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BOOK REVIEWS 727medicine specialists from Europe, Australia, New Zealand, Multiple Sclerosis, by Bernie O'Brien. Pp. 64, illustrated.
Canada and the USA. The editor, Dr J. Mark Elwood, Office of Health Economics, London, 1987. £1.00.
must be congratulated on producing a volume which
makes fascinating, informative, and easy reading, with This small book, No. 87, from the Office of Health
such heterogeneous authorship. Economics, is of the same excellent standard as previous
Professor Rona MacKie contributes two chapters and titles in the series updating an earlier MS publication
states that the incidence of malignant melanoma has (OHE, 1975). Although the main aim is to 'examine the
doubled in some countries in the past ten years, making health service consequences of the disease in terms of
malignant melanoma the most rapidly increasing malig- resource utilisation in hospitals and general practitioner
nancy after lung cancer in women; also of special interest consultations', it also succeeds at the more familiar levels
to practising clinicians is the chapter by Professor Thomas as well as with the main aim. The clinico-pathological
Fitzpatrick and his team from Harvard on the identifica- introduction is done well. The three epidemiological
tion of those at risk and the detection of precursor lesions sections cover England and Wales, international compari-
in early melanomas. His diagnostic acronym Asymmetry, sons and 'clues to a cause?' The standard of the tables,
Border, Colour, Diameter, Elevation, adorns the front graphs and maps is extremely good throughout and all
cover of the book. provide excellent teaching material. The decision to
Other chapters explore causation and pathogenesis, include both Kurtzke's scales in full cannot be praised too
ethnic origin, exposure to sunlight, and important host highly. After all, the major basis to research into MS, as
factors such as benign and dysplastic naevi. the author points out, is to define a homogeneous patient
Melanoma and Naevi is compulsory and compulsive group and currently these are the only scales which seem
reading for all dermatologists, oncologists, and plastic to be accepted by investigators from different countries.
surgeons, though the price may inhibit individual The discussions on treatment, health costs and also the
purchase. future are equally well done. The references have been
Patrick Hall-Smith thoughtfully selected, a difficult task in this subject.
Brighton General Hospital, In summary, this is a superb little book to suit the
Elm Grove, needs of nearly everybody - and at £1.00 a copy there can
Brighton BN2 3EW. be little excuse not to purchase one or more copies - the
latter to ensure at least one copy stays on your shelf.
1200 Multiple Choice Questions in Pharmacology, Second R. Capildeo
edition, edited by R.W. Foster. Pp. ix+ 177, illustrated. Department of Neurology,
Butterworths, London, Durban, Singapore, Sydney, Old Church Hospital,
Toronto, Wellington, 1986. £6.95. Romford, Essex.
The object of this book is to provide a source of ready
made questions for use by examiners and to enable them Objectives for Care: Specifying Standards for Clinical
to construct new questions. It also aims to provide Nursing, edited by G.D. Snowley & P.J. Nicklin. Pp.
candidates with practice for multiple choice examinations xiv+77. Austen Cornish, London, 1987. £7.50.
and to assess their own progress in learning pharmaco-
logy. All nine of the most commonly presented question In just over seventy pages this book attempts to list a set
forms and their general rubrics are demonstrated. The of nursing objectives for promoting individualized patient
questions cover a wide range of topics in both the pre- care based on an activities of daily living framework. That
clinical and clinical pharmacology syllabus although the the editors have succeeded in distilling the array of
use of this book will encourage students to maintain their information down into several statements under each of
knowledge of basic pharmacology until the final medical the main headings is noteworthy. However one is
examination. The questions are mainly up-to-date involv- reminded of a statement in the introduction when consi-
ing current therapy and usage. This book is useful as far dering the content and purpose of the book - 'what has
as it goes and I will recommend it to my students. been accomplished in preparing this book should not be
However, many students have difficulties with multiple measured in terms of its completion - the product - but
choice questions because they are unable to grasp the by the quality and rigour of the debate - the process' (p.
nature of the rules regarding the marking of such xii). It is a pity the reader is not party to this exchange
questions and the need to optimise their choices in the because without it the book could be perceived as nothing
true/false/don't know paradigm. A discussion of marking more than a statement of the obvious.
systems and optimising choices would enhance future However, this criticism would be missing the point and
editions. Although this information is available in other it would take away several of the book's strengths. Firstly,
books on multiple choice question techniques, it would be the authors have succeeded in linking an individualized
very useful if it could be included in the next edition of patient care approach with the nursing process. They have
this book. produced core statements that will guide practitioners and
learners to look more carefully at their daily practice.
R.M. Pearson They have established a set of baseline statements and
Department of Clinical Pharmacology, they have successfully demonstrated the differences
St Bartholomew's Hospital Medical College, between the assessment, planning, implementation and
London EC1A 7BE. evaluation phases of nursing care.
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