Margot Jefferys

A set of tests for measuring motor impairment in prevalence studies.

THE Social Research Unit at Bedford College was given a grant by the Ministry of Health to investigate the feasibility of an enquiry to establish how many individuals in the population at any given time have motor impairments or limitations.5 The planning, provision and evaluation of medical and social services for people with severely limited motor capacity are all impeded by the lack of knowledge of their numbers, demographic characteristics and social circumstances. As TOWNSEND [I] has suggested, a major reason for the lack of data on the disabled in society is that, although many statutory and voluntary services are concerned with such individuals, these agencies do not share a common unambiguous definition of what constitutes disablement, impairment or limitation. Moreover, even if there were a set of common definitions, some impaired individuals may be known to several agencies while others may be known to none. Basically, two kinds of approaches have been used in the identification of the physically disabled. The first identifies individuals who lack part or all of a limb, or who have a defective limb, organ or mechanism of the body. This kind of identification is usually undertaken by medical assessors on behalf of agencies which have to determine whether a given individual is entitled to monetary compensation or other form of benefit. Each agency has its own rules as to what constitutes a departure from the ‘normal’ sufficient to warrant labelling as ‘disabled’, ‘handicapped’, ‘impaired’ or so on. Sometimes it is sufficient for the agency to know that an individual has suffered from a chronic disease which habitually causes a static or progressive physical impairment. In other cases the agency requires a detailed medical examination to establish the amount of residual function left to a limb or body mechanism. The second approach is sometimes combined with the first. In this, those who, by reason of a physical defect, are apparently seriously handicapped in performing a

The medical school as a social organization

Summary. The paper reviews sociological research on the medical school as a social organization from the 1950s to the present. Despite significant differences between societies in the organization of medical education, such research has been largely confined to the USA. Some reasons for this are suggested. Ways in which the climate and organization of medical schools—at least in Great Britain — have changed in the recent past are described as well as reasons for such changes. It is argued that more research into these processes and into the organizational obstacles to change, including cross‐national studies, are needed.

Medical sociology and public health: Interdisciplinary relationships 1950–90

Relationships between epidemiology and sociology applied to medicine are traced from the early 1950s to the late 1980s, against the background of developments taking place in the disciplines and in the career opportunities of their proponents. Negative tensions between them are ascribed to the identity crisis which public health/community medicine faced during the period, to its weak position in the hierarchy of medical specialties and to the emphasis given by sociologists to the analysis of power structures within health services. Positive tension arose from the intellectual discourse between them and the opportunities for mutual exchange of ideas.

Social Class and Health Promotion Some Obstacles in Britain

VARious socio-medical studies, based on nation-wide statistical information or on local enquiries, have shown that a good many of the most refractory problems facing the social services in general and the health services in particular are much more common in families where the chief wage earner is an unskilled manual worker than they are in other sections of the community. For example, there has been a general and large-scale decrease in infant mortality in England and Wales during the last 40 years. This decrease, however, has left intact the proportional difference between the rates for infants whose fathers are unskilled manual workers arid of those whose fathers are professional men 1. Infant morbidity, equally, has been shown, in both a national and

Social Science Teaching in Medical Education: An Overview of the Situation in Great Britain

In 1965, a Royal Commission representative of doctors, social administrators and the lay public was set up in Great Britain to review the current state of medical education, including the methods and type of recruitment to medical school, the content, length and focus of the curriculum, and future manpower recquirements for generalists and various kinds of specialist. It reported in 1968 and recommended, among other things, that all medical students should be introduced to the basic principles of medical sociology during the first two years of their studies.1 It envisaged sociology as well as psychology as essential disciplines whose relevance for medicine needed to be understood as much as did the biological sciences which were already an accepted part of the preclinical learning experience of students.

Book Reviews : Ageing and the Care of Older People in Europe Richard Hugman Macmillan, Basingstoke and London, 1994, 199pp, £10.99 pbk

care characteristically given to older people in contemporary European countries. It is not a comprehensive survey of the legislative putative provision of financial, health and social welfare services. Nor does it assemble a picture of the empirically verified actualities of care given by family and professions. Those who look for such information will be disappointed. What the author tries to do is illustrate the use of certain theoretical

Book reviews : The Caring Relationship: Elderly people and their families Hazel Qureshi and Alan Walker Macmillan Education, Basingstoke and London, 1989, 299pp., £30.00 hbk

outcomes, but in a footnote (p93) he suggests that the ’losers’ in the West German welfare state amount to as much as 30 per cent of the electorate being ’the unemployed, ... groups with short working life careers and low income from work ... and among post-materialists’. It is a pity we could not have heard more on this. In the chapter on Britain Patrick Dunleavy argues that the post war British welfare state is ideologically and politically ungrounded, and therefore

Book Reviews : Aging and Health Care: Social science and policy perspectives Marcia G. Ory and Kathleen Bond (eds) Routledge, London and New York, 1989, 265pp, £13.95 pbk

material throughout the book, not viewing the past as separable from his understanding of the present. I wondered what the residents thought about Professor Gleason, sitting there in his lounge chair while psychologists did ridiculous things with stop-watches. He came into their apartment for weeks at a time, then went off, then came back again. The book is obviously intended to stimulate an overhaul of professional practice with people who have severe disabilities, ultimately with desirable consequences for the residents themselves. But was it enough that he did not

THE SEXUAL, MARITAL AND FAMILY RELATIONSHIPS OF THE ENGLISH WOMAN, by Eustace Chesser, et al. (Hutchinson's Medical Publica tions. 1956. Pp.642. Price 75s.)

THE CIRCULATION OF THE BLOOD. (Tartan Filnzstrips. 24 frames with captions (no notes). Black and white. Price 7s. 6d.) This filmstrip describes by means of diagrams the circulation of the blood ; it uses the analogy of transportation in a civilised community. Railway trucks labelled &dquo; food &dquo;, &dquo; oxygen &dquo; and &dquo; waste &dquo; are loaded and emptied at the appropriate places, e.g. the intestines and lungs. The strip concludes with