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Problems Associated with the Effects of Low Doses of lonising Radiations Acadernie des Sciences, Techniques et Documentation. Available from TEC & DOC Lavoisier, 7 I rue Lavoisier, 75008, Paris, France, 1996 (ISBN 2 7430 0159 3). 278 pages. Fr 350.

This is an English translation of the report of a n advisory group estab- lished by the French Academy of Sciences. It was written in response to a question from the Minister of Health in France regarding a n international proposal to reduce the radiation dose limit to the general public. It is aimed at those, partic- ularly i n i h e nuclear industry, who are concerned with radiation safety and regulatory policy.

The report is short but there are 16 appendices. One of these is a 145- page compilation of more-or-less relevant abstracts of papers from French scientists.

It is not a book for physiothera- pists nor for many other health service professionals. I t has some fascination for those of us who are concerned with radiation protection because its conclusions are highly unfashionable and contentious. In 1990 the International Commission on Radiological Protection (ICRP) recommended tha t the dose limit for the general public be reduced from 5 mSv to 1 mSv per year. The recommendation was based on a reappraisal of the risk factors for radiation, largely arising from a

review of the incidence of cancers in the surviving populations in Hiroshima and Nagasaki, the Jap- anese cities destroyed in 1945.

Extrapolation of risks from high radiation doses at high dose rates to much lower doses from environ- mental radiations, both natural and artificial, is controversial. The ICRP chooses to take a conserva- tive approach which is strongly supported by official bodies in the UK. Thus we arrive at dose limits which probably err greatly on the side of safety. The French view is more robust. One wonders how environmental groups in France would react to a nuclear industry which discharges five times more nuclear waste into the environment than is allowed elsewhere.

One of the underlying principles of radiation protection (the ALARA principle) is that doses arising from the use of radiation should be kept as low as reasonably achievable. This phrase is not used in the report. The scientific argument for reducing the dose limit to 1 mSv per year may be weak, but it should be recognised tha t this limit, as well as the proposed new limits for occupationally exposed workers, is reasonably achievable. It should be adopted for these reasons if no other. In most other countries the public would expect such conserva- tive standards to be set.

Jerry Williams BA MSc FIPEM

The Other Half of the Rainbow by Vera Waters. Penn Cottage Books, 1996 (ISBN 0 9516952 I 5). 170 pages. f6.95 from bookshops orpost free from the publisher at Prudential Buildings, 79 Union Street, Oldham, Lancashire OL 1 1 HL.

The author of this book is a coun- selling consultant who in addition to her private practice is retained by Greater Manchester Police to help train officers to deal with the fami- lies of murder victims.

Her expressed view is that life is like a patchwork quilt, which is an appropriate maxim for a book full of apparently unrelated episodes and characters. The main theme seems to be dealing with difficult situa- tions, including some not often covered in non-fiction books, such as embarrassment and being jilted.

Any information on how to help

distressed people must be useful to clinicians in health care, especially those to whom counselling does not come naturally. That is the main value of this book. There are some good ideas; others are quite alarming such as telling bereaved children that stars in the night sky are the ‘precious parts’ of people who have died.

The most irritating aspect of the book for some readers will be the frequent gnomic sayings inter- spersed between and sometimes within chapters - for example: ‘Life passes like a drift of silk chiffon slip- ping thro’ [sic] the fingers of time.’

I ts most appealing features are the occasional flashes of humour and cheerfulness which lighten what would otherwise be a n intensely emotional text.

J W

Deinstitutionelisation and Community Living Intellectual disability services in Britain, Scandinavia and the USA

edited by Jim Mansell and Kent Ericsson. Chapman and Hall, London, 1996 (SBN 0 4 12 57010 6). 289 pages. €39.99.

Despite the title this book is a thoroughly good read. The various chapters by the 16 eminent profes- sionals involved in the development of learning disabilities are as infor- mative and analytical as would be expected, but are also written in an easy-to-read literary style.

The first section, looking at insti- tutional closure and replacement, highlights the different approach in response to different driving forces in each of the three regions. In many ways this is, for me, the most useful section of the book in that it gives a n insight into why this country has approached the issue of hospital closures as it has done. It is clear that transposing a succ- essful method from elsewhere will not work in the British scenario.

Part 2 compares different models of community services, again relat- ing them to the underlying political and social structures.

Parts 3 and 4 look at the impact of deinstitutionalisation on people who use the service and their families respectively. The section on the impact on people who use the service supports findings elsewhere in the literature on the effect of moving out of long-stay hospitals. The section looking at the impact on families of service users highlights the tremendous power families have in the process, either as a positive, enabling force, or negative and obstructive.

This book is not only interesting to read but is a pleasure t o handle, printed on good quality paper and well put together. It is of academic interest to many physiotherapists working with people who have learning disabilities, particularly as many services are now beyond the era of large institutions. Despite this, it still helps put current issues into a broader per- spective. For many areas that are still in the process of closing learning disability hospitals it is required reading for any senior manager involved, .particularly those concerned with commis- sioning services.

Simon Plummer MCSP

Physiotherapy, August 1997, vol83, no 8