Communicating in the Health and Social Sciences
JOY HIGGS, ANN SEFTON, ANNETTE STREET, LINDY McALLISTER & IAIN HAY, eds
South Melbourne, Victoria: Oxford University Press
ISBN 01955 16982, 274 pp. Price: AU$39.95
This recently published book is edited, and mainly written, by a group of prominent Australian health sciences academics with many years of experience in delivering health care and in teaching students. The book is aimed at undergraduates in the health and social science professions including medicine, dentistry, nursing, allied health, social work and welfare studies.
The list of contents came as a surprise. There is a much wider coverage of communication than the health professional – patient interface, the usual emphasis in such titles. The strength of the book is that it takes this unexpected line in covering a wide range of topics ranging from ethical communication in written assignments, writing for journals through to working in groups and negotiating with patients and colleagues.
After providing a fairly brief framework and rationale for the importance of good communication in health care in Part 1, the authors divide the book into three main parts: communicating in academic and fieldwork settings, presentation styles, skills and strategies and interpersonal communication.
Part 2, ‘Communicating in academic and fieldwork settings’, outlines key elements of study skills and academic honesty, writing assignments, journal papers and theses, as well as record-keeping and referrals, case conferences and presentations.
Part 3, ‘Presentation styles, skills and strategies’, gives specific details about font styles and sizes. Although initially sceptical about the value of such specific concrete information, I was very interested to read why certain fonts were generally used (where does one usually come by this ‘taken-for-granted’ knowledge?).
Regarding part 4, ‘Interpersonal communication’, again this section does not stay with the expected—talking to colleagues, patients, clients and carers—but continues with working in groups, advocacy and negotiation, intercultural communication, giving feedback and communicating clinical reasoning.
The strength of the book also provides the major flaw. In ambitiously trying to cover such a wide area, it does not do justice to the complexities of each one. The usefulness of combining basic instructions on study skills and literature searching with more advanced skills on writing journal articles and theses has to be questioned. The authors may envisage the book as a text that will be purchased by first‐year students and used throughout their 4 – 5 years as a reference book into their honours or research higher degree years. However, for this most of the topics covered would need much more in-depth treatment to really gain an adequate grasp of the subject matter.
It is, however, frustrating for tertiary educators that the information on many of these small but important skills for new undergraduates are not generally found in a single place, leading many of us to compile our own course readers. Thus, I can understand why the authors decided to roll all this disparate information into one book.
Another criticism is the tiny font size for most of the text. I may be showing my age here, admitting to failing eyesight, but it makes for very crowded pages despite highlighted key topics and handy hint boxes.
In conclusion, this is an ambitious book that would be a useful undergraduate text to cover the wide variety of skills educators expect students in health and social science professions to master.
Sue Outram
Behavioural Science
School of Medicine and Public Health
Wallsend Hospital Campus
Wallsend
New South Wales
Australia
Neuroscience of Psychoactive Substance Use and Dependence
WORLD HEALTH ORGANIZATION
Geneva, Switzerland: World Health Organization, 2004
ISBN 92 4 156235 8, 264 pp. Price: AU$58.00
The Neuroscience of Psychoactive Substance Use and Dependence is a review by the World Health Organization of current research into the biological processes underlying the chemical action of various substances and subsequent dependence.
Chapter 1 introduces the reader to the broader context and background of the report which makes up the text. Specifically, this book is a synthesis of the World Health Organization's accumulated knowledge about the biological factors related to substance use and dependence. Chapter One also provides key definitions and terminology to assist readers who may be unfamiliar with this area of research.
The second chapter provides an overview of the basic neuroanatomy, neurobiology and neurochemistry of substance dependence. This section comprehensively covers background information about brain regions, neuronal structures and neurotransmission. Clear definitions are again given to help an audience with only passing knowledge of neurobiology to understand the key principles more clearly, and hence derive more meaning from the book as a whole.
The behavioural view of dependence is presented in chapter 3. The authors of this chapter use learning theory and knowledge of the brain's functioning to elucidate the powerful behavioural forces which maintain substance use and abuse. This chapter introduces the reader to the key concepts of behaviourism and the role that conditioning can play in addiction. The authors propose several theories for how substance dependencies develop and are maintained, including reinforcement learning and neurochemical sensitisation.
Chapter 4 systematically describes the pharmacology and behavioural effects of different classes of psychoactive substances. Here, recent research on behavioural effects, mechanism of action, tolerance and withdrawal, adaptation to prolonged use and pharmacological treatment of dependence are covered for a range of substances including alcohol, sedatives, tobacco, opioids, cannabis, cocaine, amphetamines, ecstasy, solvents and hallucinogens. Again, these findings are structured in a manner that makes the task of quickly searching for, and reading about the effects of a particular substance, an easy one for the reader. In addition, a summary table at the end of the chapter allows for quick reference use of the text.
In the fifth chapter of the book, genetic studies are addressed, with a focus on the genetic differentiations that may distinguish humans of differing heritage. With a clearly stated acknowledgement that complex disorders such as substance abuse and dependence are not caused by genes alone, chapter 5 examines the contribution of genes to the development of substance dependence.
Chapter 6 examines the relationship between substance use and mental illness. Sighting recent evidence, neurobiological hypotheses are proposed to explain the comorbidity between substance use and mental illnesses such as depression and schizophrenia.
The seventh chapter deals with the ethical questions raised by research into substance use disorders. These questions include the issue of a participant's ability to give informed consent while substance dependent, as well as the debate around the use of pharmacological interventions for substance dependence.
The eighth and concluding chapter discusses implications of this research for public health policy makers. A theme which acknowledges the complexity of issues surrounding substance use and dependence and the need for accessible and effective treatments is made clear. Overall, Neuroscience of Psychoactive Substance Use and Dependence is a clearly written and comprehensive summary of current research in this area. It is recommended as a useful reference tool for those working in alcohol and other drug services, as well as being a good introduction to the concepts that arise in relation to substance use and dependence.
Sally Hunt
Centre for Mental Health Studies
Faculty of Health
University of Newcastle
Callaghan
New South Wales
Australia