196 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 2009 vol. 33 no. 2© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia

doi: 10.1111/j.1753-6405.2009.00372.x

Essentials of Biostatistics in Public Health & Essentials of Biostatistics Workbook: Statistical Computing Using Excel

By Lisa M. Sullivan. Published by Jones and Bartlett Publishers, Sudbury, Massachusetts, US 2008, Paperback 203 & 135 pages. ISBN 9780763756208 and 9780763754778. RRP AUS$99.00 each.

Reviewed by Lyndsey WatsonMother and Child Health Research, La Trobe University, Victoria

The textbook and its accompanying workbook provide clear

and useful guidance for elementary statistical procedures such

as descriptive statistics, confidence intervals, hypothesis testing,

power and sample size determination and regression analysis. The

descriptions and formulae enable students to know and calculate

the relevant statistics. These will go some way to overcome the

tendency for those with little mathematical background to rely on

the ‘black-box’ use of statistical packages. They cover essential

skills for Public Health researchers.

The books are part of an introductory series Essential Public

Health which include Environmental Health, Health Policy and

Law, Health Behaviour, Global Health, Infectious Disease, Health

Economics and Epidemiology. They are well laid out with clear

and useful figures and boxes summarising issues and formulae.

The author is the Chair of the Department of Biostatistics at

the Boston University School of Public health and clearly has had

much experience assisting those new to data analysis on the road

to competence. She has been involved with the Framington Heart

Study and uses data from that study for the worked examples.

The textbook, has nine chapters covering study designs,

quantifying disease extent, descriptive statistics, probability,

confidence intervals, hypothesis testing, power and sample size

and multivariable methods including an introduction to linear and

logistic regression. Each chapter has practice (sic) problems. The

workbook runs in parallel to the textbook with good illustrations

on using Excel to do summaries of data and analysis and has

problems included. Together these books would provide the basis

for a semester introductory biostatistics unit in a Public Health

course. I think the books would have less appeal for individual use.

They would be a valuable resource in Public Health Department

libraries.

I discovered minor errors in the Figures in Chapter 2 of the

textbook: the study start time for both retrospective cohort designs

and case-control designs should be on the right hand side of the

time lime line. At present Figure 2-3 is identical to Figure 2-2.

Letters

data, to monitor the trends and the outcomes of interventions. We

argue in our paper that using hospital morbidity data enhances our

ability to compare data to other states and countries as hospital

data uses universal classification of diseases and conditions, while

child protection data is often influenced by definitional and policy

change. Hospital admission rates are only one possible indicator of

changing prevalence and it is not hospital admissions for alleged

child abuse and neglect which we are suggesting would be most

useful (for the very reasons outlined in the letter), but other types of

admissions e.g. the rate of infants admitted with burns, ingestions,

head injuries and retinal haemorrhages, are potential indicators of

supervisory neglect and physical abuse.9,10

Hospital data has also allowed us to monitor the birth prevalence

of conditions highly associated with future child maltreatment

allegations and substantiations, such as neonatal withdrawal

syndrome. Our paper, shows an increasing prevalence of neonatal

withdrawal, with children highly likely to have substantiated

allegations and enter periods of care.11 Using public health

research methods to investigate the characteristics of families

and children at risk, as well as factors that protect children from

maltreatment, will inform our efforts to target prevention and

intervention programs.

We welcome the debate around interventions and the research

required to underpin prevention of child abuse and neglect,

particularly around any new approaches which will enhance the

chances of success.

References1. De Bortoli L. Response to O’Donnell et al. on preventing child abuse and neglect

with public health principles. Aust N Z J Public Health. 2008;32(6):580-1.2. O’Donnell M, Scott D, Stanley F. Child abuse and neglect – is it time for a

public health approach? Aust N Z J Public Health. 2008;32(4):325-30.3. Strathearn L, Mamun AA, Najman JM, O’Callaghan MJ. Does breastfeeding

protect against substantiated child abuse and neglect? A 15-year cohort study. Pediatrics. 2009;123:483-93.

4. Zuravin SJ. Fertility patterns: their relationship to child physical abuse and child neglect. J Marriage Fam. 1988;50(4):983-93.

5. Doggett C, Burrett S, Osborne DA. Home visits during pregnancy and after birth for women with an alcohol or drug problem (Cochrane Review). In: The Cochrane Database for Systematic Reviews, Issue 4, 2005. Oxford (UK): Update Software; 2005.

6. Kingston DA, Fedoroff P, Firestone P, Curry S, Bradford JM. Pornography Use and Sexual Aggression: The impact of frequency and type of pornography use on recidivism among sexual offenders. Aggress Behav. 2008;34:341-51.

7. O’Brien J. Planned respite care: Hope for families under pressure. Australian Journal of Social Issues. 2001;36(1):51-65.

8. Loxley W, Toumbourou JW, Stockwell T, et al. The Prevention of Substance Use, Risk and Harm in Australia: A Review of the Evidence. Canberra (AUST): National Drug Research Institute and the Centre for Adolescent Health; 2004.

9. Bechtel K, Stoessel K, Leventhal JM, Ogle E, Teague B, Lavietes S, et al. Characteristics that distinguish accidental from abusive injury in hospitalized young children with head trauma. Pediatrics. 2004;114(1):165-8.

10. Chang DC, Knight V, Ziegfeld S, Haider A, Warfield D, Paidas C. The tip of the iceberg for child abuse: the critical roles of the pediatric trauma service and its registry. J Trauma. 2004;57(6):1189-98.

11. O’Donnell M, Nassar N, Leonard H, Hagan R, Mathews R, Patterson Y, et al. Increasing Prevalence of Neonatal Withdrawal Syndrome: Population study of Maternal Factors and Child Protection Involvement. Pediatrics. In press 2009.

Correspondence to: Melissa O’Donnell, Telethon Institute for Child Health Research, 100 Roberts Rd Subiaco, Western Australia 6008. Fax: 9489 7700, e-mail: melissao@ichr.uwa.edu.au.

2009 vol. 33 no. 2 AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH 197© 2009 The Authors. Journal Compilation © 2009 Public Health Association of Australia

doi: 10.1111/j.1753-6405.2009.00373.x

The Collectors of Lost Souls: turning Kuru scientists into whitemen

By Warwick Anderson. Published by The John Hopkins University Press, Baltimore US 2008, Hardcover 310 pages plus index. IBSN 9780801890406. RRP AUS$49.95.

Reviewed by Lyndsey WatsonMother and Child Health Research, La Trobe University, Victoria

This book about kuru, a fatal brain disease, is a medical detective

story, an anthropological intrigue and a social history of all the

great characters involved. It begins in the highlands of New Guinea

when the indigenous Fore people first encountered white men and

is a great well-told story.

The central character of the story, American doctor D. Carleton

Gajdusek, marches resolutely throughout the book, his energy and

brilliance compellingly portrayed.

Warwick Anderson is well qualified to tell the story that has

tantalised him for more than 20 years. He is uniquely placed to

undertake this study with his medical training and science history

interests. With him, we travel up and down the mountainsides of remote

parts of New Guinea and around the world as the remarkable tale

unfolds − right from the first contact between the Fore and white men

in the early 20th Century until the beginning of the 21st century, when

the disease slowly dies out but importantly while first-hand accounts

are still available. He is to be congratulated on his scholarship. The

energy with which he has pursued the primary documentary evidence

and obtained first-hand accounts with many of the protagonists from

around the world matches the subject matter admirably.

This is not a textbook; the scientific, sociological or administrative

accounts are readily available elsewhere. It is a saga of proportions

seen before in tales such as Jonah and the Whale, or the magical

mystery of Joseph Conrad’s ‘Heart of Darkness’. Yet the kuru story

is true and this book about it demands to be read from the beginning

to the end. Its fascinating elements of anthropology, epidemiology,

biochemistry and genetics are woven together with the personalities

of the native New Guineans and all those who interacted with them.

It proceeds forward to the US and the UK where occurrences and

studies of other spongiform encephalopathies (CJD and BSE,

scrapie) took place and helped eventually to unlock the mystery

of infectious protein. We have sorcery, cannibalism and a couple

of Nobel prizes in the mix. The author brings Public Health alive,

and the story has the same kind of appeal as that of John Snow

Book reviews

who turned off the Broad Street pump after tramping the streets of

London to find the answer to the 19th Century cholera epidemic.

The book is well-written, with many explanatory notes and

clear referencing of primary sources. Illustrations, retrieved from

archival material, are informative and vital although the black and

white reproductions are dark.

I have a few minor quibbles. I found the title obscure and it is

not clear whose souls were being alluded to, or which of the kuru

scientists were turned into white men. Perhaps obscurity is the

point and pondering on this did remind me of the strong exchange

relations theme and the powerful voice given to the New Guineans

throughout the book. The author intrudes unnecessarily with time

and place when he introduces his interviews (see pages 32, 55,

125, 146, 164, 177 for instance). These interviews are listed on

page 281 and adequately referenced in the notes.

Some passages in the book are quite technical and required

several readings which rather interrupted the flow. The first chapter

is dry and dense and I found myself skipping ahead. However, from

the moment Daniel Carleton Gajdusek arrives on the page, the

book came alive and I was enthralled by his ups and downs, both

the literal traipsing around New Guinea and those of his personal

saga. The author shows great skill in presenting Carleton and all

the other characters without judgment. He relies wherever possible

on first-hand recollections to achieve this.

It is unlikely we will have another such story in our lifetime. It

is hard to imagine contemporary researchers with the freedom to

pursue passions and to write so prolifically on them. I thoroughly

recommend this valuable book.

Note: Gajdusek died in Norway on 11 December 2008, aged

85 years.

Although I have found the books accessible, clear and accurate,

as reference books they are too expensive for their content,

especially for students.

doi: 10.1111/j.1753-6405.2009.00374.x

The anatomist: a true story of Gray’s Anatomy By Bill Hayes. Published by Scribe, Carlton North, February 2008. Paperback, 250 pages with index. ISBN 978-1-021215-89-6. RRP A$32.95.

Reviewed by Neville HicksAustralian Institute for Social Research, The University of Adelaide, South Australia

After lunch at the London Hospital Medical School, my

sociologist colleague asked “would you care to see the anatomy

museum?” There they were: skeletons of A Man 7 Feet Tall, Woman

with Widow’s Hump (bent over at about 75o) and, of course, The

Elephant Man (whom the School “cared for before and after his

death”). We went past the gold-leaf record of donations made to the

School by brewers such as Bass and Charrington, then out to the

street plaque in Whitechapel where General Booth had preached

against the ‘liquor traffic’ in the 19th century. Bill Hayes apparently

spent some equally interesting time around St George’s Hospital as