94 Book reviews

Changing school health services. Eds: Brown P, the report very stimulating. I think it deserves to be
Gordon P, Hughes J. (Pp 76; £8.50) London: read widely and discussed in every child health
Primary Health Care Group, King's Fund department.
Centre, 1988.
L POLNAY
Department of Child Health
This publication consists ofpapers on different aspects University of Nottingham.
of a school health service. They arose from a series of
workshops on school health services held at the King's
Fund Centre in 1986. There are five sections: a Guide to clinical interpretation of data. Ed: Bert
summary of current debates on policy and practice in Spilker. (Pp 400, $42) New York: Raven Press,
community child health services; two case studies 1986.
which offer some clear directions on what to look for
when assessing service quality; guidelines on reviewing This remarkable book is part of that well known
and developing policies; an overview of organisation, North American literary genre of self improvement
statistics and performance indicators; and an up-to- manuals. The author is a clinical pharmacologist
date annotated bibliography. jointly employed in the pharmaceutical industry and
The report, I feel, will be useful to doctors working in academic medicine. With this unusual background
in community paediatrics. It will help to clarify he has produced a comprehensive and practical guide
policies and sharpen up some of the more blurred to the interpretation ofclinical data that contains over
aspects of school health. It casts valid, critical 200 tables, figures, flow charts and checklists. Some
attention on current practice and highlights new flavour of these can be obtained from the table listing
developments which deserve wider implementation. seven factors associated with a surgeon's expertise
Whilst trying to iron out some basic issues in school which influence results. This separately lists his
health there are some dogmas which it still does not training, his experience, his preference and the
question. For example, it discusses the routine medical presence of a member of the surgical review
examination in very traditional terms rather than as a committee! The author draws heavily from the recent
broad review of everything that has gone before. The texts on clinical epidemiology produced by Feinstein
report draws appropriate attention to new et al, Fletcher et al, and Sackett et al.
developments such as those of parent-held records, Unfortunately the book tends to oscillate between
and old problems such as those of professional rivalry. absurd detail and statements which beg the question,
The role of the consultant community paediatrician such as the author's opening definition of abnormality
is discussed. The model which they use is that as being something not characteristic of normal.
originally put forward in the Court Report as a Nowhere could I find any subsequent definition or
hospital paediatrician who spends 50% of his time discussion of what is normal. Much of the book is
within the community and who is the chairman of the concerned with the interpretation of clinical
district handicap team. The nature of posts in pharmacological studies and therefore the book may
community paediatrics has developed widely from this be of value to researchers in this area with little
model and many other patterns of post exist which do experience of human data. Clinicians and other
not involve a hospital paediatric commitment. researchers interested in data interpretation would be
The report rightly stresses the professional better advised to read one of the excellent clinical
development of the school nurse. However, it does not epidemiology texts currently available.
cast its critical eye on the role of doctors in the
immunisation programme. It is certainly R F A LOGAN
uneconomical to use doctors, as many health Department of Community Medicine and Epidemiology
authorities do, as the agent for delivering University of Nottingham.
immunisations. Many Third World countries have
learnt long age that this is not an economic use of
doctors' time. Non-sexist research methods. A practical guide.
The reader could become confused with the section
devoted to training. It implies that a three year general Ed: Margrit Eichler. (Pp 183; £5.95) London:
professional training would lead one to a consultant Allen and Unwin, 1988.
appointment in community paediatrics. This is clearly
not the case but may be inferred from the information Sexism appears to be a major problem in social
given in the report. scientific research. Did you know that there were seven
Outside of these criticisms, which are small, I found different categories of sexism and more than 40
Book reviews 95
problems (all with names) which have relevance to Mental health problems in old age. Eds: Brian
research methods in the social sciences? Well, I Gearing, Malcolm Johnson and Tom Heller. (Pp
certainly didn't, but this book by an eminent Professor 222, £10.50) Chichester: John Wiley, 1988.
of Sociology identifies all of them, over and over
again. Indeed, one of the stated aims of the book is to: This "reader" produced by the Open University
"break down sexism in research into manageable consists of reprints of articles by such authors as
components, these components are more easily and Margot Jefferys, Elaine Murphy, and J A Muir Gray.
clearly identifiable ifthey have names" (p 107). .. like The topics cover the demography of ageing and the
androcentrism, gynocentricity, gender insensitivity, epidemiology of mental disorders, community needs,
overgeneralisation, gender dysphoria and biological factors, assessment of mental health and
decontextualization. Whilst the blurb on the back of approaches to treatment and care. It should be a useful
the book proclaims the text to be relatively free of source book for students.
technical terms, I feel that several good points were in
fact obscured in a welter of sociological/feminist
jargon. "Sexual dichotism" is: . . . "a modern version
of biologism which treats a biological variable (sex) as Peer review in general practice. Ed: R P T M
if it were a social variable" (p 125). I'm bound to say Grol, P J R Mesker and F G Schellevis. (Pp 230,
that for me it's sex in its social context that is fun. The fl.50) The Netherlands: Nijmegen University,
author provides us with some stunning insights into 1988.
research methodology...: "If we ask different
questions of the two sexes we will receive different The Nijmegen University Department of General
answers about them" (p 92). Practice in The Netherlands has produced a detailed
This book clearly identifies types of sexist problems text on peer review, with discussions of problem
and the component of the research process in which solving, issues in the provision of care in general
particular kinds of difficulties may appear. The author practice, and the development ofprotocols and of peer
illustrates her typologies well, with recent examples review method. Specific protocols for peer review are
from the literature. She also provides thought given for a range of conditions such as abdominal
provoking guidelines for good non-sexist practice. pain, sore throat, and hearing impairment. This
There is no doubt that sex, in all its permutations, should be a useful source book for those involved in
must be taken seriously as a potential source of bias in peer review and audit, particularly in primary care.
research. Perhaps this book takes it a little too
seriously.
P A GILLEES Epidemiology, health and society. Ed: Mervyn
Department of Community Medicine and Epidemiology Susser. (Pp 309; £35.00) Oxford: Oxford
University of Nottingham University Press, 1988.
SHORT REVIEWS This is a very interesting collection of reprinted
Handbook of occupational medicine. Ed: Robert J chapters and papers, written by Dr Susser and his
collaborators. Mervyn Susser writes well and covers
McCunney. (Pp 510; £15.95) Boston: Little, many interesting and original concepts. Several relate
Brown Co, 1988 (distributed by Churchill to approaches to logic and judgment, addressing
Livingstone). Popperian philosophy, causal thinking, the separation
of hereditary and environmental factors, and
This 500 page, small format American paperback analytical methods. The main strength is the 13 papers
gives up to date information on occupational health under the heading of "Health and society", which
problems and approaches in a practical fashion. Thus present an epidemiological perspective on such issues
the sections on occupational diseases suggest critical as the definition of health, the effects of
questions in the clinical history, and provide a industrialization and of apartheid, life stresses, and
practical review of management. All the major early environment. The opening section on
occupational conditions are covered, and there are epidemiologists in society deals with the ethics of
useful sections on health promotion, economics, risk epidemiology and its development, both historically
assessment, and the role of the occupational physician. and in recent times, and is an apologetic for the value
While limited for British readers by its American and relevance of the epidemiological method. This
orientation and references, this is a practical and collection should be attractive to a wide range of
readable book. readers.