Media Reviews

Muscle Pain: Understanding its Nature,Diagnosis and Treatmentby S. Mense, D.G. Simons andI.J. Russell.Lippincott Williams and Wilkins,Philadelphia, 2001, 385 pages, £35Æ00,ISBN 0 683 05928 9.

As an individual who regularly sufferswith myofascial pain caused by triggerpoints and post-exercise muscle sore-ness (the latter not regularly enough)the prospect of reviewing this bookcaused great excitement. More impor-tantly, muscle pain is the most com-mon reason for seeking healthcare anda leading cause of disability. The textaims to bridge the gap between basicresearch on muscle pain and clinicalmanagement. The information is clearlylaid out with an index and summary atthe beginning of each chapter andinformative illustrations throughout.Early chapters set the tone for thebook outlining the basic principles,defining terms and challenging thecurrent theories surrounding the pro-gression of acute pain to chronic pain.The authors provide detailed informa-tion of recent laboratory research,which is often based on animal mod-els, and a basic knowledge of neuro-anatomy and physiology is required.The chapters progress in a logicalsequence through the subject, criticallyexamining topics such as localized,neuropathic and referred pain. Subse-quent chapters explore increased mus-cle tension, reflex-mediated pain,postural pain, centrally modified painand myofascial pain associated withtrigger points. These sections are largelydevoted to the research and measure-ment of pain and medical managementin the form of drug therapy. Disap-pointingly, adjunct therapies and amultidisciplinary approach to painmanagement are not explored in anydepth. The exception to this is thechapter on myofascial pain caused bytrigger points which examines a range

of treatment modalities including self-management techniques.

Jon Russell contributes to the book bywriting the final chapter on fibromyalgiasyndrome, a recently recognized condi-tion that is not fully understood. Thisexcellent section encapsulates the suf-ferer’s experience and outlines a trulyholistic and multimodal approach to itsmanagement supported with currentresearch. Despite the medical focus, thisbook would prove to be an extremelyvaluable resource for clinical nurse spe-cialists or those wishing to further theirknowledge about individuals with mus-cle pain.

Emma BriggsUniversity of Hull, UK

The Care Assistants Portfolio Part I, II& IIIHealth Care Assistants Programme,Radcliffe Medical Press, Abingdon,individual parts £45.00, all three parts£120.00. Further information at http://www.radcliffe-oxford.com/education/E06_The_Health_Care_Assistants_Programme/

The concept of life-long learning hastaken firm hold in the UK at govern-mental and National Training Organi-zation levels. A continuum of training,education and qualifications now existswithin the health and social care sec-tors. For many this raises fears of apotentially reductionist and mechanisticconstraint of training and education,atomising learning into quantifiable,empirically verifiable competence state-ments. It may be argued that thisignores the fostering of critical judge-ment and analytic depth so necessary inhealth care professionals. For others,however, the development of compe-tence-based approaches to learning her-alds recognition of the value of alllevels of health care practitioner, andseeks to link qualifications appropriatelyto role and task. It is in this contextthat the three portfolios are located and

over-simplistic pronouncements aboutreductionism or competence maydetract form the potential thesematerials have in promoting learningwithin the health sector.

The Care Assistants Portfolio com-prises three open learning files dealingwith working with people, issues ofprotection and aspects of care pertinentto health care assistants. The format isaccessible, easy to complete and com-petence-based. Each portfolio containsinteractive workbooks covering com-mon situations that build together toform a first-stage learning programme.The abuse of vulnerable people is cov-ered but only briefly and this couldhave been expanded. It is also surpris-ing that specific sections in the work-books are not dedicated to questions ofvalues and attitudes, although discus-sion of such does permeate the material.

The portfolios represent a pre-NVQlevel course and may prevent learnerstaking such a programme because ofthe lack of resulting formal qualifica-tion. It also lacks the depth of profes-sionally orientated programmes.Having said this, it is just this kind ofprogramme that is championed in theUK Government’s modernising agenda,in the training skills councils andnational training organizations forhealth and for social care. Indeed, theuse of such training materials mayprovide a pathway to widening partic-ipation in education and encouraginglearners to follow a career path inhealth care. The knowledge base isappropriate to those assisting in healthcare settings. However, it must also beremembered that knowledge often pre-dates understanding and the develop-ment of �practice wisdom� is essentialif these materials are going to achievean increase in learning and good prac-tice amongst health care assistants.

Jonathan Parker,University of Hull, UK

400 � 2002 Blackwell Science Ltd

The Biology of Ageing (a special issue ofMechanisms of Ageing andDevelopment, Volume 127, no. 7, 2002)edited by Tom B.L. Kirkwood andMalcolm H. Goyns.Elsevier, Oxford, annual subscription$2,967, ISSN 0047–6374.

All the papers in the special issue of thisjournal were delivered at a state of theart symposium on the biology of ageingat the Royal Society in London whichwas jointly sponsored by the Institute ofBiology and the British Society forResearch on Ageing. The papers spanthe field of biological research intoageing from yeasts, through nematodesand fish to human and include a contri-bution on the social impact of ageing byAnthea Tinker, King’s College London,UK.

Perhaps the most important paper, interms of theory, is by Tom Kirkwood,University of Newcastle, UK who is theauthor of the disposable soma theory ofageing. This theory has really taken itsplace at the top of the hierarchy oftheories of ageing and Kirkwood is nowworking on empirical evidence usingsecondary databases and other lines ofinvestigation. The papers include oneon the ageing of plants by HowardThomas, Institute of Grassland andEnvironmental Research, Aberystweth,Wales, UK in which the differencesbetween the ageing of plants and ani-mals are explained. Fungi, nematodesand fish are all used as model systemsfor the study of ageing and the ingenu-ity of the laboratory scientist is dis-played in the relevant papers withcontributions from the USA and Ger-

many. The place of telomeres in theprocess of ageing – either as causes,effects or just spectators – is not clearbut the arguments and evidence arewell covered by the guest editor, Mal-colm Goyns, University of Sunderland,Sunderland, UK.

The regular recipients of this journaland those who attended the biology ofageing symposium at the Royal Societyare lucky to have this issue of thejournal. If you teach the biology ofageing or are merely curious then Iwould strongly advise you to hunt downthis issue for yourself.

Roger WatsonMedia Reviews Editor

Promoting Health: Knowledge andPractice, 2nd editionedited by Jeanne Katz, Alyson Peberdyand Jenny Douglas.The Open University in association withPalgrave, 2000, 365 pages, £16Æ99,ISBN 0 333 94930 7.

This interesting book provides a com-prehensive, yet highly accessible, explo-ration of the relationship between healthpromotion theory and practice. As asecond edition, it brings the reader up todate with changes in health promotionpractice and reflects the current nationaland European policy agenda. The bookcontains 19 chapters arranged in fourparts. Part 1 explores the complexitiesof health promotion through the analy-sis of a range of factors and contextsthat have shaped its meaning. Part 2focuses on communication as a keycomponent of educating for health. A

range of skills and methods are exam-ined within the context of individualand group work, with counselling skillscited as central to contemporary healtheducation practice. A chapter on massmedia included within this section iden-tifies the scope of new technologies aswell as the more traditional campaignstrategies of media advocacy and socialmarketing. Part 3 critically explores thenature and sources of health informa-tion. The first chapter in this sectionincludes a useful case study based onBSE (bovine spongiform encephalopa-thy) to illustrate the complexities asso-ciated with what counts as evidence.Subsequent chapters cover the disci-plines of demography and epidemiolo-gy, the analysis of data and planningframeworks for health promotion prac-tice.

The fourth and final part examines anumber of dilemmas associated withevaluating health promotion, in addi-tion to equipping the reader with theknowledge required to design and exe-cute evaluation of both small and largescale health promotion interventions.This book makes valuable reading toall those involved in health promotionand public health. Its focus on thecurrent policy agenda, the skilful linkageof theory and practice and the inclusionof boxed activities makes it particularlyuseful in encouraging practitioners toengage in reflection to appraise criticallythe quality of their health promotionpractice.

Gillian BarrettUniversity of the West of England, UK

Media Reviews

� 2002 Blackwell Science Ltd, Journal of Advanced Nursing, 39(4), 400–401 401