Book Reviews

The Team Physician's Handbook

Edited by Morris B. Mellion, W. Michael Walsh and Guy L. Shelton. Pp. 910. Price, $62.00. 2nd ed. Hanley and Belfus, 210 S. 13th St., Philadelphia, PA 19107, 1997.

This handbook is ideal for use on the sidelines, in the training room or in the office. The outline form allows information to be easily and quickly extracted. The only disadvantage is that in two or three of the chapters, the outline is so rudimentary that it is difficult to follow. Each chapter also contains an excellent bibliography of information and landmark articles.

I found this handbook very informative and ideal for studying for my Certificate of Added Qualification in sports medicine. I highly recommend it to anyone who is interested in taking care of athletes and who wants to know the full range of sports medicine, not just the orthopedics.

Book Reviews

Protocols in Primary Care Geriatrics

By John P. Sloan. Pp. 208. Price, $36.00. 2nd ed. Springer-Verlag, P.O. Box 19386, Newark, NJ 07195-9386, 1996.

Protocols in Primary Care Geriatrics is a practical textbook written by an experienced geriatrician. Because of its small size syet comprehensive coverage, the textbook is a unique reference guide for common clinical geriatric issues. It may be a valuable resource for geriatric medicine fellow physicians, geriatric nurse practitioners and students, while academicians may find it particularly useful as a teaching guide for the basic geriatric syndromes.

The chapters are clear, accurate and easy to read. Two different teaching approaches are used throughout the textbook, making it a versatile learning instrument. It includes one approach for those who learn by reading (Geriatric Topics and Questions) and another approach for those who prefer to memorize (Notes on Geriatrics).

The textbook is divided into two parts. Part I discusses various geriatric topics and syndromes. It is further subdivided into the following sections: “Basis for Practice” (Aging and Frailty, Comprehensive Geriatric Assessment and Prescribing in the Elderly);“Clinical Problems” (Mobility Failure, Incontinence, Cognitive Impairment, Depression, Abuse, Alcohol and Automobiles, Constipation, Fecal Incontinence and Pressure Ulcers, and Difficult Behaviors), and “Special Topics” (The Team and Case Management, Home Care and Caregiver Support, Nursing Home Care, Palliative Care and Ethical Issues). Each chapter discussion is followed by a series of clinical exercises involving clinical cases. The appropriate responses to the exercises are found at the end of Part I. Part II repeats the topics discussed in Part I in an abbreviated, factual format.

Various chapters offer unique tools and pneumonics as memory aids. The chapter involving cognitive impairment and incontinence, for instance, includes triage protocols. The textbook contains important yet often overlooked information on driving for the older adult. The section on ethics discusses the important, controversial issue of euthanasia. There are also sections on palliative care, alcohol use and elder abuse.

There are a few problems with the textbook. The title is somewhat misleading since information is not presented in protocol fashion. The textbook does not contain a section on geriatric nutrition, and it does not include functional assessment, pressure ulcer assessment or geriatric depression scales. Other long-term care alternatives such as congregate and assisted living are not discussed. A triage protocol outlining the continuum of care in reference to acute and long-term care alternatives would enhance the sections on nursing home, home care and palliative care.

Book Reviews

The Classification of Child and Adolescent Mental Diagnoses in Primary Care: Diagnostic and Statistical Manual for Primary Care (DSM-PC) Child and Adolescent Version

Edited by Mark L. Wolraich, Marianne E. Felice and Dennis Drotar. Pp. 368. Price, $39.95. American Academy of Pediatrics, P.O. Box 927, 141 Northwest Point Blvd., Elk Grove Village, IL 60009-0927, 1996.

Primary care physicians often provide care for children who exhibit behaviors that warrant extra time in assessment and management but may not yet be severe enough to meet the criteria for a psychiatric disorder. A given symptom or behavior at one age may have a very different significance from the same behavior at another age. Similarly, physicians know that a child's environment often has a powerful impact on him or her, making the child more vulnerable to or more protected against the risk of developing behavioral difficulties. Finally, physicians recognize that many current reimbursement mechanisms favor delaying intervention until problems are serious, often to the detriment of children and their families. The Classification of Child and Adolescent Mental Diagnoses in Primary Care: Diagnostic and Statistical Manual for Primary Care (DSM-PC) Child and Adolescent Version (referred to hereafter as DSM-PC) was designed to address these concerns.

DSM-PC was developed by the American Academy of Pediatrics in close collaboration with the American Psychiatric Association and with the support of various psychology professional groups and the American Academy of Family Physicians. Care was taken to make it compatible with DSM-IV. Clearly, DSM-PC was designed to be used by family physicians and an effort was made to keep it succinct, consistent in form, well indexed and easy to use.

After an introductory section on how to use the manual, DSM-PC is divided into three major sections. The first discusses the impact of environmental situations on children and their behaviors. A categorization scheme is described to cover the major environmental factors that may affect a child, ranging from economic issues to family violence. Whenever possible, V codes are given for each of these for inclusion in the diagnoses of the child's problems. The second section discusses the degree of severity. This is the least well-developed section and does not provide a schema to quantify severity.

The third part is devoted to specific behavioral manifestations, listed under the following groupings: developmental competency; impulsive/hyperactive or inattentive behaviors; negative/antisocial behaviors; emotions and moods; somatic and sleep behaviors; feeding, eating and elimination behaviors; illness-related behaviors; sexual behaviors, and atypical behaviors. This is the most extensively developed section, and special care has been taken to use a consistent format. First, presenting complaints are listed, followed by several paragraphs devoted to definitions, symptoms and etiology. Then, in chart format, the behaviors are discussed in terms of those that represent a developmental variation, a problem or a disorder (using the DSM-IV criteria). Within each of these categories, details of the behavioral presentation are expanded on for each of four major age groups: infancy, early childhood, middle childhood and adolescence. Then, again in chart format, differential diagnosis and common co-morbid conditions are presented, including relevant clarifying information. Finally, the information is extensively indexed in one appendix, case examples are provided in a second appendix, and DSM-IV criteria for mental health disorders pertinent to children and adolescents are listed in a third appendix.

While this classification system is not perfect, family physicians should find it very helpful as they assess behavioral concerns in their pediatric patients. Particularly useful is the schema by which both the developmental level of the child and the environmental influences on the child are taken into account. Some of my colleagues have found it helpful to begin using one section with several patients and then to expand to other behavioral topics as they become more familiar with the format. DSM-PC has a great deal of promise, not only as a mechanism to classify the complexities of children's behavior problems, but also as a mechanism for the future to facilitate financial reimbursement for early identification of and intervention for children's behavior problems. The editors are to be commended for their efforts to address the complexities of children's behavior problems in a format that takes into account environmental influences on the child, the differences in problems and their significance at different developmental levels, and the importance of devoting time and energy early to assessment and intervention when caring for children with behavioral and emotional concerns. Family physicians should find this manual to be a valuable tool in the care of children and their families.

Also Received

The American Pharmaceutical Association Parent's Guide to Childhood Medications

By Andrea Peirce. Pp. 586. Price, $16.95. Andrews and McMeel, 4520 Main St., Kansas City, MO 64111, 1997.

Basic Cancer Medicine

By Maurie Markman. Pp. 140. Price, $35.00. Saunders, Curtis Center, Suite 300, Independence Square West, Philadelphia, PA 19106-3399, 1997.

Breast Disease

Edited by Douglas J. Marchant. Pp. 285. Price, $49.95. Saunders, Curtis Center, Suite 300, Independence Square West, Philadelphia, PA 19106-3399, 1997.

Chronic Illness and the Older Adult

Edited by Elizabeth A. Swanson and Toni Tripp-Reimer. Pp. 221. Price, $41.95. Springer Publishing Company, 536 Broadway, New York, NY 10012-3955, 1997.

Conquering High Blood Pressure: The Complete Guide to Managing Hypertension

By Stephen Wood and Bert Griffith. Pp. 307. Price, $18.95. Insight Books, 233 Spring St., New York, NY 10013-1578, 1997.

Death Investigation: The Basics

By Brad Randall. Pp. 168. Price, $24.95. Galen Press, P.O. Box 64400, Tucson, AZ 85728-4400, 1997.

Fat-Proof Your Child

By Joseph C. Piscatella. Pp. 494. Price, $15.95. Workman Publishing, 708 Broadway, New York, NY 10003, 1997.

For the Record: Protecting Electronic Health Information

Edited by the Committee on Maintaining Privacy and Security in Health Care Applications of the National Information Infrastructure, National Research Council. Pp. 288. Price, $29.95. National Academy Press, 2101 Constitution Ave., NW, Washington, DC 20418, 1997.

The Good Doctor

By Susan Onthank Mates. Pp. 123. Price, $10.95. University of Iowa Press, 100 Kuhl House, Iowa City, IA 52242, 1997.

The Headache Alternative: A Neurologist's Guide to Drug-Free Relief

By Alexander Mauskop and Marietta Abrams Brill. Pp. 411. Price, $13.95. DTP Trade Paperbacks, Dell Publishing, 1540 Broadway, New York, NY 10036, 1997.

Health Professionals Abroad: A Directory of Worldwide Opportunities

By Tim Ryder. Pp. 256. Price, $17.95. Vacation Work Publications, Seven Hills Book Distributors, 49 Central Ave., Cincinnati, OH 45202, 1997.

The Heart Disease Sourcebook

By Roger S. Cicala. Pp. 316. Price, $30.00. Lowell House, 2020 Avenue of the Stars, Suite 300, Los Angeles, CA 90067, 1997.

The High-Risk Pregnancy Sourcebook

By Denise M. Chism. Pp. 278. Price, $27.00. Lowell House, 2020 Avenue of the Stars, Suite 300, Los Angeles, CA 90067, 1997.

The Intelligent Patient's Guide to the Doctor-Patient Relationship: Learning How to Talk so Your Doctor Will Listen

By Barbara M. Korsch and Caroline Harding. Pp. 294. Price, $25.00. Oxford University Press, 198 Madison Ave., New York, NY 10016, 1997.

Polio

Edited by Thomas M. Daniel and Frederick C. Robbins. Pp. 202. Price, $29.95. University of Rochester Press, 34-36 Administration Bldg., University of Rochester, Rochester, NY 14627, 1997.

Practical Guide to the Care of the Pediatric Patient

Edited by Anthony J. Alario. Pp. 830. Price, $34.95. Mosby, 11830 Westline Industrial Dr., St. Louis, MO 63146-3318, 1997.

Primary Management of Musculoskeletal Trauma

Edited by David Seligson and Kurt Voos. Pp. 256. Price, $34.95. Lippincott-Raven, 227 E. Washington Square, Philadelphia, PA 19106-3780, 1997.

Seizures and Epilepsy in Childhood: A Guide for Parents

By John M. Freeman, Eileen P.G. Vining and Diana J. Pillas. Pp. 320. Price, $16.95. Johns Hopkins University Press, 2715 N. Charles St., Baltimore, MD 21218-4319, 1997.

Try to Feel It My Way: New Help for Touch Dominant People and Those Who Care About Them

By Suzette Haden Elgin. Pp. 178. Price, $14.95. Wiley, 605 Third Ave., New York, NY 10158, 1997.

Understanding Cancer: From Basic Science to Clinical Practice

Edited by Malcolm Alison and Catherine Sarraf. Pp. 269. Price, $29.95. Cambridge University Press, 40 W. 20th St., New York, NY 10011-4211, 1997.