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Health Care USA: Understanding Its Organization and Delivery
SEPTEMBER 1998, VOL 68, NO 3
several different formats commonly used by radiologists and other physicians. These include traditional x-rays and computed tomography scans to optimally visualize bone, magnetic resonance imaging for soft tissue, and three types of color photographs for definitive resolution. Photography provides the ultimate standard of comparison. The search for a normal representative of a large population involved the cooperation of the state anatomical boards of Colorado, Texas, and Maryland. The candidate was to be a male 21 to 60 years of age who died without traumatic injuries or invasive or infectious disease. The size criteria were based on the limitations of equipment to image or position and slice the body. The male was to be less than six feet tall, less than 22 inches wide, less than 14 inches from front to back, and of normal height for his weight, The individual selected was a recently executed 38-year-old male. He met the criteria but had slight imperfections-his appendix, #I4 tooth, and left testicle were missing. “The Visible Human Project,” released on the Internet, places these images into the hands of the world. This renewable cadaver serves as a standardized patient and a basis for digital populations of the future. This book is a magnificent reference and an inspiring tribute to the state-of-the-art technology used. It is appropriately dedicated to those people who have given their last perfect gift to societytheir bodies. The humanness of the subject is not lost by the authors or audience. This book is available from Jones and Bartlett Publishers, 40
Tall Pine Dr, Sudbury, MA 01776; (508) 443-5000. M A R Y J A N E C. E D W A R D S RN, CNOR MANAGER OF HEALTH CARE CONSULTING ERNST & YOUNG, LLP WASHINGTON, DC
SOAP, WATER AND SEX By Jacob Lzpnian 1998,191 p p $18.95 paperback
‘p his book stresses the impor-
1
tance of good hygiene and its relation to more than 30 sexually transmitted diseases (STDs). It is unusual to find such an open description of current sexual practices in a clinically based publication. The book begins with candid descriptions of what ensues when hygiene is neglected-physically, socially, and emotionally. Several passages elicited a visceral response, making it difficult to continue with the chapter. If you can survive the opening, chapters three through six provide some good advice on cleanliness, condoms, and partner investigation. The last 11 chapters describe various STDs, providing a comprehensive overview of the current epidemics facing sexually active people today. There are some cleverly captioned chapters, such as “The bumpy road,” which discusses warts, and “STDs you can’t stomach,” which discusses acquired gastrointestinal parasites. Overall, however, the book has a serious tone. One difficulty I found with this book was identifying the intended audience. There is no preface or introduction. The large, easy-to-read print and the 481 AORN JOURNAL
intentional lack of treatment regimens point to the general public; however, content readability measures close to the 12th grade, indicating use in an adult, educated population. This publication is too vague for use by nursing practitioners and it is too superficial, lacking specific treatment options or protocol, yet it may be a powerful reference tool for the senior high school health class or an introduction for a nursing or allied health student in a community health rotation. This book is available from Prometheus Books, 59 John Glenn Dr, Amherst, NY 14228; (800) 421 -0351. D O N N A LAGUEUX RN, MSN, CNOR CLINICALEDUCATIONCONSULTANT/ SURGICAL SERVICES WATERBURY (CONN)HOSPITAL
HEALTH CARE USA: UNDERSTANDING ITS ORGANIZATION AND DELIVERY By Harry&. Sultz, Kristina M . Young 1997,329~~ $39 hardcover
‘p his book offers a clear and comprehensive overview of the health care system in the United States. The focus is on public health and an analysis of the complexity of our current health care delivery system. The 13 chapters of the book are organized around three central themes. Chapters one through three provide a detailed overview of health care in the United States, including a population perspective, benchmark developments, and a historical analysis of hospital origin, organization, and operation. Chapters
SEPTEMBER 1998, VOL 68, NO 3
four through 1 1 provide a current conceptualization of health care structures and functions. These chapters include perspectives on how hospitals are adapting for the twenty-first century, the role of ambulatory care, long-term care, mental health services in health care delivery, the changing face of medical education, personnel and finance issues in a managed care environment, and the role of government in public
health care delivery. The final two chapters are dedicated to an analysis of how health care advances through research and what the future forebodes. This is one of the most readable books I have enjoyed in a long time. It has a generalist perspective and a refreshing objectivity unhampered by biased advocacy for any particular group. It would be a useful addition to any health care provider’s
library. I was so impressed, I plan to adopt it for use with my graduate nursing students in their administration courses. This book is available from Aspen Publishers, Inc, 200 Orchard Rd, Gaithersburg, MD 20878; (800) 234-1660. KAREN C. LYON RN, PHD, CNAA, CNS CLINICAL NURSE SPECIALIST CHARLES A. LYON, MD, FACS EL PASO,TEX
Education Program Encourages More Control of Diabetes The National Diabetes Education Program has launched a new campaign to encourage the 16 million Americans with diabetes to control their blood sugar levels, according to a June 23, 1998,press release from the National Diabetes Education Program. Diabetes is a chronic metabolic disease in which the body does not produce or properly use insulin-a hormone needed to convert sugar, starches, and other food into energy. Diabetes is the leading cause of adult blindness, end-stage kidney disease, and foot and leg amputations. In addition, people with diabetes have an increased risk of heart disease and stroke, and death rates are twice as high among middle-aged people with diabetes than among middle-aged people without diabetes. According to the release, compelling evidence has found that maintaining blood sugar levels of less than 7% may reduce the risk of diabetes complications by 50% to 80%. The National Diabetes Education Program’s campaign, “Control Your Diabetes. For Life” teaches Americans how to both reach and maintain their blood sugar goals to enjoy a better quality of life. To reach the proper blood sugar level, the program advises diabetics to test blood sugar regularly; keep a record of blood tests, medicines, and daily events; take diabetes medicine as prescribed eat foods that are low in fat, salt, and sugar and high in fiber; become physically active;
check feet for cuts, blisters, red spots, and swelling that can result from diabetes-related nerve damage; stay at an appropriate weight; treat low blood sugar quickly; do not smoke; manage stress; learn more about diabetes and diabetes self-care; and seek support from family and friends or join a diabetes support group. To maintain blood sugar control, the program recommends that diabetics, break big goals into small steps, make changes they can stick with, think about all the reasons for keeping blood sugar under control, figure out what tempts them to slip up, reward themselves, put a positive spin on diabetes care, and make time to relax. The National Diabetes Education Program is a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention. More information about diabetes is available by calling (800)438-5383 or by visiting the National Diabetes Education Program’s web sites at http://ndep .nih.gov or http://www .cdc.gov/diabetes/. New Awareness Campaign’s Message is ClearXontrol Your Diabetes. For Life (news release, Washington, DC: National Diabetes Education Program, June 23, 1998) 1.
482 AORN JOURNAL
several different formats commonly used by radiologists and other physicians. These include traditional x-rays and computed tomography scans to optimally visualize bone, magnetic resonance imaging for soft tissue, and three types of color photographs for definitive resolution. Photography provides the ultimate standard of comparison. The search for a normal representative of a large population involved the cooperation of the state anatomical boards of Colorado, Texas, and Maryland. The candidate was to be a male 21 to 60 years of age who died without traumatic injuries or invasive or infectious disease. The size criteria were based on the limitations of equipment to image or position and slice the body. The male was to be less than six feet tall, less than 22 inches wide, less than 14 inches from front to back, and of normal height for his weight, The individual selected was a recently executed 38-year-old male. He met the criteria but had slight imperfections-his appendix, #I4 tooth, and left testicle were missing. “The Visible Human Project,” released on the Internet, places these images into the hands of the world. This renewable cadaver serves as a standardized patient and a basis for digital populations of the future. This book is a magnificent reference and an inspiring tribute to the state-of-the-art technology used. It is appropriately dedicated to those people who have given their last perfect gift to societytheir bodies. The humanness of the subject is not lost by the authors or audience. This book is available from Jones and Bartlett Publishers, 40
Tall Pine Dr, Sudbury, MA 01776; (508) 443-5000. M A R Y J A N E C. E D W A R D S RN, CNOR MANAGER OF HEALTH CARE CONSULTING ERNST & YOUNG, LLP WASHINGTON, DC
SOAP, WATER AND SEX By Jacob Lzpnian 1998,191 p p $18.95 paperback
‘p his book stresses the impor-
1
tance of good hygiene and its relation to more than 30 sexually transmitted diseases (STDs). It is unusual to find such an open description of current sexual practices in a clinically based publication. The book begins with candid descriptions of what ensues when hygiene is neglected-physically, socially, and emotionally. Several passages elicited a visceral response, making it difficult to continue with the chapter. If you can survive the opening, chapters three through six provide some good advice on cleanliness, condoms, and partner investigation. The last 11 chapters describe various STDs, providing a comprehensive overview of the current epidemics facing sexually active people today. There are some cleverly captioned chapters, such as “The bumpy road,” which discusses warts, and “STDs you can’t stomach,” which discusses acquired gastrointestinal parasites. Overall, however, the book has a serious tone. One difficulty I found with this book was identifying the intended audience. There is no preface or introduction. The large, easy-to-read print and the 481 AORN JOURNAL
intentional lack of treatment regimens point to the general public; however, content readability measures close to the 12th grade, indicating use in an adult, educated population. This publication is too vague for use by nursing practitioners and it is too superficial, lacking specific treatment options or protocol, yet it may be a powerful reference tool for the senior high school health class or an introduction for a nursing or allied health student in a community health rotation. This book is available from Prometheus Books, 59 John Glenn Dr, Amherst, NY 14228; (800) 421 -0351. D O N N A LAGUEUX RN, MSN, CNOR CLINICALEDUCATIONCONSULTANT/ SURGICAL SERVICES WATERBURY (CONN)HOSPITAL
HEALTH CARE USA: UNDERSTANDING ITS ORGANIZATION AND DELIVERY By Harry&. Sultz, Kristina M . Young 1997,329~~ $39 hardcover
‘p his book offers a clear and comprehensive overview of the health care system in the United States. The focus is on public health and an analysis of the complexity of our current health care delivery system. The 13 chapters of the book are organized around three central themes. Chapters one through three provide a detailed overview of health care in the United States, including a population perspective, benchmark developments, and a historical analysis of hospital origin, organization, and operation. Chapters
SEPTEMBER 1998, VOL 68, NO 3
four through 1 1 provide a current conceptualization of health care structures and functions. These chapters include perspectives on how hospitals are adapting for the twenty-first century, the role of ambulatory care, long-term care, mental health services in health care delivery, the changing face of medical education, personnel and finance issues in a managed care environment, and the role of government in public
health care delivery. The final two chapters are dedicated to an analysis of how health care advances through research and what the future forebodes. This is one of the most readable books I have enjoyed in a long time. It has a generalist perspective and a refreshing objectivity unhampered by biased advocacy for any particular group. It would be a useful addition to any health care provider’s
library. I was so impressed, I plan to adopt it for use with my graduate nursing students in their administration courses. This book is available from Aspen Publishers, Inc, 200 Orchard Rd, Gaithersburg, MD 20878; (800) 234-1660. KAREN C. LYON RN, PHD, CNAA, CNS CLINICAL NURSE SPECIALIST CHARLES A. LYON, MD, FACS EL PASO,TEX
Education Program Encourages More Control of Diabetes The National Diabetes Education Program has launched a new campaign to encourage the 16 million Americans with diabetes to control their blood sugar levels, according to a June 23, 1998,press release from the National Diabetes Education Program. Diabetes is a chronic metabolic disease in which the body does not produce or properly use insulin-a hormone needed to convert sugar, starches, and other food into energy. Diabetes is the leading cause of adult blindness, end-stage kidney disease, and foot and leg amputations. In addition, people with diabetes have an increased risk of heart disease and stroke, and death rates are twice as high among middle-aged people with diabetes than among middle-aged people without diabetes. According to the release, compelling evidence has found that maintaining blood sugar levels of less than 7% may reduce the risk of diabetes complications by 50% to 80%. The National Diabetes Education Program’s campaign, “Control Your Diabetes. For Life” teaches Americans how to both reach and maintain their blood sugar goals to enjoy a better quality of life. To reach the proper blood sugar level, the program advises diabetics to test blood sugar regularly; keep a record of blood tests, medicines, and daily events; take diabetes medicine as prescribed eat foods that are low in fat, salt, and sugar and high in fiber; become physically active;
check feet for cuts, blisters, red spots, and swelling that can result from diabetes-related nerve damage; stay at an appropriate weight; treat low blood sugar quickly; do not smoke; manage stress; learn more about diabetes and diabetes self-care; and seek support from family and friends or join a diabetes support group. To maintain blood sugar control, the program recommends that diabetics, break big goals into small steps, make changes they can stick with, think about all the reasons for keeping blood sugar under control, figure out what tempts them to slip up, reward themselves, put a positive spin on diabetes care, and make time to relax. The National Diabetes Education Program is a joint program of the National Institutes of Health and the Centers for Disease Control and Prevention. More information about diabetes is available by calling (800)438-5383 or by visiting the National Diabetes Education Program’s web sites at http://ndep .nih.gov or http://www .cdc.gov/diabetes/. New Awareness Campaign’s Message is ClearXontrol Your Diabetes. For Life (news release, Washington, DC: National Diabetes Education Program, June 23, 1998) 1.
482 AORN JOURNAL