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Computers in the Life SciencesApplications in Research and Education R . Lewis (Ed) C r o o m Helm, L o n d o n (1979)

123 pages. Price 28.95 This nicely-printed report contains twelve papvrs from a symposium held in November 1977 under the ,joint patronage of the British Council and the Yugoslav Union of Sciericc Societies. T o bridge the sometimes considerable gaps of stylc arid coverage between thr papers, the editor has provided some linking paragraphs. T h e thesis is that computing will play an increasing role in both education and research for biologists, and that this will require improved liaison between the mathematical and biological disciplines. In view of thc increasing availability and power of computing systems in recent years, most will agree with this judgement. I t is one thing to assent to the general proposition that physics now contributes to medicine, or mathematics to ecology, as never before; it is another thing altogethrr to profit from a series of relatively short technical summaries of educational tactics or research findings in which computing has some part. The reader who may benefit most from this report is probably the organizer of learning or research in a biological field who has recently obtained access to computing services for the first timr and is unaware of the range of roles that a computer can play, and of how much he stands to gain by seeking contacts outside his own field. He will find in these papers examples of the computer used in data gathering, data reduction, simulation and modelling, exploratory and didactic learning. He will taste at least the general flavour of operations ranging from normalizing clinical laboratory results to developing

Medicul Teacher V o l 2 N o 3 1980

general problem-orientated computer languages which may be more readily mastered by the user than FORl’RAN, COBOL or BASIC arr at present. He will see some of the graphic output of existing programmes used in quantitative nuclrar cardioangiography, analysis of thermal disturbance of heart rate, seismological modelling. and physiological modelling of dye dilution and of counter-current exchange. He will also encounter some thoughtful general statements about the curricular difficulties in exploiting computers within the under-graduate course, and a shared optimism amongst thc symposiasts that better computing languages will solve these difficulties. What he will not get from reading this book is any guidance as to which skills he next needs to cultivate, or how he can get help. None of the arguments for acquiring a minicomputer, or the merits of various types of operating system, prog a m m e and data storage medium or peripheral device are considered. I t is, therefore, rather a source of inspiration than of information. A case exists for its purchase by the major library, but i t is unlikely to justify a place in the departmental or private collection. A. H. Short

An Introduction to the Symptoms and Signs of Surgical Disease Norman Browse Edward A r n o l d , L o n d o n (1978) 416 pages. Price f12.75 (paperback) l‘his book restores one’s faith in what can be achieved by a clear minded author sure of what he wants to say, armed with the facility for constructing superb line diagrams and backed by a photography department whose black and white pictures leap from the page with a sharpness that gives the lie to the need for colour. It is no longer very fashionable to teach by reference to the detailed clinical features of individual diseases, and possibly this has led the student to feel that he no longer needs a companion to whom he can turn when in doubt about a condition or baffled by what he has seen in the wards and clinics. Consequently, the available texts have become rather dated or have expanded into attempts at comprehensive texts. Professor Browse’s new venture should change fashion by the force of its appeal. My only criticism is that the rigour with which Professor Browse has a p proached his task of delineating clinical

method and describing clinical features has led him to eschew any attempt at all to describe mechanisms or the mental processes which go into making a diagnosis. He is, perhaps, too wary of the escalation this could mean. As he says, it is vastly important for students to feel at ease in talking to patients because they have a background of system and knowledge such as this book so ably provides. However, to take but one example, it is also important that whenever a history of pain is elicited, the clinician reflects on mechanisms and asks himself if he can link the occurrence with a conceivable pathway. Similarly, it is vital that data should not be collected without interpretation and moreovcr we should recognize and teach to our students that such interpretation is going on all the time as a history is elicited or a physical examination carried out. On these matters Professor Hrowse is deliberately silent and, what is perhaps more disappointing, he fails to give any references that could be followed u p . It will be very much up to the teachers to make sure that the book is not abused, and perhaps this is the author’s challenge to us: here is an educational tool; take i t and use i t ; if i t does not work do not blame me-tools only work if properly guided by thr hand of a craftsman. Reviewers often conventionally m d by praising in a muted or open manner the quality of the production. 1 do not like this reflex habit but, in this instance, paper, printing and photographic reproduction are splendid. I shall certainly recommend this book to my students with confidence and enthusiasm. H . A . F. Dudley

Multiple Choice Questions on Paedia trics

R o y Meadow Blackwell Scientific Publications, O x f o r d (1 979)

60 pages. Price 21.90 I find multiple choice questionnaires irresistible. Only recently those in the popular press have confirmed that I am unlikely to r u n off with someone else’s wife (or husband for that matter) and that I am only five points short of being an exemplary father. As a method of testing mcdical students’ knowledge multiple choice questions have come in for a lot of punishment. They are an efficient way of trsting the knowledge of

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largc numbers of studcnts, permitting wide areas to be searched in a short time. Of course. the validity of this approach partly depends on setting unambiguous questions for which ttirrc, are unequivocal answers. Roy Meadow's little book consisting of multiple choice questions in paediatrics grnrl-ally fulfils thcsc critcria. There are 175 questions in the form of short statements followcd by five answcrs which must be marked 'yrs' or 'no'. A very hroad field of paediatrics is covercd. including sections on thv newborn and infant feeding. growth and tlcvrloprnent. mental handicap. be. haviour problems, thcrapcutics. infectious diseases. and the various organ systems. There arc also 12 challenging case studies, each followed by several short-answer questions. I t is difficult to steal sly glances a t any of the answers which are confined to the end of the book. 'l'hcrc. are few points with which to takc issue in this helpful book. I d o not agrcc. that patent ductus arteriosis gener ally rcquire surgical correction if the newhorn population is considered. Most students would be forgiven for including measurement of blood urea as part of the routinc management of a boy with

urinary tract infection. I t is rather unfair to specify weakness of the hand as a complication of' intraventricular hacrnorrhage whcn its neurological effects are so widespread. I will strongly recommend this modestly priced book to my studcnts and look forward to going through the questions with thcm in small groups an excellent way of revising matrrial and pointing to gaps in knowledge. D r Meadow's scnsc of humour will stop us becoming bored. Who would darc to suggest that alleygy to haggis and bagpipes might caust' wheezing in Scotland: M. L. Chiswick

Psychiatry: Patient Management Review William B. Easson Arc0 Medical Review Series, New York ( 1 977)

163 pages. l'his is a series of 40 bricf patient management problems of a sort similar to those in Part 111 of thc FLEX

examination. but written as scqucnces of Multiple Choice Questions. Thcy will be useful for candidates preparing themselves for FLEX and similar examinations, and for usc as a means of self.assessmcnt. T h e rangc of clinical problems is wide, including cncopresis and brain abscess, mourning a n d phantom limb: with a substantial e m phasis on organic and 'medical' psychiatric problems, and less interest in psychological illness as such. Typically. each case gives the rcsults of a siniplr history and exarninatinn. and then pobes inultiple true-false questions dealing with investigation and treatment options. with a commendable crnphasis on selecting what to say to the patient and to thc relatives. What might result from each option is listed and scored, with a clinical commentary There is some lack ol varicty and imagiriation. and too often all options are appropriate. In addition. the level of performancc required ib not very demanding. There arc rclerrnces to appropriate pages of thc most massive tomcs o l American psychiatry I doubt if the awragc reader will hothcr to use such wrist -spraining references! Michael A . Simpson

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Medical Teacher V d 2 No 3 1980

Computers in the life sciences-applications in research and education.

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