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Most people reading this review will be familiar with the work of Louis Gifford who died in February Over many years Louis delivered a number of courses and these form the basis of these three volumes.
I must declare that Louis was a friend who I admired greatly as a clinician, author and teacher so this review may lack some objectivity; however, both the author and the potential reader deserve a fair review so I will try my best.
This final publication from Louis Gifford is presented in a boxed set of three volumes: This is a difficult series of books to review because they defy a traditional classification. A traditional review would criticise the series for not using the most up to date references throughout the book to illustrate the many fundamental points made.
This would be erroneous and misses the point of much of the book which is a reflection of the journey Louis took to come to his understanding of pain through his learning and clinical practice.
This does not make his conclusions and his interpretation any less valid, most of the references cited are seminal in our understanding of the current theories of pain. In doing so it is a call to use this as a basis for understanding and a stimulus to better our own knowledge and understanding rather than to accept something as the given dogma.
Personally I found the first two books the most satisfying maybe because I, like Louis have a deep and unending fascination with the neurophysiology of pain in all its guises. This is not, mercifully for the casual reader, a complex discourse full of detailed descriptions of neurotransmitters, brain areas and detailed neurophysiology, it is described with a lightness of touch which few authors can achieve.
This is peppered with case histories to illustrate points which clinicians will find very close to home and will recognise in many of their own patients. It lets the reader understand that pain is a dynamic, ever changing process which evolves into a complex phenomenon and, I hope, will stop people seeing acute injury pain and chronic pain as two completely separate entities.
Louis has tried to bring together the neurophysiology, psychology, behavioural and immune responses together with the social environment within which the pain is interpreted and shows how these alter the presentation in clinic and how a better understanding can make us more effective clinicians.
It is in this section that Louis expounds further on his Mature Organism Model of chronic pain which was a seminal advance in the understanding of pain for many physiotherapists. With the passage of time since the original model was published more information has come to light which helps to support the model and to develop it further.
In conversations with Louis he always considered this a work in progress which was unlikely to ever be complete. This is likely to be the section many physiotherapists will enjoy reading — how we can put much of the learning into clinical practice.
Some will argue that there is a lack of reference to some of the more recent developments in the management such as more focused use of screening, the recent developments in the use of values driven rehabilitation approaches and mindfulness in chronic pain programmes but to me these are to be forgiven.
Minor niggles are an occasional repetition of information from one section to another and a lack of indexing making it hard to find information quickly.
I am not sure the poetry and song lyrics contribute to the chapters but these are examples of the idiosyncrasies of the author, I am sure in a lecture he would make them seem perfectly in place.
There are incomplete sections which were not completed before Louis became unable to continue, the sections are completed by his wife Philippa suggesting what Louis would have written; this adds a poignancy to the books.
I found these books eminently readable and I have read allwords with ease and found greater clarity in them than in many other textbooks on the subject. Even though the books are aimed primarily at physiotherapists I would recommend these to all clinicians from all professions.
For students and people new to the study of chronic pain it gives a context for the current views of pain and synthesises a vast area which one could not hope to cover as quickly as one will by reading this series.
The books are a testament to the intelligence, wit and charm of the author and represent a fitting final tribute to an excellent teacher and communicator.Volume , Hawkins, The Rt Revd Richard Presidential Address: ‘Church and Community in Devon’ Volume , , pp.
1– The address outlines elements in the traditional picture of the relationship between church and community in the parochial context, particularly the roles of the parish church and the parson.
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