Media Reviews

Kelley’s Textbook of Internal Medicine,4th editionedited by H. David Humes.Lippincott, Williams and Wilkins,Philadelphia, 2000, 3254 pages,$110Æ00, ISBN 0 781 71787 6.

According to the editors, this book isregarded as a classic text within themedical community. Now in its fourthedition, the publication promises anupdated version with new expert con-tributors. Each disease is explainedthrough definitions, epidemiology,pathophysiology, clinical findings,diagnosis, prognosis, management andassociated complications. The RapidAccess Guide complements the 473chapters and provides a summary ofthe main recommendations for prac-tice. However, differences between theNorth American and British healthcare systems are evident in the lan-guage, pharmacology and protocolsfor treatment. The book addresseswider issues such as evidence-basedpractice, ethics and quality of life butthese important areas are only superfi-cially explored due to the sheerbreadth of the topics in the publica-tion. The discussion of consent is sur-prisingly brief for a litigation-consciousculture.

Similar to other medical texts, thebook is descriptive and not heavilyreferenced although sources of furtherwork are presented at the end of eachchapter. The editors also advertisethree supporting books (Essentials ofInternal Medicine, Clinical DecisionManual and Review of Internal Medi-cine) and a multimedia version of thetext. For nursing practice the bookmay be useful as a general referencetext but the detailed examination ofsome subjects and the lack of infor-mation on others (such as managingchronic pain) may frustrate readers.Practitioners also need to be aware ofthe differences between the two health

care systems and protocols for treat-ment before applying this knowledgein practice.

Emma BriggsUniversity of Hull, UK

Universities: The Recovery of an Ideaby Gordon Graham.Imprint Academic, Thorverton, 2001,132 pages, £8Æ95, ISBN 0 907 84537 1.

Anyone working in or with an interest inhigher education, especially in the Uni-ted Kingdom (UK), should read thisbook – it is nothing short of brilliant.Gordon Graham is Regius Professor ofMoral Philosophy at the University ofAberdeen and he takes you on a veryreadable but short trip through recentdevelopments in UK higher education.The book takes a Newmanesque line onthe purpose of universities and, while itis clear that Graham is not wholly inaccord with Newman’s philosophy, henevertheless demonstrates how far mod-ern universities have moved from New-man’s ideas. Nursing is not mentionedin the book but the book is as relevantto nursing academics in higher educa-tion as to anyone else. There is nosnobbishness about applied subjects norabout the alleged usefulness of onesubject over another – something whichlargely precluded nursing from UKhigher education except in a few enligh-tened institutions, until recent UK gov-ernment reforms.

The recovered idea for universities isnot explicit. However, an examinationof the current structures under whichUK universities have to work: abolitionof the binary divide between establisheduniversities and polytechnics, researchassessment, teaching quality assessment,quality assurance and the increasingpressure to educate 50% of schoolleavers at tertiary level, and you cansee where the answer may lie – probablyin the abolition of all these initiatives.University academics no longer work

under anything approaching the originalconcept of academic freedom and poly-technics have been abolished. The mis-sion they sought to fulfil no longer existsand the concept of excellence has beenso redefined and perverted as to becomealmost meaningless: more students arein higher education, the absolute num-bers receiving a proper higher educationmust have fallen significantly since theearly 1990s, which is one of the worstlegacies of the years of Conservativegovernment in the UK up until 1997.

For me, the book ended on rather alow note in that Graham refers to andquotes liberally from a keynote speechby Lord Sutherland, lately Vice Chan-cellor of the University of Edinburgh.Sutherland is an arch-elitist and, wheretrue elitism was quite clear in the pre-1990s: it existed in the establisheduniversities, Sutherland tried to defineit through a failed attempt to create anIvy League of universities in the UK.Such a group would exclude manyestablished universities which have suf-fered greatly in the post-1990s because,in one fell swoop, their funding wasradically reduced. Graham also makesreference to the academic study of therelationship between intelligence andgenetics. He defends the right – theacademic freedom, if you like – ofindividuals to pursue such lines ofenquiry, as I am sure Sutherland wouldalso do. However, it is worthy of notethat Sutherland presided over the dis-missal of an academic who, howeverdisagreeable and seemingly extreme hisviews, was one of the first UK academicsto tumble due to the expression ofpolitically incorrect views. Rather thanquoting second-hand views on the fu-ture of UK universities I would ratherhave heard Graham’s own solution tothe problem.

Roger WatsonMedia Reviews Editor

484 � 2002 Blackwell Science Ltd

Clinical Governance in Gastroenterology:Key Points for Primary Careby Greg Rubin, Roger Jones, Jim Priceand Richard Stevens.Radcliffe Medical Press, Abingdon,2000, 112 pages, £14Æ95,ISBN 1 857 75438 7.

This useful, concise book provides de-tails of gastrointestinal diseases andtheir management, written by four em-inent primary care medical practitionersfrom the UK for the Primary CareSociety for Gastroenterology (PCSG).The authors have identified 17 keytopics, which are examined in a system-atic format, considering the disease sig-nificance, therapeutic and clinicalpoints, access to services required andrisk management for each identifiedarea. In addition to direct clinical issues,consideration is given to health econom-ics and record-keeping. Wherever poss-ible the book is written from anevidence-based perspective and identi-fies key risk management initiatives,which can be incorporated into clinicalpractice. The inclusion of pertinent fur-ther reading advice, and the provision ofa section in each chapter which directsthe reader to the appropriate guidelinesfor clinical management are other usefulfactors. This book is structured to

provide a framework for clinical gov-ernance in gastroenterology from a pri-mary care perspective. Therefore it willbe of interest to GPs, practice nurses andclinical nurse specialists involved in themanagement of gastrointestinal disease.

Diane PalmerUniversity of Hull, UK

The Challenge of Sexuality in HealthCareedited by Hazel Heath and Isabel White.Blackwell Science, Oxford, 2002,296 pages, £22Æ50, ISBN 0 632 04804 2.

This edited work by Hazel Heath andIsabel White scans the terrain of sexu-ality in health care, which challengenurses and health professionals in avariety of settings. Professionals familiarwith this area of interest author eachchapter. It offers a useful historical andpost-modern view of concepts, contextsand influences that have brought thisissue to its pressing state of affairs atthis turn of the century/millennium.Each of the chapters allows the readerto follow social changes that haveshaped the moral backdrop facing con-temporary nursing. Sexuality is devel-oped as a theoretical perspective relatedto individual populations and/or set-tings. This work is not intended nor

developed as a text to suggest thenurse becomes a psychosexual therapist,rather, a useful and neglected resourceand source book for assisting nurses tobe skilled practitioners for timely inter-vention/prevention. Some of the princi-ple themes identified are: public andprivate aspects; issues of control in acare environment; power – use andabuse of; gender issues, includingintimacy within professional activities;impact of being deemed ‘asexual’;access vs. exclusion related to ‘control-ling’ sexual behaviour within care envi-ronments.

Philosophically this work addressesexpanded notions of sexuality and over-all sexual health as inherent in all caresettings. In summary, this book is in-formative, comprehensive, contempor-ary, and authoritative in scope andcontent. It offers a fresh whole person,whole care, approach to what is often aneglected, fragmented, or ignored areaof care. It is scholarly yet accessible,from students to practising nurses tofaculty. This book serves undergraduateand graduate nurse practitioner stu-dents, and makes useful reading forother health professionals.

Jean WatsonUniversity of Colorado, USA

Media Reviews

� 2002 Blackwell Science Ltd, Journal of Advanced Nursing, 40(4), 484–485 485