly "portable reference" for use by the surgeon in the operating room. This volume is meant for "on-the-fly" reading, employing a bullet-format design which brings pertinent data directly to the hands of the surgeon so that he can quickly access it and then apply it to the patient. Even though this volume condenses the material from the Textbook of Surgery, the pocket edition corresponds directly to the original text, making it easy for the physician to explore topics in deeper detail should the need arise.

MASSACHUSETTS EYE AND EAR INFIRMARY ILLUSTRATED MANUAL OF OPHTHALMOLOGY. Peter K. Kaiser. Neil Friedman. Roberto Pineda II. W.B. Saunders. Written in an atlas format that allows for quick reference, Massachusetts Eye provides direction for the ophthalmologist on diagnosis and treatment of a variety of the most prevalent eye disorders. For each malady discussed, the authors provide the physician with comprehensive analysis, including definition, etiology, common symptoms, methods of diagnosis, course of treatment, prognosis and patient management. The new edition is noteworthy because it provides dissertation on advancements in treatment (along with better illustrations/graphics to better guide the doctor and his staff). A chapter on medication is also featured in this second edition, presenting recommendations for drug treatment by condition (with important guidance on dosing). The simple atlas design encourages this book to be used in the office by the physician in the course of patient care - a reference text for daily use that won’t rot away in obscurity on the shelf.

Recommended to all eye care specialists for the reasons cited. Further recommended to Health Science libraries at institutions with Optometry programs.

Order from booksmd.com;or go to http://www.us.elsevierhealth.com

NURSE’S POCKET DRUG GUIDE 2005. Judith Pollachek. McGraw-Hill. This annual reference guide collects dosing data and mechanisms of action for over 1,000 generic medicines and is meant to provide nurses with a quick and easy tool to use in the course of patient treatment. In addition to basic drug profiles, pertinent information on side effects and special precautions is included. This information is absolutely imperative as nurses are the last line of defense to protect hospitalized patients from medicines that could cause sudden and life-threatening adverse reaction.

THE PRETEST SERIES. McGraw-Hill. The pretest series by M.H. marks the consummate tool facilitating preparation for the United States Medical Licensing Examination (USMLE). This series is written to provide the doctor with counsel on how to approach the examination, including guidance on what types of questions to expect and analysis on why an answer is correct or incorrect. Such detail is enormously important -- since the underlying motivation here is not only to pass an exam, but to prove competency toward the practice of medicine (and the treatment of patients). Thus, preparation for the USMLE must delve deeper than mere "what should I expect to see?" knowledge. Instead,this processshouldhelp the young doctor begin to utilize everything he’s learned in order to help patients. Highlights here are many, including practice exams/questions and review of all the basic sciences. Each text is student tested and reviewed, which demonstrates that the material is presented in a way which is conducive to how medical students absorb and retain material. Many topics are covered in the series, including Pathophysiology, Clinical Vignettes for USMLE Step 1, Biochemistry and Genetics, and Pathology. Priced at $25, these volumes are quite affordable and seem to be a necessity for any doctor preparing for formal licensing. Also see: usmleasy.com.

THE ESSENTIAL REPRODUCTIVE MEDICINE. Bruce R. Carr. Richard Blackwell. Ricardo Azziz. McGraw-Hill. This text is formatted specifically for use by the Obstetrician/Gynecologist, examining in comprehensive terms the practice of reproductive medicine. Essential has been written for use by the practicing clinician in the course of patient treatment and consultation. To this end, it covers myriad topics, including: infertility issues, disorders of the endocrine system that impact reproduction, hormonal and non-hormonal contraception, the pros and cons of hormonal replacement, discussion of recurrent pregnancy loss, and menopause.

THE DIABETES MELLITUS MANUAL. Silvio E. Inzucchi. McGraw-Hill. Manual written for the primary care physician or general practitioner, providing basic analysis of Diabetes, including diagnostic and treatment guidelines for both type one and type two Diabetes. In addition to these guidelines, information is provided on various drug therapies. Moreover, Inzucchi is careful to note that proper control of this disease cannot be accomplished completely with drug therapy, but instead is achieved in conjunction with drug therapy and in depth patient education which stresses proper nutrition and exercise. Finally, the reader will be engaged in discussion on complications from Diabetes involving other organ systems, including cardiac, renal and ophthalmologic problems.

Benton’s text is written in classic textbook style, juxtaposing illustrations with declarative analysis to create a teaching guide with the capability to take a student completely unfamiliar with the subject matter through its every layer. By constructing Vertebrate in this manner, Benton promotes a deeper ‘step-by-step’understanding of the data, allowing students to see the role the Vertebrate has played in our evolutionary cycle:

"The pterosaurs, relatives of the dinosaurs, filled the skies, and the birds, descendants of the carnivorous dinosaurs, also came on the scene. Other land animals included the more familiar lizards, snakes, turtles, crocodilians and mammals..."

(Page-188)

Benton’s study offers the complete history of the Vertebrate, with documented study from all points of world (including North and South America, Russia, Europe and China). This second edition presents updates from studies conducted during the 1990s, thus giving students the most recent data available.

In addition to the in depth analysis of the Vertebrate, Benton also explores the research techniques which Paleontologists use. This is quite useful to students because it begins to foster an appreciation for the discipline and encourages the investigation of the subject matter not only as a "class" but as a possible career path (see: the illuminating outline on how to dig up a dinosaur’s bones and then sift the fragments into a scientific story).

Authoritatively written and broad in scope, Vertebrate will not only teach the novice student the basics about Vertebrate Paleontology, it will surely inspire a few curious individuals to delve deeper into this fascinating material.

Recommended as a text for Biology and Geology courses with Vertebrate courses. Further recommended to both private sector and college-level libraries as a general reference text.

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THEOLOGY, PSYCHOLOGY, HISTORY, MUSIC, SOCIOLOGY, GOVERNMENT& ART

DIASPORA, POLITICS, AND GLOBALIZATION. Michel S. Laguerre. Palgrave-Macmillan.

Reviewed by Frank Aiello

ART, TIME AND TECHNOLOGY. Charlie Gere. Berg.

Recommended as a supporting text in Sociology or Popular Culture courses that analyze the impact of technology on the evolving culture. Further recommended to all libraries in the college sector as a general reference text.

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© Frank Aiello. 2006. All rights reserved. Frank Aiello and The Electric Review.

A HISTORY OF PSYCHOLOGY IN LETTERS. Ludy Benjamin. Blackwell Publishing.

POLITICAL SCIENCE AND HISTORY TEXTS FROM THOMSON

INVENTORS OF IDEAS: An Introduction to Western Political Philosophy (Second Edition). Donald Tannenbaum and David Schultz. Thomson-Wadsworth.

OTHER CURRENT GOVERNMENT TEXTS FROM THOMSON

AMERICAN FOREIGN POLICY AND PROCESS. James M. McCormick. Thomson/Wadsworth.

NEW FROMTHOMSON INSOCIOLOGY & ANTHROPOLOGY

AMERICAN GOVERNMENT, Tenth Edition. Susan Welch, John Gruhl, John Comer, and Susan M. Rigdon. Thomson-Wadsworth.

SOCIAL PROBLEMS (Second Edition). John J. Macionis. Pearson/Prentice Hall.

PSYCHOLOGY. Robert J. Sternberg. Thomson/Wadsworth.

Now in its 4th edition, this sparkling text by Professor Sternberg (Yale University) is a true benchmark in the field: notable not only for its comprehensive coverage of one the most popular disciplines in the college curriculum, but also because of its uniqueness. Even though the book is written for entry level psychology students, Sternberg is inventive in his approach, moving though the material in a way that forces students to interact and analyze as they are reading. Moreover, each chapter contains a summary that allows readers to test themselves on the concepts that have been covered, and then apply the findings. In this regard, students are being taught the fundamental practices that all psychologists use in the field -- this constant ‘learn-relearn-verify-analyze’ step-ladder is constantly being used in the discipline as deeper exploration into the depth of the human mind is achieved. Sternberg’s treatise is broad in scope, with coverage of biological, cognitive, developmental, social and psychophysic aspects of psychology stitched together expertly to allow the novice student to move into the real ‘meat’ of the course material: the idea here is to build and sharpen and hone the student’s interest to a point where deeper knowledge is sought. At this point, the student will naturally start to consider a career in Psychology. Aside from the substantive analysis, the other thing that stands out about this up-dated edition is its organization, as shaper editing has made for a more logical presentation of material, rendering it easier to both read and understand.

LITERATURE & PHILOSOPHY & ENGLISH COMPOSITION

PHILOSOPHY. Bryan Greetham. Palgrave-MacMillan.

THE AMERICAN TRADITION IN LITERATURE. George Perkins. Barbara Perkins. McGraw-Hill.

TWENTIETH-CENTURY FRENCH PHILOSOPHY. Alan Schrift. Blackwell Publishing.

By John Aiello

Here, Schrift (Grinnell College) has designed a detailed and vital textbook that cuts to the core of French Philosophy by setting the major movements against the eyes of the philosophers who inspired them.

The study of Philosophy is basically the study of thought -- as scholars come to grapple with deep questions of existence, weaving their journey into discernible and digestible summaries which, in turn, come to guide our own patterns of thinking.

In the end, the study of the world culminates in a great life and death war against the mind, as we fight through random concepts and holy ideas (religion, sexuality, conformity, revolution, war, madness, society, history) -- looking for some semblance of logic where none actually exists.

Accordingly, in each culture, there is a group of thinkers -- philosophers -- who are the ones who ask the tough questions, investing the blood of their lives in a grand struggle to discover answers for themselves and for future generations. And the answers: they are not at all based in scientific or mechanical exploration, but instead steeped in the need to know, to search, to reason beyond reason -- spitting forth a desire to find God in the invisible naked blue nuances of the human condition:

"The notion of structure, whose present good fortune in all domains responds to an intellectual need, establishes a whole system of thought. For the philosopher, the presence of structure outside us in natural and social systems and within us as symbolic function points to a way beyond the subject-object correlation..."

Maurice Merleau-Ponty, at page 46

French Philosophers marks a splendid examination of the philosophical movements that grew from this specific period, including discussion of Positivism, Idealism, Spiritualism, Existentialism, Structuralism, Ethics and Religion. And even though Schrift is careful to expand on the thinkers behind these topics (Focault, Derrida, Merleau-Ponty, Sartre), what’s best about the text is that it never fails to lead the reader back to the self -- challenging the student to find his own answers within his own personal context.

In Philosophy, as with so many other disciplines that flow forth through the mind (poetry, painting, music, theology), it is left up to the individual to corral the light within himself and pursue the silhouette of the muse that dances at the depth of the secret distance (this interplay between thought and person as distinct and original as the skin you wear).

In a flawless style, Alan Schrift’s French Philosophers documents the lines of French thought during the crucial 20th-century, the lucid and eloquent prose calling the student to take this material into himself and make it his own. As we learn here, the true study of Philosophy demands the thinker to dissect bloody questions of life and death for himself and on his own terms.

Recommended as a teaching text in Philosophy courses dedicated to exploration of the French masters. It would also serve well as a supporting text in World History courses looking to spotlight a specific culture.

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Of Related Interest

A COMPANION TO RATIONALISM. From Blackwell’s Companions to Philosophy. Edited by Alan Nelson. Blackwell Publishing.

Reviewed By Frank Aiello

"[W]e can only imagine what is absent." — Marcel Proust

In his fascinating chapter " Proust and the Rationalist Concept of the Self," Alan Nelson uses Proust’s masterpiece, A la recherche du temps perdu (Remembrance of Things Past) to approach the concept of the self (a topic that was also considered by Descartes, Hume and Leibniz).

This struggle to find purpose in the apparent randomness of existence has driven philosophers since the dawn of time. Descartes, whose work inspired so many thinkers in so many realms, dissected the dilemma in this oft-quoted thought: " The time of life can be divided into innumerable parts, each of which in no way depends upon the other."

Proust, too, would struggle against the dark pathos of the human experience. And like Descartes, he found solace in the sweetness of the infinite:

"For what we suppose to be our love or our jealousy is never a single, continuous and indivisible passion. It is composed of an infinity of successive loves, of different jealousies, each of which is ephemeral, although by their uninterrupted multiplicity they give us the impression of continuity, the illusion of unity." [p. 404.]

A Companion To Rationalism comes to us a layered text that stitches together the most profound thoughts on Rationalism (the study of finding truth through factual analysis rather than in religion or dogma). As Proust so eloquently infers, emotion, hunger and need are transitory and ephemeral. Still, the shard of consciousness that rises to capture them can be recovered through a phenomenon known as involuntary memory. As Nelson puts it:

"This familiar though infrequent experience, perhaps most famously typified in Marcel’s tasting of the tea-soaked madeleine, involves a present impression (only rarely a visual impression) evoking strongly a past impression . . .One cannot successfully attempt to produce them. Their appearance is entirely and fortuitous and literally ‘against one’s will. ’ " [p. 404]

And Neslon continues:

"Proust extends these points into a bold thesis of theoretical philosophy. He proposes that the involuntary memory is identical with the past experience, or more precisely that there is something in the two experiences that is identical... Part of the power and joy we feel in involuntary memories (the power and joy so well described by Proust) comes from their revelation of the identity of the self through time — or better, the self’s identity outside time." [p. 405.]

Still, such memories in the human experience are, at best, bittersweet, somehow always tinged with an unknowable sadness. As Proust wrote:

"A moment of the past, did I say ? Was it not perhaps very much more: something that, common to both the past and to the present, is much more essential than either of them ? So often in the course of my life, reality has disappointed me because the instant when my senses perceived it my imagination, which was the only organ that I possessed for the enjoyment of beauty, could not apply itself to it, in virtue of that incalculable law which ordains that we can only imagine what is absent. " [p. 405.]

This text provides a wonderful choice as a supporting text for courses dedicated to analyzing the history of philosophy through specific intellectual movements. Further recommended as a general reference text in all college-level libraries.

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© Frank Aiello. 2006. All rights reserved. Frank Aiello and The Electric Review.

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John Aiello, who founded The Electric Review in 2001, has been a journalist for the better part of the last 25 years, and has reviewed books professionally in myriad subject areas since 1987. In addition, Aiello has taught the fundamentals of composition in both college-level writing labs and in private settings since 1983.

Frank Aiello is an attorney who has practiced law in California since the 1970s, including criminal defense, civil and probate work. He holds a History degree from the University of California at Berkeley, and a Law degree from Hastings College of the Law in San Francisco; he has also studied Anthropology, Sociology and Political Science extensively. Reach him via The Electric Review.

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DUBLINERS. Edited by Andrew Thacker. Palgrave.

Reviewed By Frank Aiello

Hugh Kenner, perhaps the definitive Joycean scholar, recounts in his Dublin’s Joyce that one of the great novelist’s pupils recalls him dreamily gazing at a glass paperweight which contained floating crystals, at once remarking that "Yes, snow is general all over Ireland."

It must remembered that Joyce was, after all, a voluntary exile whose native land was a series of shadows which he could not exorcize from his psyche. Certainly, the last paragraph of Joyce’s immortal short story, "The Dead", written in 1906, evokes a reverie for his homeland in addition to a dark and unspeakable sadness:

"Yes, the newspapers were right: snow was general all over Ireland. It was falling on every part of the dark central plain, on the treeless hills, on the Bog of Allen, and further westward, softly falling into the dark, mutinous Shannon waves. It was falling, too, upon every part of the lonely churchyard on the hill where Michael Furey lay buried ..."

In his analysis of "The Dead", Robert Spoo concentrates on the uncanny aspects of the story. According to Freud's theory, the uncanny included "the resurfacing of primitive religious beliefs that have been ‘surmounted’ by modern civilization (such as the belief in the omnipotence of thoughts, secret injurious powers, the return of the dead) ..." (Emphasis added).

And Spoo goes still further:

"The intertextual ‘haunting’ in the final paragraphs of "The Dead" hint at the presence of a dialogism — to be fully realised in Ulysses and Finnegans Wake — in which the vast hosts of discourses that make up the ‘realistic’ mode are permitted to have their ghostly say."

[p. 141.]

Like his creations, Gabriel and Greta Conway, Joyce was haunted by the past, by a deep sense of loss and return. For example, Greta Conway is resurrected on the lips of Leopold Bloom in the "Calypso" episode of Ulysses at the point when he recalls the dance where his wife first met her lover, Blazes Boylan. Further, in the "Aeolus" episode, Joyce informs his readers that Gabriel Conway wrote fiction reviews in the Daily Express as Joyce himself had done.

And Spoo himself notes in his analysis of Joyce’s notes for his play, Exiles (written some seven years after "The Dead") that the character, Bertha, is based in part on the experiences of Joyce’s wife, Nora:

"Joyce records snippets of Nora’s early life in Galway, including images of her young admirer, Sonny Bodkin, the original of Michael Furey: ‘Graveyard at Rahoon by moonlight where Bodkin’s grave is. He lies in the grave. She sees his tomb (family vault) and weeps. The name is homely . . . He is dark, unrisen, killed by love and life young The earth holds him.’ . . . A few lines later, relating Bodkin’s grave to the poet, Shelley’s in Rome, Joyce writes, ‘Shelley whom she has held in her womb or grave rises’..." (emphasis added in bold).

[pp. 147-148.]

An acquaintance of mine who spent a decade reading and re-reading Finnegans Wake once remarked that the novel embodies more of the Neolithic and lessofthe Nineteenth century. Indeed, Joyce was both primordial storyteller and literary Lazarus who, in the incarnation of the resurrected Irish hodcarrier, Tim Finnegan, becomes our guide in the telling and re-telling of the fall and resurrection of his Adam and Eve (disguised as Humprey Chipden Earwicker, his wife, Anna Livia Plurabelle, and their children). In the Wake, the host of mankind, including the vilified and the forgotten, are always permitted by Joyce to have their "ghostly say."

Recommended as a supporting text in literture courses dedicated to exploration of the work of the great novelist.

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© Frank Aiello. 2005. All rights reserved. Frank Aiello and The Electric Review.

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Frank Aiello is an attorney who has practiced law in California since the 1970s, including criminal defense, civil and probate work. He holds a History degree from the University of California at Berkeley, and a Law degree from Hastings College of the Law in San Francisco; he has also studied Anthropology, Sociology and Political Science extensively. Reach him via The Electric Review.

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SONTAG AND KAEL: Opposites Attract Me. Craig Seligman. Counterpoint Press.

BETTER WRITING. Mary T. Carbone. Thomson/South-Western.

Released in December of 2005 and under revision from its 2001 edition, Devlin’s is the recognized authority in the discipline, melding analysis of the biochemical construction of mammalian cells together with their clinical correlation in order to create a textbook as unique and layered as its subject. Devlin’s is premised on the idea that what occurs on the cellular level (due to biochemical processes) causes a physiological response within the structure of the "whole animal." Accordingly, the mission of this text is to show the reader that human disease is the result of aspects of the biochemical process gone awry. Topics of coverage are vast and build into well-detailed chapters of amazing depth. Highlights from this edition include discussion of Amino Acids and Metabolism; Lipid Metabolism; DNA Replication; digestion and absorption; and the principles of nutrition. Devlin’s is notable for its ability to synthesize a staggering amount of data and reduce it to understandable "chunks" that serve to escort the reader through the study of Biochemistry. Simply, the intent here is to allow the student to test himself as he works through the next concept, a style that promotes thorough and precise understanding of the subject as whole. In this era when the world lives under the threat of several different biohazards, the importance of this material cannot be over-emphasized. In addition to lingering threats of bioterrorism and nuclear war, the discovery of the Avian Flu has made renewed study into the correlation between cell structure, antigen and disease imperative. Here, Devlin’s has made relevant the study of Biochemistry to the current state of the world. And by doing this, the author has artfully drawn a link between mechanical (classroom) concepts of Science and the practical walls that house the Clinician. In the end, this text will be as useful to the student as it is to the laboratory researcher who might require a refresher course on the interplay between the biochemical process and human disease.

CHEMOGENOMICS. Volume 22. Edited by Hugo Kubinyi and Gerhard Muller. Wiley-VCH. This hallmark text marks a breakthrough in the field in that it aligns the primary concepts of chemistry and biology, then takes the process one step further, applying chemistry to genomics and proteomics. This interlinking process ends up being vital to the researcher, allowing for the full and complete investigation of the interactions between proteins and their environments (in order to determine a organism’s state of wellness). Here, Muller (a scientific researcher from Munich) and Kubinyi (a medicinal chemist from the University of Heidelberg) have drafted a study that allows these fundamental platforms of scientific study to be applied to medicinal chemistry: the goal is for the health researcher to be able to understand exactly how drugs impact the body (and why these reactions are occurring). Once this is done, the possibility for the development of more efficient drugs with less troublesome side effects is possible.

TRANSITION METALS FOR ORGANIC SYNTHESIS. Edited by Matthias Beller and Carsten Bolm. Wiley-VCH. This wonderful text in two volumes is suitable for both the classroom (as a course text) and the reference library. Impeccably researched and flawlessly presented, Transition provides authoritative analysis from 70 top researchers in the field. Here, the authors have come up with a major reference meant to serve both the academic community and the industrial professional. Myriad subjects are analyzed, including catalytic and stoichiometric reactions with regard to transition metals (including a well-defined section on hydroformylation). Volume two features deep analysis of modern concepts/methods of synthesis, including important information on ionic liquids. Given the state of the planet right now (and our dwindling natural resources), this area of study is of increasing importance.Transition marks an imperative reference tool for anyone touching on the discipline.

PREVENTION OF TYPE TWO DIABETES. Editor: Manfred Ganz. Wiley. Diabetes is a huge medical problem in the United States and abroad, costing tens of millions of dollars annually and evoking huge plagues of suffering (as 180 million people worldwide are known to have the disease). Ganz (University of Rome) has done a sound job in presenting a wealth of information on Type Two Diabetes (adult-onset non-insulin dependent). As denoted by the title, Prevention is focused on developing patient awareness of the disease through physician awareness of the disease. According to the experts here, the key to defeating this disease is in preventing its onset. This has to be done through 1) appropriate screening of high-risk patients and 2) teaching behavior modification (better control of weight, blood pressure, and lipids through diet and exercise) to forestall the actual development of Diabetes. Highly recommended because it presents the latest global perspective on the affliction. Appropriate as an in-office reference for internists, endocrinologists and metabolic researchers, and also is recommended to all Health Science libraries as a general reference text.

BIOMINERALIZATION. Second Edition. Edited by Edmund Baeuerlein. Wiley-VCH. Like the Chemogenomics title referenced above, this text marries aspects of biology and molecular biology in its investigation of Biomineralization (the natural process by way living organisms form minerals from bioorganic molecules and inorganic solids). Baeuerlein’s text is a comprehensive study of this phenomenon, and takes the reader through the topic in a well-organized and well-paced fashion, these processes of Biomineralization documented with step-by-step lucidity. Aside from the uniqueness of this text, we recommend it because of its varied value: not only will students find it useful as a learning resource, but active researchers and biologists will find it vital because of its inclusion of modern advancements in the field that have occurred over the last decade. Further, because of the way it melds differing areas of the sciences, it is recommended to both biologists and physical scienctists who are interested in exploring the link between the living and the inorganic worlds. Also recommended to all college-level libraies as a general reference text.

ANALYTICAL CHEMISTRY. Second Edition. Edited by R. Kellner, J.-M. Mermet, M. Otto, M. Valcarcel, H.M. Widmer. Wiley-VCH. This outstanding text should be considered by all college-level analytical chemistry instructors because of its breadth of coverage and command of the subject matter. Here, the authors have developed a massive tome which contains comprehensive data on analytical chemistry and instrumental analysis. In the course of the in depth discussions of these areas, study questions have been included to allow the student to test their retention as they are moving through the chapters. The editors have also included references toother supportive readings as they relate to each independent section of the book, thus attempting to foster a deeper awareness of the material on the part of theinquisitive student. Finally, the new edition includes information on advancements that have taken place in the laboratory during the last decade, making it particularly relevant to the advanced student who is in a professional program and about to enter the community as a researcher, healthcare worker or chemist. Well-thought out and impeccably detailed, the first-class editing job that was done here has resulted in an easy-to-follow text that will lend itself well to classroom instruction. Further recommended to all college-level libraries (and especially Health Science libraries) as a general reference text.

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This manuscript by Steven Shepard (a Vermont writer with deep expertise in international telecommunications) marks the first technology text to explore radio frequency identification from both the consumer’s and supplier’s perspectives.

Basically, RFID is the foundation of the wireless communications industry and it stands at the forefront of a market that is expected to boom in the next decade. Shepard’s text covers the topic in broad terms and he escorts the reader through the subject with amazing deftness - giving us an over-view of the business side of RFID and then segueing into its pertinent technical aspects: explaining each of the components of radio frequency identification and then noting how these labyrinths interlock to create a multi-layered system.

Throughout the course of his treatise, Shepard is careful to thoughtfully address security issues that could develop as a result of using high-grade radio frequency systems - especially important at a time when threats of terrorism dominate. Mr. Shepard should be commended for his work here: the writing is crisp and clear, bringing the ability to dissect an ultra-complex topic and speak to it in practical terms.

For the majority of the populous, the way theirelectronic gadgetswork is secondary to the fact that they actually work. However, RFID is written in a way that illuminates howadvances in technology have revolutionized our lives and will continue to instigate change as we move deeper into the 21st century. Since the industry is predicted to generate over 10 billion in earnings over the next decade, the information contained here is vital to beginning to understand the changing aspects of our world. Interesting not only for the wealth of technical information presented, but also for the social issues that are revealed as a result of the way we now communicate.

Recommended to all college-level libraries as a general reference text. Also should be considered by technical science instructors whose courses over-lap with this subject matter. A burgeoning area of study that is addressed in concrete and thorough terms.

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CARPENTER’S CALCULATIONS MANUAL. Roger Tarbox. R. Dodge Woodson. McGraw-Hill.

Here, Tarbox and Woodson have createda guide that speaks to the way that carpenters and contractors learn: instead of hammering out explanations in long-winded passages, Carpenter’s uses illustrations, photos and charted tables to convey its information - truly a change of pace in this era of over-explained "how-to" books.

The authors - both master carpenters - offer a manual that everyone who picks up a hammer (both professional and amateur) should own, for it provides in depth guidance on how to approach, plan and complete a building project.

The majority of the errors that carpenters make are a product of miscalculations being made and guess-work gone awry. Carpenter’s offers an answer to this, for it takes the builder step-by-step through the process of putting up an edifice. From data on how to formulate the foundation to direction on joist calculations to instruction on figuring stair rise, Tarbox and Woodson strip away the confusion and present tables and charts augmented by artful illustrations - follow the directions as they are laid our here and carpenters will circumvent potential problems before they ever occur.

The result of this will be cleaner jobs that waste less resources and come in on budget. The result will be less waste in the building trade and more efficient workmanship. Given the boom in the housing market across the country in addition tothe record number of folks applying for contractor’s licenses these days, and this text couldn’t be more timely.

Recommended as a general reference text in all libraries - both at the college level and in the public sector. Further recommended to high school instructors as a teaching text for wood shop classes at both the beginner and advanced phase.

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ILLUSTRATED POCKET DICTIONARY OF CHROMATOGRAPHY. Paul C. Sadek. Wiley. This marks a well-developed pocket dictionary of Chromatography, combining conceptual definitions with illustrations/graphics to create a multidimensional reference tool. Dictionary has been designed for use by the practicing scientist in the laboratory setting, and it covers myriad subject areas, including analysis of both liquid and gas Chromatography (in addition to capillary electrophoresis and solid phase extraction - the primary scientific techniques used to separate components for chemical analysis/investigation). Readers will also find a broad assortment of photographs depicting the instruments/equipment used in the field; also note the compilation of references to encourage further study for both student and professional.

Pocket Dictionary does a fine job in laying a "foundation of facts" so that students of the discipline can begin to explore this very complex subject. Mr. Sadek (Chemistry Group Leader at Access Business Group in Michigan) has done a note-worthy job in constructing the book, for even though it appears in dictionary form, it does not stop there: instead, scientists will also find that the author has gone to great lengths to examine vital concepts of Chromatography - intent on promoting a complete and fundamental understanding of the subject area. Notwithstanding the fact that Dictionary is a remarkable teaching text, it will serve the professional scientist equally well - similar to the way generations of lawyers have come to trust in (and rely on) Blacks Law Dictionary for direction.

Recommended to all college-level libraries as a general reference text. Would further serve as a useful study text in advanced analytical Chemistry courses.

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By John Aiello

Now its 5th edition, this text is meant to provide the practicing Paralegal with salient information on current Bankruptcy procedures. In terms of changes to traditional law, the recent overhaul of the Bankruptcy Code redefining the stepsconsumers must go through before they will be allowed towrite off a debt has literally changed our perceptions of personal finance.

No longer does the safety valve of Bankruptcy Court automatically exist for those caught between the proverbial ‘rock and a hard place.’ Now, consumers have to be more responsible with their plastic cards and other forms of impulse or luxury-based spending. In turn, those operating within the legal arena need to update their education and reconnect themselves with aspects of the Bankruptcy Code.

Introduction To Bankruptcy by Martin Frey (University of Tulsa College of Law) and two co-writers is the first text we have seen to address material changes in the Bankruptcy Code (following ratification of the Bankruptcy Abuse Prevention and Consumer Protection Act of 2005). Here, the authors do an exemplary job of discussing applicable changes in the law and modifications to court rules while simultaneously up-dating procedural forms and paths of strategy -- painting this full picture of what it takes to set a Bankruptcy case in motion through the judicial system.

Frey and co-writers have done a fine job with the organization of this textbook, outlining the history of Bankruptcy law before moving directly into myriad legal elements, giving special consideration to how an individual’s specific circumstances dictatehis ability to dischargea debt. The authors have also included a series of sample Bankruptcy scenarios that analyze cases from inception through the point of resolution. To this end, myriad types of Bankruptcy filings are discussed with inclusion of ‘flow charts’ which provide a ‘visual aid’ so that the student can actually see the different paths a Bankruptcy filing will often take.

In addition to these charts (and the updated forms), Frey and co-authors offer an interactive approach to the learning experience, posing problems that students are meant to jump into and analyze. The lesson here?: To show that assisting clients with legal issues requires precise attention to detail and the ability to dissect a ‘theory’ and then quickly apply it to the practical world.

Chapters routinely build on each other to create a seamless read ("The Cast Of Characters" chapter moving into an exploration of the "Bankruptcy Judge And Staff" serves to show that one issue is always married to next in the study of the law). Further to its breadth, Introduction To Bankruptcy stands out for its writing: Clear-cut and sharp with focus, this book is meant to impart complicated legal theories to a student audience so that the information can be retained for future application.

The authors have designed this text for the classroom, and more specifically, for the Paralegal student. Accordingly, it is recommended to college-level instructors who teach Paralegal courses which focus on Bankruptcy Law. Additionally, it would prove useful to the practicing Paralegal in an office setting: the up-to-date forms and review of changes in the code render this a title that has lasting and long-term value.

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CALCRIM JUDICIAL COUNCIL OF CALIFORNIA CRIMINAL JURY INSTRUCTIONS.January2006 Edition. Thomson-West.

Reviewed by Hon. Paul J. Aiello (Retired)

The tradition that first began with the CALJIC Standard Jury Instructions has blossomed into this innovative approach we now find in the CALCRIM Criminal Jury Instructions. Designed by a special task force of the California Judicial Council, the authors' driving focus was to "write instructions that are both legally accurate and understandable to the average juror."

In drafting this manual, the committee premised its work on the belief that "sound communication takes into account the audience to which it is addressed," in turn recognizing the vital task that a jury performs and the substantial reliance placed upon their service by courts, lawyers, and litigants. Simply, in order for a jury to apply the law fairly, understandability of the appropriate legal principles becomes absolutely critical.

The CALCRIM Instructions are now approved by the Judicial Council as the official instructions for use in the State of California. California Rule of Court No. 855 (a) "strongly encourages their use." However, since this is merely a recommendation and not mandatory, many trial courts remain hesitant to abandon the security of CALJIC. Yet, by all accounts, the Judicial Council has successfully accomplished its goal of creating a set of user-friendly, easy-to-understand jury instructions.

After many years of offering ADR services, I recently returned to an active criminal law practice, and I have found CALCRIM helpful in combining the preciseness of the CALJIC black letter law statements in a paraphrased form that sheds the heaviness of the more specialized statutory and case law language.

Here, the writers have provided users withmore complete explanations of myriad legal principles in a checklist form, this approach meant to easily guide the jury through its task of analyzing the components of the individual instruction before fitting them into the particular factual setting.

For example, the CALCRIM instruction for misdemeanor Driving Under The Influence begins where CALJIC does, listing the two elements that create the statutory offense (defendant drove a vehicle and when he/she drove, the defendant was under the influence), but then significantly departs from CALJIC’s style in two major ways.

First, unlike CALJIC, which offers a separate instruction regarding evaluating the manner in which the vehicle was driven, CALCRIM includes this as part of the primary instruction, something which immediately assists the jury in coming to understand that the way a car was driven is not enough in itself to find a person to be under the influence (but only one factor to be considered in light of all of the other circumstances). As a result, CALCRIM immediately links the term "under the influence" to a concrete piece of evidence, thereby offering the jury a specific way to understand what might otherwise remain just a vague legal term.

Second, the CALCRIM Instruction offers yet another evidentiary method by which to give substance and reality to the term "under the influence." It informs the jury that if the prosecution has proved beyond a reasonable doubt that the defendant’s blood alcohol was .08 % or more at the time of the chemical analysis, it may (but is not required to) conclude that defendant was under the influence at the time of the alleged offense. Finally, the instruction cautions the jury that, in evaluating the test results, it can take into account whether or not the person administering the test followed certain specific state regulations.

Consequently, the jury is given understandable evidentiary bases to help them reach a meaningful conclusion as to whether a defendant should be adjudged guilty or innocent on the facts before them. Moreover, the format of the instruction gives counsel a valuable tool in being able to identify and then link key pieces of evidence to a legal principle (which is then reinforced by the actual instruction from the court).

As with CALJIC, the CALCRIM Instructions are in two volumes and follow a similar organization of subject matter. The text of each instruction is followed by Bench Notes, setting forth the instructional duty of the court (as well as relevant lesser-included offenses). The "Authority" Section also lists all pertinent sources for the instruction, including case precedent. Italicized notes in the language of the instruction further serve to alert the reader to necessary modifications for specialized issues.

Criminal law practitioners will find the Bench Notes a particularly valuable resource. Returning to the Driving Under The Influence Instruction as an example, counsel may be facing a situation wherein the statutory blood alcohol presumption may be applied -i.e.- if defendant had a blood alcohol content of .08 % at the time of the chemical analysis, the jury may conclude that defendant was under the influence at the time of driving. The Bench Note alerts counsel that if any evidence exists that defendant was below .08 % (or if the test results fall within the range in which no presumption applies), then the prosecution loses the benefit of the presumption and the Court must remove the language from the instruction.

Accordingly, criminal lawyers now have an officially-endorsed and viable alternative to the more technical and basic language of CALJIC. In addition to presenting lawyers with a vital tool by which to prepare for trial, this manual serves to insure that the jury will be more-easily guided to a clearer understanding of myriad complex legal principles (and thus better able to apply these instructions evenly and effectively).

Recommended for criminal law offices, law libraries, general reference libraries, and as a supplement to general criminal law texts.

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Of Related Interest

CALJIC CALIFORNIA JURY INSTRUCTIONS -CRIMINAL.APRIL 2006 Edition. Thomson-West.

Reviewed by Hon. Paul J. Aiello (Retired)

For criminal law practitioners, ready access to a set of Thomson-West CALJIC California Criminal Jury Instructions becomes indispensable, both for research purposes and for trial preparation.

Experienced attorneys often begin their case strategy by reviewing the elements that make up criminal offenses as a practical guide through the sometimes thorny issues presented by unique factual settings (knowing that these key statements of the law will become the standards by which juries will reach their decisions as to guilt and innocence).

Moreover, trial lawyers frequently attempt to fashion special jury instructions to highlight key issues in their cases. Their obstacle is a formidable one, however, since trial courts almost uniformly rely upon the time-tested and appellate-affirmed standard jury instructions set forth in CALJIC.

One criticism of these standard instructions, observes Justice Carol Corrigan, is that, being "based on the language of case law and statutes written by and for a specialized legal audience," they have, on occasion, become " impenetrable" to the average juror. This criticism is not only a valid one, but one frequently one shared by both the Bench and the Bar.

The resulting challenge of making this material more understandable to the "average juror" has recently been addressed by the California Judicial Council in its revisions to these standard instructions [see companion review of new CALCRIM Jury Instructions above].

Communication problems notwithstanding, the CALJIC Instructions have been in use for well over 60 years. Moreover, local court rules in many jurisdictions throughout the state mandate their use in all criminal jury trials. As a result, although revised official jury instructions are now available, counsel must continue to be well-versed with not only the content of CALJIC, but also the style, organization, and philosophy underlying their development.

The CALJIC Instructions essentially provide a straightforward, no-frills, basic definition of the applicable law. For example, while each one of us probably has his or her own idea of what precisely created a "reasonable doubt" in our minds in a particular case, CALJIC 2.90 compels that this precise wording be given to every jury:

"It is that state of the case which, after the entire comparison and consideration of all the evidence, leaves the minds of the jurors in that condition that they cannot say they feel an abiding conviction of the truth of the charge."

The Use Note to CALJIC 2.90 provides insight into why reliance upon such exact language is so highly valued. Noting prior attempts to clarify or improve upon the definition of reasonable doubt, the drafters caution: "It is safer to follow the language of the code section than to struggle for originality where precedent alone should govern."

And therein lies both the beauty and the burden of using CALJIC. While unadorned in their basic, plain, and technical language, the instructions are, nonetheless, crafted with a precise accuracy, calculated to give a jury maximum assistance in discharging its often difficult duty of applying the law to a given set of facts. Next to its longevity, perhaps the best testament to CALJIC is that juries have consistently demonstrated an ability to navigate through the difficulties of language to do their job.

Prepared and designed by the Committee on Standard Jury Instructions of the Los Angeles Superior Court, the CALJIC instructions begin with introductory admonitions and definitions, followed by rules as to evaluating different forms of evidence. At this point, the elements of each crime and defense are thoroughly set out. The two volume manual concludes with instructions to cover such specialized matters as multiple counts or defendants (as well as prior convictions and punishment enhancement issues).

In addition to its actual statement of law, each CALJIC instruction contains a Use Note (prompted by recent appellate decisions) and commentary, including case law supporting use and application of the particular instruction. As a bonus, practitioners should review the wealth of information contained in the Appendix, which includes helpful guides to the giving of sua sponte instructions and lesser included offenses.

The reality is that CALJIC will likely continue as the preferred form of jury instruction for most courts. Other than exchanging originality and creativity for the security of precedent, the legal profession risks little in turning to them for accurate, up-to-date black letter statements of the law.

Accordingly, CALJIC remains the most widely-respected, complete, definitive, and reliable resource available to lawyers -- this compendium presenting the essential elements of the substantive crimes that make up the discipline of criminal law.

Recommended for criminal law offices, law libraries, general reference libraries, and as a supplement to general criminal law texts.

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© Paul J. Aiello. 2006. All rights reserved Paul J. Aiello and The Electric Review.

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PAUL J. AIELLO is a retired Judge from Northern California who serves as Legal Editor for The Electric Review. Educated at The University of California, Berkeley and at U.C. Berkeley’s Boalt Hall School of Law, Aiello has conducted hundreds of mediations and arbitrations since 1992. Aiello is also on the adjunct faculty at College of The Siskiyous in Weed, California, where he has taught courses in the Social Sciences andHumanities, as well asin Police-Community Relations. He can be reached through The Electric Review.

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NEW FROM NOLO

Reviewed by Hon. Paul J. Aiello (Retired)

Recent significant developments in the Federal sphere of criminal law formed the genesis of this new edition of Federal Criminal Law and Its Enforcement. Accordingly, co-authors Abrams and Beale have crafted a worthy vehicle through which law students can evaluate and assess such timely topics as federal drug prosecutions and the use of the RICO and forfeiture laws, in addition to analysis of controversial sentencing guidelines.

Other noteworthy features of this selection include more extensive use of text and note material and an Appendix from which the reader can survey the actual civil rights and forfeiture statutes or review the pertinent guidelines used by the Federal bench in sentencing.

The authors have wisely decided to reserve the book’s case law entries only for the most important appellate decisions in each of the areas covered, shedding the more extraneous precedent in favor of in-depth analysis of the primary cases. In all instances, the writing is erudite, lean, and persuasive - a style which might be described as "basic" in the way it moves from introductory federalism issues and then proceeds into various detailed studies of specific federal criminal law topics.

Obviously, Abrams and Beale cover a lot of important ground here. For example, United States vs. Lopez 514 US 549 (1995), the "first decision in 60 years to strike down a federal statute on the grounds that it violated the Commerce Clause" is thoroughly dissected, as are the 1996 legislative revisions that essentially rewrote the body of law on False Statement prosecutions. The new Hate Crime legislation is another fresh topic which receives scholarly and thoughtful analysis by the Abrams-Beale tandem.

This book, now in its third edition and guided by the combined credentials of its authors, succeeds on a high level, making significant academic contributions to the discipline at every point along the way. Beyond that, the impact that federal criminal law has had on the life of ordinary people in recent years makes the subject matter not only extremely relevant, but truly compelling to an integrated study of how laws help shape both our society and our culture.

Recommended as a teaching text in courses on criminal law or evidence; also useful as a general reference text for college and law school libraries.

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PAUL J. AIELLO is a retired Judge from Northern California who serves as Legal Editor for The Electric Review. Educated at The University of California, Berkeley and at U.C. Berkeley’s Boalt Hall School of Law, Aiello has conducted hundreds of mediations and arbitrations since 1992. Aiello is also on the adjunct faculty at College of The Siskiyous in Weed, California, where he has taught courses in the Social Sciences, Humanities and in Police-Community Relations. He can be reached through The Electric Review (see home page email link).

Reviewed by Frank Aiello

The timeliness of Thomson West’s Health Law Handbook ("Handbook") is immediately obvious as one starts to understand the magnitude of the looming health care crisis in America and the government’s apparent unwillingness to confront the problem at its source: here where the staggering cost of basic health care is juxtaposed with the consumer’s inability to afford it.

Readers should consider the following data:

According to the National Coalition on Healthcare ("NCHC"), health care expenditures increased by 7.7% in 2003, or four times the rate of inflation for that year. According to the NCHC, health care spending in this country increased to 1.7 trillion dollars in 2003. And it is further projected that by 2013, 18.7% of this country’s Gross National Product will be spent on health care costs.

The U.S. Department of Justice has publicly stated that every type of health care provider commits health care fraud -- including publicly traded companies. This conduct includes billing for services not rendered or not medically necessary, billing for more highly reimbursable services than the ones actually provided, or billing repeatedly for groups of services performed together in order to obtain a higher reimbursement rate. A GAO report in May, 1996 estimated that annual losses range from 3% to 10% of all health care expenditures. Based on 1995 expenditures of one trillion dollars, health care providers were defrauding this country and its citizens of between 30 billion dollars to 100 billion dollars annually .

Looking back, Medicare was established by the 1966 adoption of title XVIII of the Social Security Act to provide both basic and supplementary health insurance to individuals 65 years of age and older (and to other qualified individuals such as the prematurely disabled). The Medicare program itself has different components which are financed separately and which provide separate and distinct coverage to beneficiaries.

The primary components to the Medicare program are Part A (which covers institutional services) and Part B (which covers outpatient services rendered by physicians and other identified professionals). Neither Part A nor Part B claims are processed by Medicare; instead, the Medicare program contracts with "intermediaries" (under Part A claims) or "carriers" (under Part B claims) which are almost always private insurers under contract with the Health Care and Financing Administration. These intermediaries and carriers not only are supposed to process claims, but also have a responsibility for making coverage and payment decisions. In effect, intermediaries and carriers as an intermediary against the prospect of fraudulent claims.

Medicare payments are issued according to an unimaginably complex methodology adopted by Congress in 1983 entitled the "Progressive Payment System" which was intended to reimburse providers for only their "reasonable costs" under a cost-based approach, a fee schedule, or a combination of both methods. For all purposes, a provider’s "reasonable costs" are defined as "the cost actually incurred, excluding therefrom any part of incurred cost found to be unnecessary for the efficient delivery of needed health services [as] determined in accordance with regulations establishing the method or methods to be used, and the items to be included, in determining such costs . . ." 42 U.S.C. § 1395x (v)(1)(A). (Emphasis added.)

Given this background, one of the cases reported in the Handbook’s chapter entitled "Update on Fraud and Abuse" by Sanford V. Teplitzky and S. Craig Holden is especially troubling.

The Federal False Claims Act ("FCA") was enacted during the Civil War at the urging of President Abraham Lincoln in response to the profiteering of unscrupulous Union supply contractors (See: "Bad Mules: A Primer on the Federal False Claims Act", by Larry D. Lahman, The Oklahoma Bar Journal, (Vol. 76, No. 12, April 9, 2005.)

The FCA not only makes it illegal for a claimant to make a false statement in writing to obtain money from the United States Government, but also allows private "relators" to act as bounty hunters on behalf of the Government. The 1986 Amendments to the FCA provides for treble damages, increased the relator’s share and lowered the level of proof for fraud. As Lahman states: "Because wrongdoers now face the threat of having to repay more than the amount stolen under its treble damage provisions, the FCA deters untold fraud against the government by its mere presence." Id. at p. 902.

In U.S. ex rel. Atkins v. McInteer (N.D. Ala. 2004) 345 F. Supp. 2d 13202, a Federal District Court adopted a strict interpretation of the FCA provision that liability occurs when any person "knowingly presents, or causes to be presented to an officer or employee of the United States Government . . . a false or fraudulent claim for payment or approval."

The Court held that state Medicaid officials who received the allegedly false or fraudulent claims for payment did not have an employment relationship with the United States Government; thus, the prohibitions and penalties of the False Claims Act were inapplicable. The authors write:

"Those familiar with entities such as carriers, fiscal intermediaries and DMERCs will immediately see the implication of these two cases. Those entities are not officials or employees of the United States Government either; they are contractors. Claims made by health care providers are necessarily submitted to those entities that are under contract to the government to conduct claims processing. If the courts continue to apply Totten as Judge Acker did to Alabama Medicaid, then the FCA becomes wholly inapplicable to the vast, vast numbers of claims submitted to carriers, fiscal intermediaries, and DMERCs." [§ 7.4, pp. 373-374.]

The authors also note that D.C. Circuit had denied rehearing en banc on December 8, 2004, and a petition for certiorari had not been made as of the date of the writing. Clearly, unless Atkins, supra, and the case on which it relies as authority, U.S. ex rel. Totten v. Bombardier Corp. (D.C. Cir. 2004) 380 F.3d 488, are either limited or overturned by the U.S. Supreme Court, unscrupulous health care providers will have little to fear from the treble damages deterrent of the FCA (nor will whistle blowers have any financial incentive to disclose such fraudulent conduct).

Readers will find the Handbook’s chapter on "Consumer Directed Health Care" by Gary Scott Davis and Susan M. Nash especially informative, since the authors identify what is driving this movement in the marketplace along with the models on which it relies:

"How has the marketplace come to its flirtation with consumer-directed health plans" Plain simple economics. Over the past decade, employers have increasingly revolted against the rising, and some argue staggering cost, of employee health benefits. With increasing willingness and resolve, employers have asserted that employees must pay more of the share of increasing health care costs or alternatively, the employer will simply provide fewer benefits. A Hobbesian dilemma at best." [§ 2.1, p. 148.]

In addition, the authors note that the "new paradigm" for Consumer Directed Health Care premises that "consumers will personally pay more of the cost of care and benefits, but in exchange be provided with the tools to make more informed decisions regarding care and treatment and a tax advantaged account to finance a portion of these costs. Under this paradigm, once the patient is transformed into an educated consumer with a financial stake in their cost of care, the purchase of medically unnecessary or marginally beneficial services and items will be curtailed leading to containment of the escalating health care premiums over the past decade." [Id., § 2.1, p. 148.]

Unfortunately, the creators of such health care "models" fail to account for the fact that up to ten percent of every health care dollar —if we are to believe ten year old Department of Justice statistics— are lost to fraud or mismanagement. Nor do such models apparently take into consideration the hourly media barrage of advertising by pharmaceutical manufacturers which drive the marketing of often unnecessary -- and sometimes downright dangerous -- drugs to the American consumer, turning many of them into prescription junkies.

Finally, how is the American consumer going to pay for those services which may become medically necessary ? As a personal example, one family member underwent two surgeries for uterine cancer in 1972 and spent ten days in the hospital. The total cost of the medical procedures at that time —surgeries, doctors, medicine, hospitalization and follow up consultations— was less than $2500. Today, such a medical procedure would cost hundreds of thousands of dollars and economically destroy any family without health insurance (and perhaps even substantially harm families with such insurance). Obviously, the paradigm-makers fail to recognize that individual health care policies are now simply unaffordable and that health care costs are beyond the control of the individual consumer.

When one reviews the authors’ well-developed and expertly summarized analysis of "tax favored" accounts, it becomes apparent that such accounts will do little or nothing to lower the unconscionable cost of medical services at the source, i.e., preventing a broken leg from accelerating into a personal bankruptcy. For example, a "Health Savings Account" authorized by IRC § 223 allows a maximum contribution which cannot be greater than $2,650 for an individual or $5,250 for a family, assuming other qualifications are met including the fact that an individual must be covered by a "high deductible health plan" and not covered by any other health insurance.

As another example of the looming health care crisis, the authors of the chapter entitled "Long Term Care Future Trends" note that within the next eight years, 77 million baby boomers will turn age 65, further citing that "LTC costs are expected to be $135 billion in 2004, rising to $260 billion by 2025, at which time the government’s share through Medicaid through Medicaid is expected to be 83 billion dollars. Medicaid spending accounts for about 21% of state budgets, with growth at 11% per year." [§ 12.20, p.642.]

The authors also point to a growing advocacy of home and community-based services as part of future long term care. Unfortunately, what such advocates often fail to realize is one especially haunting government statistic routinely taught to agents selling long term care insurance as part of their mandatory education, namely, that 1 individual in 10 over the age of 65 will suffer from Alzheimers disease or other dementia-related illness. Many of these individuals will almost certainly require care in an institutionalized setting, in turn creating even more of a burden on already stressed state Medicaid budgets. Sadly, if such people end up dying in their home, it will likely not be because of choice.

Review of this text makes it readily apparent that unless this country and its "policy makers" begin to deal with reality and begin to lower the barbaric health care costs faced by working men and women in America, it may wake up one morning —as the leaders of East Germany did a decade and a half ago— to find that the only people still going to work are its bureaucrats and policemen.

Recommended to all general practitioners for its timely direction on Health-Law regulations. Should further be considered as a supporting class text in courses designed to instruct the advanced student on the law as it relates to modern health care systems. Finally, recommended to law libraries at both the government level and in the University setting for its long-range reference value.

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© Frank Aiello. 2005. All rights reserved. Frank Aiello and The Electric Review.

CASES AND MATERIALS ON THE RULES OF EVIDENCE. Third Edition. Olin G. Wellborn III. From the "American Casebook Series." Thomson-West.

Reviewed by Hon. Paul J. Aiello (Retired)

Courtroom skill is not a product of chance or circumstance. As with any other profession, occupation, or calling, the practice of the law requires the student to master a carefully crafted set of tools -- tools that trial lawyers routinely must depend on in order to competently represent their client’s interests.

Olin G. Wellborn III's third edition of Cases and Materials on The Rules of Evidence, from the American Casebook Series by Thomson-West, presents students of the law and related disciplines with a text that lays out these "tools of the trade" in a scholarly yet pragmatic way, capturing both the technical nature of the material and the theoretical underpinnings of the rationales supporting the application of the rules.

Basically, the main purpose of the rules of evidence is to help the court system operate in a balanced and fair manner, by protecting a jury from seeing or hearing evidence that is unreliable or prejudicial. Following rules of evidence ensures that a set of strict standards will be followed by the parties to prove or disprove the factual issues in a case. Wellborn's book provides a basic knowledge of the role each federal rule plays in such a trial setting.

As the author notes in the Preface to the work, the materials in the book are meant to be entirely self-sufficient, thus allowing for maximum benefit to the student, when studied with a current copy of the Federal Rules of Evidence. Each chapter examines an article of the rules. Wellborn has compiled carefully selected cases demonstrating not only the substantive parameters of each rule, but its application to a specific factual context. Enhancing the student's understanding of the rule's operation are detailed notes following each case which further expand upon the discussion.

A feature worthy of note is the text's organization, uniquely evidencing the author's familiarity with his subject as well as his classroom experience. The simplicity of the linear approach creates a logical sequence of building blocks for the reader. The book begins with the most fundamental evidence concepts, relevancy and the hearsay rule. It then proceeds with a review of the procedural criteria for admitting and excluding evidence, including documentary and other tangible evidence. It concludes with the peculiarities of the rules on privilege as well as substitutes for evidence, including presumptions and judicial notice.

Wellborn wisely chooses not to intrude into the learning process by interjecting either personal judgment or viewpoint. Instead he simply presents the rules of evidence in a variety of contexts (primary cases, secondary cases, statutory analysis), showing how each tool is to be used and trusting the reader to then use the rule correctly in a professional setting. This is teaching at its most basic level and the core of learning, showing great respect between author and reader, instructor and student.

As a result the style of the book has a "let's get down to business" feel to it - simple, direct, unadorned with superfluous commentary and extraneous material. Most satisfying is that Wellborn has selected interesting cases to demonstrate each rule, the factual settings of which bring a true human dimension to the material.

But more importantly, in a subject that can be deadly technical and dry, the author has succeeded in showing the relevance of evidence - not as an abstract concept - but as organic, vital, critical, operating in real life settings to protect rights, level the playing field, give expression to societal expectations, and ensure that results will be based not on chance, but on objective standards that seek to preserve fundamental notions of fairness.

Recommended as a teaching text in law or law enforcement courses on evidence. Imperative as a general reference text for college-level law libraries.

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PAUL J. AIELLO is a retired Judge from Northern California who serves as Legal Editor for The Electric Review. Educated at The University of California, Berkeley and at U.C. Berkeley’s Boalt Hall School of Law, Aiello has conducted hundreds of mediations and arbitrations since 1992. Aiello is also on the adjunct faculty at College of The Siskiyous in Weed, California, where he has taught courses in the Social Sciences, Humanities and in Police-Community Relations. He can be reached through The Electric Review (see home page email link).

-From "Interviewing the Victim"-

Professor Gilbert uses the scenario to instruct students in the behavioral clues common to victims of crime, and notes that their absence can indicate that the victim may be untruthful in their report of a crime. At the same time, he cautions that not all crime victims react to the trauma in the same way. Some victims may not recall the details at all. The author concludes that, when judging the victim, the police officer must take the totality of the circumstances surrounding the complaint into account.

Since this material is based on actual experiences, instructors should find the scenarios useful for interactive classroom discussion. Through them students can learn to recognize common mistakes, and appreciate the nuances and attention to detail necessary to completing an effective interview.

The substantive content of the book covers myriad topics, including ethical considerations (making deals and breaking the law in order to get a statement), preparation steps, and interrogation techniques for different types of offenders. The author expands the subject matter to include chapters on how and why false confessions happen and concludes with an interesting chapter on forensic hypnosis. An appendix offers helpful forms, including a sample interview worksheet as well as a sample rights warning and waiver certificate. On a separate level, Gilbert also discusses human motivations and influences, critical elements to knowing not only what to ask but how to ask it.

Ultimately, the discovery of truth is the primary goal of law enforcement work, and Professor Gilbert's book will assist the student in competently performing this essential police function.

Recommended for criminology students and their instructors, it would best serve as a supplemental text accompanying more general criminal justice works, or as a specific instructional module in reserve officer training.

COMMUNITY POLICING: Partnerships for Problem Solving. 4th Edition. Linda S. Miller and Karen M. Hess. Thomson-Wadsworth.

The new edition of Community Policing is completely revised from previous editions both in terms of structure and focus. Co-authors Miller and Hess, frequent contributors to the growing body of work on police relations, have organized the text into three primary sections. Section I discusses the evolution of community policing in terms of the necessity for the police mission to include the involvement of the community. Section II addresses the communication and interpersonal skills required by police officers to gain trust and cooperation from community members. Finally, Section III concludes with a discussion of the collaborative efforts needed to manage various community problems, ranging from traffic control to workplace and domestic violence as well as hate crimes and terrorism.

Miller and Hess's study functions effectively as a textbook for serious students interested in a career in law enforcement. The material has been completely updated, with new terms, tables, figures, and photographs included. Each chapter begins with a highlight of key concepts to be covered which also doubles as a statement of objectives for the subject matter. The authors then allow further exposure to a chapter's key information by providing a detailed chapter summary. Discussion questions, references, and a suggested community project round out the instructional features of the work.

The book's scholarship blends nicely with its practical "nuts and bolts" approach to the subject matter. Its value to the reader is enhanced by clear, understandable writing. The substantive content has been designed to promote attitudes of professionalism and competency commonly expected of police officers operating in such a highly visible environment. For example, the section on developing interpersonal skills addresses the challenges inherent in interacting and communicating with individuals who are culturally, racially, or socioeconomically different. The chapter on proactive policing includes a timely discussion of how law enforcement must come to understand and be prepared to use the fundamentals of mediation as a problem-solving tool. A thought-provoking section looks at how law enforcement benefits from adopting concepts borrowed from business: networking and being service oriented, treating community members as customers.

The authors have added a new chapter which highlights the central theme of this edition, the importance of building partnerships between the police and community. Emphasizing its critical nature in the field, Miller and Hess begin this chapter by quoting the police chief of the Charlotte-Mecklenburg Police Department :

"Problem-solving without partnerships risks overlooking the most pressing community concerns. Thus, the partnership between police and the communities they service is essential for implementing a successful program in community policing."

A thoughtful concluding chapter, looking to the future of community policing, analyzes what has and has not worked in the field, forcing the student to look at the question in terms of whether community policing is a philosophy or an actual reality.

A minor weakness in the book is the absence of critical-thinking problems which would enhance its pedagogical value enormously, providing the student practical hypothetical situations against which to apply the principles learned. The book remains, however, a thorough exploration of the subject and is a recommended text for criminology students and instructors. Miller and Hess succeed at showing how, working together, the police and the community can accomplish what neither can accomplish alone.

POLICE INTEGRITY AND ETHICS. Matthew Hickman, Alex R. Piquero, and Jack R. Greene. Thomson-Wadsworth.

Reviewed by Hon. Paul J. Aiello (Retired)

Part of the Wadsworth Professionalism In Policing Series, the authors have gathered a collection of essays addressing the timely topics of police misconduct and integrity. The contributors are all noted experts and are uniformly regarded as qualified commentators in the field. As a result, the book is immensely informative and offers the prevailing theories, philosophies, and concepts on the subject.

Beginning with an examination of how to define and measure integrity, the essays then explore the theme of intervention strategies to identify "at risk" situations and conclude with a consideration of the public perception of police misconduct. In another section of the volume, discussing situational contexts and their impact on integrity, the reader will find a fascinating study of the types of situations in which police officers are most likely to find themselves corrupted. For example, in one essay, the issue of the amount of force directed against racial minorities (as compared to the force used against whites) is weighed, with the piece then identifying how such behavior can be the product of patterns of thought that seek to disregard legal standards of conduct.

Positing the book's central theme, author Jack Greene writes in the Introduction, "Police integrity is thus best conceived of as the product of both police behavior and the public perception of that behavior." Collectively, then, the insights afforded through the in-depth essays will help to illumine the complexities surrounding these competing interests. For the serious student, the volume will be a compelling read, focusing on an aspect of law enforcement for which the police have increasingly come to be judged, individually and as an organization.

As noted by the publisher, anthologies such as Police Integrity and Ethics, in exploring contemporary problems and reframing debates, perform a valuable educational function by filling in the gaps left by more general and traditional texts.

The present volume makes an effective companion reader to general criminology, sociology, or law texts. It is also recommended as a general reference text for both college and public libraries.

© Paul J. Aiello. 2004. All rights reserved Paul J. Aiello and The Electric Review.

PAUL J. AIELLO is a retired Judge from Northern California who serves as Legal Editor for The Electric Review. Educated at The University of California, Berkeley and at U.C. Berkeley’s Boalt Hall School of Law, Aiello has conducted hundreds of mediations and arbitrations since 1992. Aiello is also on the adjunct faculty at College of The Siskiyous in Weed, California, where he has taught courses in the Social Sciences,Humanities and in Police-Community Relations. He can be reached through The Electric Review (see home page email link).

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Mediate, Don’t Litigate is a timely, welcome and worthy addition to the Nolo library, appearing at a time when mediation has gained both acceptance and respect in both the legal and business communities.

In the fast-paced world of the 21st century, mediation clauses have become commonplace in almost every real estate, employment, and health care contract. Moreover, courts are looking to mediation as just one part of a larger ADR (Alternative Dispute Resolution) tool-kit that will help to reduce its caseloads and provide disputants with an inexpensive, less formal mechanism by which to resolve or settle their cases. Many counties are now establishing mandatory mediation programs for most civil cases, finding it an effective means of conflict management. For these reasons, it is essential that everyone should develop a fundamental understanding about mediation as an ADR method. Mediate, provides a one-stop resource from which that basic knowledge can be obtained.

Co-written by a longtime professional mediator and one of Nolo’s own legal editors, each of the authors are well-credentialed to write about the subject of mediation. The contents have the imprimatur of the depth of their background, experience, and scholarship. They are knowledgeable not only about the broader process of mediation, but also its "fine-tuned" nuances and the book should help both lawyers and lay persons better prepare for and participate in this particular dispute resolution format.

Mediate is written in an understandable, readable, user-friendly style that contributes to its value. It has been prepared with the clear intention to assist both lay persons and lawyers unfamiliar with mediation understand the process through a step-by-step "guided tour" where the basic principles are broken down and explained simply and directly.

Lovenheim and Guerin proceed from the premise that mediation may provide a better answer for people than the more traditional "day in court" mind-set. In comparing mediation with other forms of dispute resolution in the book’s opening chapters, readers will quickly discover the flexibility of mediation by seeing how the same techniques have been used successfully in a myriad of contexts, including complex business disputes, employment relationships, landlord-tenant, consumer-merchant, neighbor-neighbor, or divorce and custody cases. The book also explains both the factors which favor and oppose mediation to help the reader make an informed decision as to whether mediation will make sense in a specific dispute and therefore should be considered in place of litigation.

Mediate covers a wide range of important basic information, including:

Where to find a mediator and factors to help you choose the right mediator;

How to get a mediation started;

How to prepare for a mediation, including evidence gathering and deciding who should attend;

How to write an agreement that will work for all of the interested parties.

Mediate treats the reader to an in-depth discussion of mediation in three specific contexts: (1) Divorce; (2) Business Disputes; and (3) Employment disputes, noting specific types of issues likely to emerge and considerations useful to their resolution. The book is at its best, however, when it actually takes you inside the mediation room, placing the reader in one of the chairs around the conference table and actually making you one of the disputing parties:

"The caucus is a private meeting between you and the mediator, during which the mediator can talk with you more informally and candidly than if the other side were present. Some mediators consider it the "guts" of the mediation…"

(pg. 6/27)

"To help you arrive at a solution to your dispute, your mediator has to get both parties to change their positions (or simply to see that their positions don’t really conflict.) One way to do this is to question the correctness or wisdom of the position you expressed in your opening statement. The mediator’s questions will be designed to make you wonder if you are being realistic about your case."

(pg. 6/29)

"An important part of the mediator’s job is to help you think of new ways to resolve your dispute. People caught up in a conflict often get stuck seeing only one perspective…To help you move off the dime, your mediator might ask you questions like these:

" How would you really like to see this dispute resolved, from a practical perspective?"

"What are some ways of settling this dispute that would be fair to you and the other side?"

( pg. 6/31)

In this section of Mediate, the authors outline in detail the six stages of the process: (1) Mediator’s opening statement; (2) Disputants’ opening statements; (3) Joint discussion; (4) Caucus; (5) Joint discussion; and (6) Closure The authors then explain the mediator’s role in organizing the issues, challenging your position, giving you a reality check, and helping to create settlement options. Particularly valuable are insights into how can a party can use the mediator to assist in the negotiation process. After reading the material in this section, one should be able to participate meaningfully in a mediation with a full understanding of what to expect.

Lovenheim and Guerin have done an exemplary job in educating their audience on a very complex topic. Anyone contemplating mediation should make this book a must-read in preparation for what they will encounter.

________________________________

And also from Nolo:

BECOMING A MEDIATOR. Your Guide to Career Opportunities. Peter Lovenheim and Emily Doskow. Nolo Press.

Mediation is by far the most popular of the conflict resolution methods that comprise the burgeoning ADR field. Its appeal is based upon its many distinguishing features, including confidentiality, informality, nominal or low cost, and placing the ultimate decision-making in the hands of the parties.

The current demand for mediation - from minor neighborhood squabbles to multi-party complex business disputes - has probably never been greater. As a result, there is a demand for qualified mediators in a variety of settings, creating an abundance of career opportunities.

Attorney Mediator Peter Lovenheim and Nolo Editor Emily Doskow have written this present Nolo entry as a guide for anyone considering a possible career in mediation. The authors have prepared the book with a diverse audience in mind. Both lawyers and non-lawyers alike, contemplating a move into the mediation arena, should find the book beneficial and its informational content useful. Practicing mediators interested in learning more about building up their mediation practices are also offered valuable insights and suggestions. As Lovenheim and Doskow conclude in their introduction to the work,

"Whatever your background - law, social work, teaching, psychology, business, homemaking, or parenting - if you have the skills and desire, we believe you can become a mediator and find a satisfying career."

With no requisite background necessary to become a mediator, the field remains wide open to everyone. Yet, as the book notes, about 3/4 of the people who complete mediator training never actually practice mediation, once they discover that they are not suited to the work. So, as with all good career guides, the authors begin with a reality check, a "self-evaluation" chapter, which poses the question which all prospective mediators must ask themselves: Is mediation the right career for me? To help answer that question, Lovenheim and Doskow identify and discuss skills and traits common to successful mediators. The list becomes a measureable standard by which a person can decide if (s)he possesses these fundamental qualifications, including:

Lacking one or more of these traits does not necessarily preclude one from becoming a mediator. Those who possess instead what the authors describe as "intuitive peacemaking skills" can also find rewarding job opportunities without necessarily fitting the standard mediator profile. The book provides an in depth discussion of the places where mediators can find work, outlining both the positive and negative aspects of typical mediation venues, including community mediation centers, court-annexed programs, government programs, and private dispute resolution companies. The discussion then expands to offer insights into the kind of mediation training available and touches upon where that training is offered, both general training and specialized training in such areas as heath care, securities, environmental issues, real estate and employment.

By far, however, the heart of the book lies in the comprehensive information that the authors have gathered concerning the resources available for showing mediators where employment can be found. Lovenheim and Doskow have done an impressive job in both the scope and detail of their research. These are the "nuts and bolts" sections for prospective mediators, who will find great value in its practical information.

Featured in the Chapter entitled, "Job Opportunities in Mediation," for example, are an array of sample "job descriptions" for different types of mediation positions at both the state and federal level. To these the authors have included job qualifications, salary ranges, contact telephone numbers, and website addresses. Selected programs are profiled in a detailed Case Study which adds to the value of the information being placed at the reader's fingertips. Finally, the Career Resources section presents a list of resource websites that include individual job postings.

For the independent mediator in private practice, the book offers tips on making oneself better known. If a mediator has expertise in a particular area, opportunities to expand his/her practice can be found by networking, making presentations at conventions, writing and distributing a newsletter, or posting online articles of interest in the field.

Although mediator job opportunities may not be as plentiful for non-lawyers, this book can still assist them in their job search. The authors note that the new area of online mediation is providing good opportunities for mediators who are not lawyers. In addition, Lovenheim and Doskow include two sections in the book describing mediation support jobs (case management, administration, sales and development) and mediation-related fields (ombudsman, training and teaching, consulting and coaching), all of which are providing employment opportunities without requiring a law degree.

Ensuring that readers will make a truly informed decision about the mediation profession, the book also includes a cautionary section describing the "dark side" of mediation and explores how it can often be lonely, stressful, and emotionally draining. Despite these potential negative costs, however, most practitioners find the work meaningful and enjoyable, as seen in this case study offered by the authors:

A recent case...involved a father and 27 year-old son who had been estranged for many years. The son said the father cared little for him and was too busy for him. The father said it was impossible to talk with his son because he would blow up at the most innocent remark. They met with the mediator for four hours over two late afternoon sessions. They worked hard, each owned up to his own part in the dispute, and together they reached deeply to find solutions. At the end of the second session, they worked together to come up with the terms of an agreement: regular family dinners, weekly meetings for coffee, use of civil language, respect for each other's work, and so on...As they put on their coats to leave, the son turned to his father and said, "I really do love you, Dad," and the father said, "I love you too, son." They embraced, and left together. This is mediation at its best and most rewarding.

From the Case Study, "Father and Son"- p. 2/4

Readers can expect Becoming A Mediator to be as readable and comprehensible as other titles in the Nolo Library. The writing is crisp, direct, and unpretentious. Enhancing the book's value in a visually-pleasing way are the many graphics and interesting side-bar observations that augment each chapter. The appendix is as informative as the book's substantive content. It includes sample rules of mediation, a list of statewide mediation offices, and academic centers offering degree and certificate programs in conflict resolution. In short, Lovenheim and Doskow, in a satisfying read, effectively present those interested in a mediation career with all of the information necessary to make that dream a reality.

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© Paul J. Aiello. 2004. All rights reserved Paul J. Aiello and The Electric Review.