JOURNAL OF THE ROYAL SOCIETY OF MEDICINE
EEG in Clinical Practice, 2nd be excessive for an introductory text, and it
edn
John R Hughes 242 pp £45
V- ISBN 0 7506 9511 0
Boston: Butterworth-Heinemann, 1994
Electroencephalography (EEG) receives
virtually no attention in the undergraduate
medical syllabus, and it is therefore in
specialist training grades, particularly for
neurology and psychiatry, that a need arises
for an introductory book on EEG. The
0 student is poorly served by most of the
0 available texts, which suffer from an excess
of technical detail and quasi-scientific jargon
and, by failing to explain EEG in the context
of clinical problems, leave the reader with
little notion as to how the investigation
should be used. Professor Hughes' book
provides a refreshing contrast; it is written
in a clear, didactic style which holds the
interest, and addresses practical issues likely
to concern its readers: How do I recognize
particular EEG patterns? Are these normal
or abnormal? What patterns may be
expected in particular diseases?
An introductory section explains the
recording and reading of EEG records with
unusual darity, and the text is supported by
numerous simple hand-drawn sketches so
that one can readily imagine the author (who
is an excellent lecturer) teaching at the
blackboard. The second and third quarters
provide a splendid account of normal and
abnormal phenomena, with particular
emphasis on the complexities of paediatric
EEG. The richness and subtlety of EEG
phenomenology has rarely been described in
such detail, and may come as a revelation to
many readers. The final section on 'topics of
special interest' is full of helpful advice on
the practicalities of managing an EEG service
and on the medicolegal use of the EEG.
It is not always clear what audience the
author is addressing. The discussion of
electroclinical correlates takes the EEG
phenomena as primary; particular EEG
patterns are first described and their
clinical significance then considered. This is
an original approach, which greatly appeals
to the reader with experience of the field,
but does not meet the needs of a trainee
neurologist or psychiatrist, who also wants
to know what strategy to adopt in
investigating a patient with, for instance,
suspected epilepsy or dementia. The space
devoted to the details of paediatric EEG may
518
Volume 88 September 1995
However, there is clearly some relevant
is unlikely that the reader for whom the first
three-quarters of the book is intended will
be running a department or appearing in
court as an expert witness. However, any
reservations concerning balance and
emphasis are more than offset by the
interest, readability and good sense of this
book. It can be recommended to every
medical school library and department of
neurology, where its presence should
encourage many readers to learn more,
and some perhaps to undertake formal
traiiing in clinical neurophysiology.
C D Binnie
Maudsley Hospital, Denmark Hill, London SE5, UK
The Fight for Public Health
Simon Chapman and Deborah Lupton
xv+270pp £19.95 ISBN 0 7279 0849 9
London: BMJ Publishing Group, 1994
After years of pursuing educational strategies
to improve people's health, it became
evident to Simon Chapman that such
approaches were 'largely piecemeal, often
pointless, and ultimately pathetic'. Such a
conclusion should come as no surprise, given
that even the tobacco industry whole-
heartedly supports anti-smoking education.
The impotence of educational strategies
should not, however, depress the
enthusiasm of those committed to
improving public health. Instead, it should
spur them into using approaches that
challenge the major structural barriers to
public health goals, rather than the
individual and behavioural ones. The
principal approaches available are political
lobbying, community development,
consumer participation in decision making
and, the subject of this book, media
advocacy.
This book grew out of a course which
formed part of the Masters in Public Health
at University of Sydney. Its aims are to
provide a comprehensive theoretical and
research oriented approach to media analysis
with a practical guide to the diverse skills
needed. To the readers of this Journal, the
notion of the academic study of mass media
may be unfamiliar or even be greeted with a
degree of scepticism. Is such a view justified?
The authors of this book acknowledge that
research on media advocacy is slight.
research from those involved in media
studies which can help public health
advocates understand such issues as what
makes a story newsworthy. What comes
through in this book, however, is that
successful advocacy depends far more on
imagination, creativity and enthusiasm than
on academic activities.
The book is littered with examples from
Australia, USA and the UK of attempts to
use mass media to promote public health
policies. Some have gained world-wide
recognition, such as the antics of BUGA
UP, the Australian anti-tobacco graffiti
group. Other examples are of local groups
working through their local media to bring
about a change in their immediate
environment. The range of strategies
suggested extend from the familiar, such as
writing letters to politicians, to more
demanding and exciting activities such as
gate-crashing your opponents functions
having first alerted the press. One of the
cleverer examples involved handing out free
authentic-looking theatre programmes at
shows being sponsored by tobacco
companies. Needless to say, the hoax
programmes did not cast the sponsors in
the most favourable light.
While public health advocates may gain
much satisfaction from their activities, does
it actually lead to changes in policy? Given
that it is rarely possible to identify a clear
link between an action and a policy change,
it is perhaps a little unfair to question the
effectiveness of media advocacy. The authors
certainly offer some fairly convincing
examples in which clever use of mass
media appears to have contributed
significantly to a change in policy.
While the subject of this book is public
health, much of the content applies generally
to people trying to influence policy through
media exposure. As such it provides a
practical guide as to how to get your
message across and maximize its impact.
Such lessons are probably of as much interest
to public health advocates as to intensive
care doctors wanting more resources for
their specialty.
Nick Black
Health Services Research Unit, Department of Public
Health and Policy, LSHTM, Keppel Street, London
WC1 E 7HT, UK