260 OCCupational Medicine
innovation at AltaMed Health Systems in Los Angeles
(http://50studies.com/about/), and he has targeted this
book at medical professionals in the widest sense in addition to interested lay people. It was initially published in
2012, but it is unclear what revisions have taken place
for this edition. He has divided the book into eight sections: preventative medicine, internal medicine, surgery,
obstetrics, paediatrics, radiology, neurology/psychiatry
and systems-based practice. Internal medicine is unsurprisingly the largest section.
A detailed synopsis is provided of each study including its method and design, how it was funded and its
conclusions. The research is critically appraised and its
limitations discussed and other studies relevant to the
topic are cited. Each chapter ends with an illustrative
case demonstrating how knowledge of the study in question may influence clinical practice.
The individual synopses are clear and easy to understand and both strengths and weaknesses of the studies are discussed. The text is well-referenced and links
to other related studies that establish the scientific
background well.
However, it is clearly written in the context of US
health care and the focus is on individual studies rather
than evidence-based guidelines that, to some extent,
more directly affect practice. No distinction is made
between primary and secondary care and this is perhaps representative of the way health care is delivered
in the USA. Certain areas that are especially relevant to
occupational medicine have very limited coverage such
as orthopaedics and rehabilitation medicine, psychiatry, neurology, oncology and rheumatology to name
a few.
By limiting his scope to identifying 50 studies across
the entirety of medicine, the author has inevitably produced a work with notable exceptions and no area is
covered comprehensively. The internal medicine section is the largest and this illustrates the limitations of
not including any other specialities in the authorship of
the book.
Future editions focussed on particular areas may
be more meaningful but given the pace of evidencebased practice, occupational health practitioners may
choose to spend their money on clinical update courses
instead.
To summarize, this book is of interest and is well written, but it is not sufficiently relevant to OH practice in
the UK to recommend that readers purchase it.
Rating
H✩✩✩ (Not recommended)
Lachlan Mackay Brown
doi:10.1093/occmed/kqu198
Oxford Desk Reference: Toxicology
Edited by Nick Bateman, Robert Jefferson, Simon Thomas,
John Thompson and Allister Vale. Published by Oxford
University Press, Oxford, 2014. ISBN: 9780199594740.
Price: £55.00. 412 pp.
The authors are recognized UK experts in toxicology,
and they include many clinical toxicologists, clinical
pharmacologists, occupational physicians and senior
academics.
Intended audience: for occupational physicians, public health personnel, environmental scientists, emergency
room staff, clinical pharmacologists, health and safety
practitioners and those with an interest in poisonings.
The organization of the chapters flows quite well. The
text is readable, and the information included is relevant,
topical and up to date. The book starts with a general overview of the mechanisms and management of poisoning, followed by details on clinical features and treatment of a range
of drugs and chemicals. There are also sections on biological
agents, radiation toxicology and chemical warfare. Industrial
hygiene and medical surveillance are included in the end
chapter on occupational toxicology. I would have liked to
see more on risk assessment and risk communication—two
important aspects of dealing with toxic substances in the
workplace. Also the section on environmental toxicology
could be expanded to include soil contamination and risks
to public health, plus remediation measures. There could
also be a chapter on the principles of prevention and control,
and perhaps some data on the extent of poisonings by specific agents in the UK and other countries for comparison.
In summary, the book is useful for the intended audience. It is a handy reference source and excellent for
occupational physicians who have come across toxic
Book Reviews 261
materials previously but cannot recall much of it and,
therefore, need a reference source for a quick consultation on health effects and what to do when faced with a
case of acute or chronic poisoning.
Rating
★★★✩ (Buy and keep as a key ready reference)
Tar-Ching Aw
doi:10.1093/occmed/kqu204
Rehabilitation Goal Setting Theory,
Practice and Evidence
Edited by Richard J. Siegert and William M. M. Levack.
Published by CRC Press, Taylor and Francis Group, Florida,
2014. ISBN-13: 978-1-4398-6329-9. Price: £95.00.
412 pp (hardcover), available as ebook
The text consists of 19 chapters on goal setting in rehabilitation written by a number of international experts
in rehabilitation medicine, psychology, physiotherapy,
speech therapy, research science, occupational therapy,
ethics, neurology and public health. It is edited by R. J.
Siegert, a professor of psychology and rehabilitation,
and W. M. M. Levack, an associate dean of research and
postgraduate studies and senior lecturer in rehabilitation; both are based in New Zealand universities. The
chapters are grouped into four sections—Goal Theory in
Rehabilitation, Goal Setting in Clinical Practice, Specific
Applications and Concluding Comments.
The forward is written by Professor Derick Wade, UK
consultant in neurological rehabilitation, who describes
the book as what he believes to be the ‘first scientifically
based text to cover goal setting within the context of
rehabilitation’, and probably also within the context of
health care. The content and tone of the publication is
that of an academic text, which extensively reviews the
evidence on the various theories and practices that can
be used to alter behaviour, and thereby the effectiveness
of goal setting. It draws on research from non-medical
arenas such as management and sport, thus widening
its appeal to the non-specialist as well as increasing its
readability. Although each chapter is supported by a
plethora of papers and other references, Professor Wade
comments interestingly that the evidence base is incomplete and weak; however, overall goal setting is likely to
be beneficial in rehabilitation.
For the occupational health professional, this is a
book to be kept in the library for reference, since its target audience is essentially rehabilitation practitioners.
Notwithstanding, individual chapters contain topics of
interest to the reader keen to gain some new perspect­
ives on how rehabilitation is practised in the UK, and
elsewhere in the developed world. Much of the research
and clinical material pertains to the rehabilitation of
potentially severely disabling neurological conditions
such as stroke, brain injury, multiple sclerosis, etc. Early
rehabilitation inevitably focuses on improving capacity to
undertake self-care and the normal tasks of daily living,
with much less emphasis on the ability to work as a goal.
There is little information about goal setting in the rehabilitation of other acute and chronic medical conditions
that affect the working age population, including mental
illnesses. This limits the book’s interest and application
for the general occupational health physician.
I enjoyed chapters on ethics, German medical rehabilitation research and on aphasia rehabilitation. German health
and social care is enshrined in the Social Code which dates
back to the time of Bismarck. Rehabilitation services are
linked to statutory insurance schemes and emphasize the
need to provide rehabilitation enabling working age people
to return to work after illness or injury and to remain in
the workforce. Aphasia is a particularly difficult condition
to treat, and the chapter on this condition describes some
recent UK research. Throughout the book all contributors emphasize that goal setting is a process in which the
patient, in addition to their families and carers, should participate in a discussion of the goals with their clinicians and
therapists to order to achieve the desired outcomes.
Occupational health professionals may wish to reflect
as to how goals are set for and by employees returning to
work after acute illnesses, and with chronic disabilities.
This would be a good reason to dip into the book. It
would also be a useful book for anyone devising occupational health research that included assessment of workplace rehabilitation.
Rating
HH✩✩ (Reference only)
Pamela Ford