Palliative Care for Advanced Alzheimer's and Dementia: Guidelines and Standards for Evidence-Based Care

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2010 AJN Book of the Year Award Winner in both Gerontologic Nursing and Hospice and Palliative Care!

This book...provides important information on best practices and appropriate ways to care for a person with Alzheimer's and advanced dementia. Drs. Martin and Sabbagh have assembled a team of experts to help craft recommendations that should ultimately become standards that all professional caregivers adopt.

-Michael Reagan
Son of former President Ronald Reagan
President, Reagan Legacy Foundation

This book testifies that caregivers can have a monumental impact on the lives of persons with advanced dementia. Through specialized programming and a renewed effort toward patient-centered care, caregivers can profoundly enrich the quality of life for these persons. Providing guidelines for health care professionals, caregivers, and family members, this book introduces palliative care programs and protocols for the treatment of people with advanced dementia.

The book is designed to guide professional caregivers in meeting the needs of patients and their families, providing insight into the philosophy, assessment, planning, implementation, and evaluation measures involved in interdisciplinary palliative care. The chapter authors offer guidelines and standards of care based on contributions from nurses, physical therapists, social workers, dietitions, psychologists, family caregivers and pastors. An exhibit at the end of every chapter clearly articulates the standards of care appropriate for all advanced dementia facilities and health care staff.

This book helps caregivers:

• Enhance the physiological, psychological, social, and spiritual well-being of the patient and the patient's family
• Anticipate and meet the patient's basic human needs: hunger, thirst, body positioning, hygiene, continence, and management of any pain
• Ensure that the patient's surroundings are safe, comfortable, and homelike
• Address health care decisions that will support the patient's right to self-determination until the end of life

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Sports Injuries: Third Edition

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Sports Injuries: Third Edition La revue

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This popular handbook comprehensively covers the prevention and treatment of sports injuries, and is thus essential reading for all athletes, trainers, physio-therapists and doctors. The book covers all international sports and features extensive use of action photographs..


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Pediatric Pain And Symptom Management Algorithms For Palliative Care (Wrede-Seaman, Pediatric Pain and Symptom Management Algorithms for Palliative Care)

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Pediatric Pain And Symptom Management Algorithms For Palliative Care (Wrede-Seaman, Pediatric Pain and Symptom Management Algorithms for Palliative Care) Info

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This is a book with the core information needed for medical professionals working with pediatric hospice, home care, palliative care resource teams, oncology services, and longterm care facilities..


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Angels of Death: Exploring the Euthanasia Underground

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Public discussion of euthanasia and assisted suicide is growing. In Australia as elsewhere the debate is difficult, contentious and confronting, and hampered by the secrecy that necessarily surrounds illegal practice. Most people simply have no way of knowing how, and how often, medically assisted death actually occurs. Roger Magnusson presents, for the first time, detailed first-hand accounts by doctors, nurses, therapists and other health professionals who have been participants in assisted death. All have been intimately involved in caring for people with AIDS, both in Australia and in California. He places these ambivalent, self-incriminating accounts within the broader context of the right-to-die debate and the challenges of palliative care. The frankness of the health workers and the richness of their collected evidence set this book apart. From within a culture of deception they speak knowingly and movingly of the merciful release of a peaceful death, while acknowledging the reality of 'botched attempts', euthanasia without consent, precipitative euthanasia, lack of accountability and professional distance, and many other disturbing issues. Angels of Death provides a wi.


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Palliative and End of Life Care for Children and Young People: Home, Hospice, Hospital

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“Anne’s contribution to our understanding of the needs of young people with cancer has been unparalleled and without her extraordinary insights our services would be that much poorer.”
From the foreword by Simon Davies , CEO Teenage Cancer Trust

This topical and timely text provides valuable insights into the choices and experiences of palliative and end of life care for young people with cancer and other life limiting illnesses. With a focus on palliative care provision across a range of different clinical settings, this comprehensive new resource explores care in the home, the hospice and hospital. It looks at how and where families and young people can access palliative care, and what support is offered to attain their preferred place of death. Bereavement support for families is discussed, as well as a discussion of multidisciplinary work, interagency co-operation and resource issues.

This title is essential reading for community children’s nurses, specialist palliative care teams, children’s hospices, school nurses, social workers and student nurses as well as families.

• A comprehensive resource on end of palliative are provision for children and young adults with cancer and other life limiting illnesses
• Timely and topical, tying in with the Department of Health palliative care strategy ‘Better Care: Better Lives’
• Written in an accessible style that does not assume either detailed medical or theoretical knowledge
• Explores palliative care provision in a range of different clinical settings including the home, hospice, and hospital
• Provides valuable insights into the experiences of parents, children and young people

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Social Capital and Health

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Social Capital and Health Description

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As interest in social capital has grown over the past decade―particularly in public health ―so has the lack of consensus on exactly what it is and what makes it worth studying. Ichiro Kawachi, a widely respected leader in the field, and 21 contributors (including physicians, economists, and public health experts) discuss the theoretical origins of social capital, the strengths and limitations of current methodologies of measuring it, and salient examples of social capital concepts informing public health practice.

Among the highlights:

Measurement methods: survey, sociometric, ethnographic, experimental

The relationship between social capital and physical health and health behaviors: smoking, substance abuse, physical activity, sexual activity

Social capital and mental health: early findings

Social capital and the aging community

Social capital and disaster preparedness

Social Capital and Health is certain to inspire a new generation of research on this topic, and will be of interest to researchers and advanced students in public health, health behavior, and social epidemiology.

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Prayers and Promises When Facing a Life-Threatening Illness: 30 Short Morning and Evening Reflections

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Prayers and Promises When Facing a Life-Threatening Illness: 30 Short Morning and Evening Reflections La revue

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Having a life-threatening illness is a constant reminder that today is precious. Prayers and Promises When Facing a Life-Threatening Illness offers encouragement and hope to those who suffer and those who love and care for them. Written by a fellow pilgrim on his own journey with Lou Gehrig's disease, this powerful and inspiring devotional guide offers thirty short reflections to nurture your faith and boost your strength. Each reflection is a small dose of spiritual truth to start or complete your day. Morning selections include a brief prayer and reflection. Evening readings are based on God's promises to encourage and enlighten you. Some of the prayers and promises include: * God, remind me that there is more to life than this disease. * God, give me strength to believe that you can heal me. * God, give me something to laugh about. * God, help me to leave a legacy for my family. * God, I don't feel like praying. After completing the thirty-day cycle, Dr. Dobson encourages you to repeat it again and again for continued spiritual nourishment that is needed during this time..


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Yoga for Health - Hamlyn

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Yoga for Health - Hamlyn La revue

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This is more than a Yoga book, more than an exercise book, more than a nutrition guide, more than a cookbook. It is all three. And it presents the total way of life by America's foremost yoga instructor..


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Sports Injuries:Their Prevention & Treatment-3rd Graphics Package

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Sports Injuries:Their Prevention & Treatment-3rd Graphics Package La revue

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New to this edition of Sport Injuries: Their Prevention and Treatment is a supplemental CD-ROM that contains much of the outstanding artwork from the text.

Readers of the previous editions have enjoyed the excellent quality of the images and their usefulness in illustrating anatomical concepts. This new CD of selected illustrations from the book will provide a further visual resource for sports medicine specialists.

The CD contains 332 illustrations and 190 photographs. The convenient CD-ROM format allows users to incorporate the images in PowerPoint presentations.

The graphics package is free to course adopters.

For non-course adopters, the graphics package is available for purchase on CD-ROM for Windows or Macintosh.

Minimum system requirements

Microsoft® Windows®

-IBM PC compatible with Pentium® processor

-Windows® 95/98/2000/ME/XP (2000 or XP recommended)

-16 MB RAM (32 MB recommended)

-At least 28 MB hard drive space recommended for installation

-Microsoft® PowerPoint® Viewer 97 (included)

-4x CD-ROM drive

-High color display setting (true color recommended)

-Mouse
Macintosh®

-Power Mac® required

-System 9.x/10.x

-16 MB RAM (32 MB recommended)

-At least 28 MB hard drive space recommended for installation

-Microsoft® PowerPoint® Viewer 98 (included)

-4x CD-ROM drive (or faster)

-High color display setting (true color recommended)

-Mouse

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Narratives and Jewish Bioethics (Content and Context in Theological Ethics)

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Narratives and Jewish Bioethics (Content and Context in Theological Ethics) Info

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Narratives and Jewish Bioethics searches for answers to the critical question of what roles ancient narratives play in creating modern norms by Jewish bioethicists utilizing the Jewish textual tradition..


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Making Sense of Near-Death Experiences: A Handbook for Clinicians

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Making Sense of Near-Death Experiences: A Handbook for Clinicians Description

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*Highly Commended in the Psychiatry category at the 2012 British Medical Association Book Awards*

A near-death experience (NDE) is a phenomenon whereby powerful physical and emotional sensations and visions are experienced by someone who is either close to death or has been declared clinically dead.

This is an accessible guide to the theory and evidence underlying the phenomenon of NDEs. With contributions from leading international experts in the field, it provides an overview of the research into NDEs, the nature of NDEs and how they have been experienced around the world, and the physiological, psychological and medical bases of the phenomenon. The book also discusses children's NDEs, NDEs from a religious perspective, the role of light in NDEs, the assessment and management of NDEs, and the future of research into the phenomenon.

This essential handbook will provide all those who may encounter someone who has had an NDE with the knowledge and understanding they need, including nurses, doctors, palliative care workers, psychologists, psychiatrists and pastoral workers.*Highly Commended in the Psychiatry category at the 2012 British Medical Association Book Awards*

A near-death experience (NDE) is a phenomenon whereby powerful physical and emotional sensations and visions are experienced by someone who is either close to death or has been declared clinically dead.

This is an accessible guide to the theory and evidence underlying the phenomenon of NDEs. With contributions from leading international experts in the field, it provides an overview of the research into NDEs, the nature of NDEs and how they have been experienced around the world, and the physiological, psychological and medical bases of the phenomenon. The book also discusses children's NDEs, NDEs from a religious perspective, the role of light in NDEs, the assessment and management of NDEs, and the future of research into the phenomenon.

This essential handbook will provide all those who may encounter someone who has had an NDE with the knowledge and understanding they need, including nurses, doctors, palliative care workers, psychologists, psychiatrists and pastoral workers..


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Exercise and Disease Management, Second Edition

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Exercise and Disease Management, Second Edition Info

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Exercise and Disease Management is designed to help managed care physicians, their patients, other health care professionals, and interested readers integrate current exercise guidelines into their practices. This extraordinary book is accompanied by a series of 11 workbooks, each one for a chronic disease, designed specifically for physicians to give to their patients. These workbooks make it convenient for physicians to prescribe physical activity to their patients in a ready-to-use format. Each book chapter and workbook contains a section on the background, medical management, and exercise guidelines, accompanied by self-care instructions for patients, encouraging them to take a proactive role in their health and disease management.

New and Updated in the Second Edition:

• A ready-to-use "Exercise Prescription Page," which follows each chapter on a specific disease, enables health care professionals, especially physicians in managed care, to prescribe exercise quickly to clients with specific medical conditions
• The "Rate Pressure Product" method for prescribing exercise helps health care providers individualize exercise prescriptions for patients with heart disease by accounting for the amount of oxygen the heart uses
• Individual companion workbooks on CD provide patient health maintenance information about diabetes, AIDS, obesity, golden years (age 65 and older), heart, kidney, peripheral arterial, and lung disease. Workbooks for physical inactivity, osteoporosis, arthritis and high blood pressure also are included on the CD
• Common question-and-answer sections that help patients understand the diseases from which they suffer and encourages them to take responsibility for their health

Exercise and Disease Management, Second Edition consolidates the current knowledge base on exercise and chronic disease, providing a ready-made format for health care providers to use when prescribing exercise programs for their clients. Using guidelines set forth by the American College of Sports Medicine and the American Association of Cardiovascular and Pulmonary Rehabilitation, this book helps physicians, other health care providers, and health enthusiasts respond to the challenge to keep patients healthier and active and reduce recurrent hospitalizations and health care costs.

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I'm Here to Help: A Guide for Caregivers, Hospice Workers, and Volunteers

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I'm Here to Help: A Guide for Caregivers, Hospice Workers, and Volunteers La revue

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This practical, caring, step-by-step guide is a standard text for the millions of professionals who are committed to taking care of those suffering from chronic or terminal illness and their families. I'm Here to Help imparts the skills and techniques necessary to facilitate communication in a succinct style and provides tips on how to initiate painful discussions, listen effectively, manage defensiveness in both the family and patient, and other vital issues..


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Hospice Voices: Lessons for Living at the End of Life

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Hospice Voices: Lessons for Living at the End of Life Description

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As a part-time hospice volunteer, Eric Lindner provides companion care to dying strangers. They’re chatterboxes and recluses, religious and irreligious, battered by cancer, congestive heart failure, Alzheimer’s, old age. Some cling to life amazingly. Most pass as they expected.
In telling his story, Lindner reveals the thoughts, fears, and lessons of those living the ends of their lives in the care of others, having exhausted their medical options or ceased treatment for their illnesses. In each chapter, Lindner not only reveals the lessons of lives explored in their final days, but zeroes in on how working for hospice can be incredibly fulfilling.

As he’s not a doctor, nurse, or professional social worker, just a volunteer lending a hand, offering a respite for other care providers, his charges often reveal more, and in more detail, to him than they do to those with whom they spend the majority of their time. They impart what they feel are life lessons as they reflect on their own lives and the prospect of their last days.

Lindner captures it all in his lively storytelling. Anyone who knows or loves someone working through end of life issues, living in hospice or other end of life facilities, or dealing with terminal or chronic illnesses, will find in these pages the wisdom of those who are working through their own end of life issues, tackling life’s big questions, and boiling them down into lessons for anyone as they age or face illness. And those who may feel compelled to volunteer to serve as companions will find motivation, inspiration, and encouragement. Rather than sink under the weight of depression, pity, or sorrow, Lindner celebrates the lives of those who choose to live even as they die.
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Communicating at the End of Life: Finding Magic in the Mundane (LEA's Series on Personal Relationships)

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Communicating at the End of Life: Finding Magic in the Mundane (LEA's Series on Personal Relationships) Info

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This enlightening volume provides first-hand perspectives and ethnographic research on communication at the end of life, a topic that has gone largely understudied in communication literature. Author Elissa Foster’s own experiences as a volunteer hospice caregiver form the basis of the book. Communicating at the End of Life recounts the stories of Foster and six other volunteers and their communicative experiences with dying patients, using communication theory and research findings to identify insights on the relationships they form throughout the process. What unfolds is a scholarly examination of a subject that is significant to every individual at some point in the life process.
 
Organized chronologically to follow the course of Foster’s involvement with hospice and the phases of the study, the book opens with Part 1, providing background and contextual information to help readers understand subsequent stories about communication between volunteers and patients. Part 2 of the volume emphasizes the adjustments required by the volunteers as they entered the world of hospice and the worlds of the patients. Part 3 underscores the importance of improvisation and finding balance within the role of volunteer—in particular how to be fully present for patients as well as their family members. The volume concludes with Part 4, which addresses how volunteers coped with the death of their patients and what they learned from the experience of volunteering.
 
Communicating at the End of Life is appropriate for scholars and advanced students studying personal relationships, health communication, gerontology, interpersonal communication, lifespan communication, and communication & aging. Its unique content offers precious and meaningful insights on the communication processes at a critical point in the life process..


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The Art of Conversation Through Serious Illness: Lessons for Caregivers

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The Art of Conversation Through Serious Illness: Lessons for Caregivers Info

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Every day, thousands of people receive a diagnosis of serious, life-threatening illness, and their families and friends suddenly become caregivers. Despite the best of intentions it is not always easy to communicate well under these circumstances, or find deep empathy for something one has never before experienced. When is it best to speak, and when to be silent? How can someone provide real comfort, and how can relationships with loved ones facing serious illness be enhanced in this most difficult time?

This book is about how to be an encouraging caregiver and friend under the most difficult circumstances, when the possibility of death is all too real The authors believe that open dialogue must not be avoided until the last minute when opportunities will be limited, but that caregivers and loved ones can embrace this time, mortal time, honestly as a way to sensitively and compassionately engage with those for whom a central fact of life is realized--that all of our lives are time-limited.

In The Art of Conversation Through Serious Illness, the authors consider how to best listen to and speak with one facing life-threatening illness, with lessons on being a primary conversation partner, becoming properly empathic and receiving empathy, maintaining everyday conversation, using platitudes appropriately, understanding healthy denial, and talking about dying. Offering bedside guidance usually only available to professionals and peppered with insightful anecdotes from the authors' own experiences, this gentle, succinct book is appropriate for anyone going through this uniquely difficult yet universal life experience.
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Prevention Program Development and Evaluation: An Incidence Reduction, Culturally Relevant Approach

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Prevention Program Development and Evaluation: An Incidence Reduction, Culturally Relevant Approach La revue

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The use of seatbelts, the requirements for smoke detectors, and other kinds of public health interventions have been highly successful in reducing disability, injuries, and premature mortality. Prevention in mental health— identifying and treating mental illnesses before they become full blown syndromes or identifying people at risk for a condition—is just as critical to public mental health. This research-based resource gives practitioners a nuts-and-bolts guide to designing and evaluating prevention programs in mental health that are culturally relevant and aimed at reducing the number of new problems that occur.

Key Features

• Employs a 10-step prevention program development and evaluation model that emphasizes the concepts of community, collaboration, and cultural relevance
• Offers a brief, practical, how-to approach that is based on rigorous research
• Identifies specific prevention program development and evaluation steps
• Highlights examples of "everyday prevention" practices as well as concrete prevention programs that have proven, effective implementation
• Promotes hands-on learning with practical exercises, instructive figures, and a comprehensive reference list

Intended Audience
Written in a straightforward and accessible style, Prevention Program Development and Evaluation can be used as a core text in undergraduate courses devoted to prevention or in graduate programs aimed at practice issues. Current practitioners or policymakers interested in designing prevention programs will find this book to be an affable guide.

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Nutrition and Hydration in Hospice Care: Needs, Strategies, Ethics (The Hospice Journal , Vol 9, No 2-3)

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Nutrition and Hydration in Hospice Care: Needs, Strategies, Ethics (The Hospice Journal , Vol 9, No 2-3) Info

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This scholarly book enables health care professionals to appropriately address hospice patients’and families’concerns about nutrition and hydration. Nutrition and Hydration in Hospice Care is a comprehensive resource that provides hands-on practical information that readers can use in everyday hospice practice. The chapters identify problems, solutions, and ethical issues of nutrition and hydration in hospice care.

The contributing authors provide the way for health care professionals, especially those in nursing, dietary, and pharmacy units, to jointly and effectively manage troublesome symptoms and ethical issues. The following topics are included in the scope of coverage:

• nutrition/hydration needs during end-stage disease
• nursing and dietary roles in identifying nutrition/hydration problems and implementing treatment
• how needs of dying children and adults are different
• legal and ethical dilemmas of withholding or withdrawing nutrition and hydration
• appropriate and inappropriate uses of enteral and parenteral nutrition support during end-stage diseases
• food service considerations in inpatient hospice facilities
• appetite stimulant use in palliative care
  
  Because Nutrition and Hydration in Hospice Care is comprehensive, all members of hospice staffs can find practical information to use each day. The authors cover issues not found in other books for nurses, dietitians, pharmacists, and physicians. They will find the information ready to apply at their work settings.

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Healthy Living in a Contaminated World

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Healthy Living in a Contaminated World La revue

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What causes cancer, type-2 diabetes and other debilitating conditions? Often it's the toxic chemicals that surround us and infiltrate our bodies. Healthy Living in a Contaminated World shines a light on these toxic chemicals and leads the reader toward a healthier life. It describes the health damages caused by specific chemicals, and recommends actions that people can take to avoid exposure to them.
This book is an updated edition of How to Be Healthy in a Toxic World..


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Spiritual Care at the End of Life: The Chaplain as a 'Hopeful Presence'

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Spiritual Care at the End of Life: The Chaplain as a 'Hopeful Presence' Info

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Chaplains in healthcare settings offer patients spiritual care that involves companionship, counselling and maintaining hope. This is particularly important at the point where a patient has run out of treatment possibilities. This book reflects creatively on the work that chaplains do with people who are dying and the unique quality of the relationship that palliative care professionals construct with patients at the end of life. Based on qualitative research with practising palliative care chaplains, Spiritual Care at the End of Life explores the nature of hope in its different forms at different stages of terminal illness, and asks how chaplains can help dying people to be hopeful even when facing the inevitability of their death. This book identifies key moments in this relationship, from the person's initial reaction to the chaplain, to the chaplain becoming an accompanying presence and creating the potential to provide comfort, strength and hope in the present. This thoughtful and inquisitive book investigates the underlying theory that spiritual care is rooted in relationship. It has implications for practice in the work of chaplains, counsellors and all healthcare professionals supporting people who are dying..


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End-of-Life Care for Children and Adults with Intellectual and Developmental Disabilities

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End-of-Life Care for Children and Adults with Intellectual and Developmental Disabilities La revue

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This unique reference by a physician and medical sociologist is the only resource to addresses in-depth the medical, social, legal, and ethical issues in end-of-life care that people with intellectual and developmental disabilities face from youth to old age. End-of-Life Care contains 20 chapters from leading experts that cover issues from ethics and law and pain management to coping with grief and bereavement in the context of the lives of children and adults with developmental disabilities. The book is a must-have resource for physicians, providers, social workers, individuals, and caregivers to get a complete understanding of the various issues faced by people with disabilities who are facing death and/or are dying.

Here's how you benefit from End-of-Life Care:

* Analyze the construction of a 'Good Death'
* Learn historical and foundational materials to end-of-life care for children and adults with intellectual developmental disabilities
* Understand how to anticipate upcoming needs of patients and how to secure resources to assist them for successful planning at the end-of-life
* Gain perspectives from a diverse group of authors including practicing physicians, medical ethicist, attorneys, sociologists, and gerontologists
* Learn about treatment options, ethical dilemmas and legal issues, and see the impact on families and caregivers
* Recognize the social, emotional, and spiritual needs of the patients, their families, and caregivers
* Read guidelines for making decisions that are thoughtful, respectful, and ethical
* Understand the importance of involving all relevant stakeholders in making of end-of-life decisions
* Identify the challenge of providing nutritional support at the end-of-life
* Discover comprehensive palliative care strategies and treatment options for children and adults in a solemn, but warm and respectful manner
* Obtain important health-related information on the complexity of issues involved in caring for people with disabilities who are dying

Since 1876, the American Association on Intellectual and Developmental Disabilities (AAIDD) has been providing worldwide leadership in the field of disabilities. AAIDD is the oldest and largest interdisciplinary organization of professionals and citizens concerned about intellectual and developmental disabilities.

AAIDD publishes books for professionals in developmental disability in the areas of:

-Supported living
-Definition of intellectual disability
-Disability funding
-Positive behavior support
-Palliative care
-Quality of life
-Health.


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Hope for a Cool Pillow

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Hope for a Cool Pillow Info

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Margaret Overton's Hope for a Cool Pillow is a passionate argument for planning end-of-life care. As physician, daughter and student of American health care, Overton pulls from all corners, showing us the emotional, financial and physical costs of not being prepared. Her daily rounds reveal harrowing consequences, her studies at Harvard highlight the industry's limits, and her own aging parents make her case universal. Deeply felt, frankly told, this book will challenge you--and then help you--make your own choices about end-of-life care..


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Transitions in Dying and Bereavement: A Psychosocial Guide for Hospice and Palliative Care

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Transitions in Dying and Bereavement: A Psychosocial Guide for Hospice and Palliative Care Info

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Explains the key transitions chronically ill and dying people and their families face during the process from diagnosis to death to bereavement. Clear explanations along with case studies and sample dialogues reveal the issues and challenges presented at each phase of the journey. For physicians and nurses. Softcover..


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Music Therapy in Palliative Care: New Voices

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Music Therapy in Palliative Care: New Voices Description

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Working together in a creative way to enhance the quality of living can help patients make sense of dying. Within the past decade, music therapists have developed their work with people who have life-threatening illnesses and with those who are dying.

Music Therapy in Palliative Care presents some of the work from music therapists working in different approaches, in different countries. They describe their experiences when working with children and adults living with HIV/AIDS, cancer and other chronic degenerative diseases. Music therapists, as clinicians, are strongly engaged with their clients: it is this intimacy which is so important for those who are suffering. In this book, the dedication of the therapist to allow and encourage personal expression in others, is reflected. It is of relevance, therefore, to all those involved in caring for the sick and the dying. While there are traditions of case presentation and musical excellence within music therapy, and a developing practice of research, the tradition of clinical writing has been neglected..


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Gender, Ethnicity, and Health Research

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Gender, Ethnicity, and Health Research Description

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Health researchers routinely evaluate health and illness across subgroups defined by their sex, gender, ethnicity, and race. All too often, these classifications are proffered as an explanation for any differences that may be detected, for example, in access to care, frequency of disease, or response to treatment. Relatively few researchers, however, have examined what these classifications mean on a theoretical level or in the context of their own research. Assume, for example, that a researcher concludes from his or her data that African- Americans utilize certain surgical procedures less frequently than whites. This conclusion may mean little without an examination of the various underlying issues. Is there such a construct as race at all? How were whites and African-Americans classified as such? Does this finding reflect inappropriate overutilization of the specific procedures among whites or inappropriate underutilization among African-Americans? To what extent are socioeconomic status and method of payment related to the less frequent use? Are there differences in the manner in which health care providers present the various treatment options to whites and to African- Americans that could account for these differences in utilization? Are there differences in health care-seeking and health care preferences between the two groups that would explain the difference in utilization? Is the racial classification a surrogate measure for another variable that has remained unidentified and unmeasured? All too often, unfortunately, such issues are ignored or lightly dismissed with an entreaty for additional research..


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