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In Step on Manipulation MADAM -We were disappointed to read that Mrs Kettle (August, page 584) is surprised and perturbed to hear about the recognition by the CSP of the Association of Chartered Physiotherapists in Ortho- paedic Medicine as a Clinical Interest Group. We hope that the following facts will help her to overcome her difficulty in undemanding why ACPOM has been founded. 1. ACPOM, as its name makes clear, is not just a second orthopaedic manipulative physiotherapy group but is the first designed for chartered physiotherapists with a common interest in orthopaedic medicine. This is primarily a scheme of diagnosis and treatment incorporating many techniques of which manipulation is only one. 2. It is not a combination of any other groups, Cyriax or otherwise, and does not follow any one ‘manipulative philosophy’. 3. Membership is open to all chartered physiotherapists with an interest in orthopaedic medicine -there is no entry examination or requirement to complete a Wyear coum. Local groups have already been set up to provide opportunity for review, discussion, patient sessions and innovation of new approaches. ACPOM seeks to advance physiotherapy skills and is no threat to the MACP.

Ms Kettle chastises the CSP for not

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encouraging the pulling together of different factions within a clinical area. She is obviously unaware that the CSP has implemented and supported the formation of BACPIM, an umbrella organisation of all the different groups interested in manipulative therapy in its widest sense. This organisation is working hard to unite different factions, including the MACP, and ACPOM strongly supports it. Jane Cohen MCSP Elizabeth Kelly MCSP Robert Packham MCSP Stephanie Saunders MCSP Jo Smith Oliver MCSP The Association of Chartered Physiotherapists in Orthopaedic Medicine See also pages 63Z 649.-Editor

Hands Off or Hands On! MADAM - I am sure many physiother- apists would appreciate if Mr Skyte could elaborate on his comments in the August issue of Physiotherapy (page 579), as he touches upon a problem which deserves more attention than it has been given SO far.

Many chartered physiotherapists would rightly argue that the problem is not that ‘the profession wants to have it both ways’, It seems to me that the real issue is much wider, it relates to the promotion of physiotherapy at a national level.

We would benefit if he could enlighten us regarding the three problem areas involved.

First, there appears to be Some

uncertainty among the profession about the practicalities of projecting a particular professional image through the media.

Secondly, many chartered physiother- apists are very active in promoting physiotherapy in their own region. However, all these activities are taking place without the supporting framework of a national promotional strategy and without the benefit of knowledge relating to the marketing concept, the essentials of the promotional mix, market segmentation and media choice.

Thirdly, projecting a cohesive, Corporate image of a profession as diversified as physiotherapy is not an easy task. Surely the profession has to formulate its promotional aims including the corporate image it wishes to project.

We need to address these issues if we want to end the ‘hands on/off’ confusion and give direction to the aggregate public relations activities. Edward Bakker BPhys MCSP Welton, Lincs

Stuart Skyte replies: Mr Bakker raises some important points

but surely the spekific issue is that physiotherapists are in no position to complain that they are being thought of as quasi-electricians if they allow themselves to be photographed with an ultrasound machine. The choice is theirs.

When the CSP Public Relations Dep artment sends photographs to national papers and magazines, we are careful fo select those showing hands-on treatment.

The Health of Europe World Health Organisation. Regional Office for Europe, 8 Scherf/gsvej, Dk-2100 Copenhagen, Denmark. 1993 (ISBN 92 890 1313 3). Charts, 18 pages. sw fr 12.

The second large-scale evaluation of WHO’S health-for-all strategy in Europe is reported in this booklet.

It shows that, on the whole, health in Europe improved in the 1980s, with increased life expectancy, progress in eliminating infectious diseases, and reduced mortality from the leading causes of death.

Equality of provision has made no real progress, however, and there are still wide differences between the north and western parts of Europe and those in the centre and east. Southern European countries have an intermediate health standing.

The report concludes by urging all policy makers, in any sphere, to re- member and accept their responsibility for health when making daily decisions.

Piano Music for One Hand National Music and Disability lnformation Service, Dartington Hall, Totnes, Devon TO9 6EJ. 1993. 24 pages. f2.

This revised resource paper includes details of all known piano music published for one hand. Many people with

use of only one hand (due to illness, congenital deficiency, or injury) wish to learn, or to continue playing, piano but may not know how to find suitable scores. Pieces are listed according to level of difficulty, whether in or out of print, and whether fingered for left or right hand. Details are also included of people able to offer further help or advice.

How to Choose a Powered Vehicle Banstead Mobility Centre, Fens Pool Avenue, Brierley Hill, West Midlands DY5 IOA. 1993. A4 triptych. Free.

This is a do-it-yourself assessment, produced with the help of Sunrise Medical. Page 1 is a questionnaire which will determine the type of vehicle anyone will need. The centre pages form a chart showing the features of models available. Having selected those with the required characteristics the purchaser moves to a page of advice about how to try out suitable models. The last side is a check list to be completed for each vehicle tested.

For newly disabled people, those who are not mechanically minded, and as a reminder of points which might be overlooked (performance on grass, nearness of servicing agent), this leaflet should be very useful and reassuring to

those contemplating a major acquisition. Feedback is welcome as the publication

will be periodically updated.

HINT: National HIV Nutrition Team lnterface Partnership, Pasture Lane, Hoving- ham, North Yorkshire YO6 AIT. 32 pages.

A list of recent publications on nutrition and HN, with reviews of those considered particularly important. There are also some reports of conferences.

Looking After Someone At Home? Camden and Islington Community Health services NHS Trust, National Temperance Hospital, Hampstead Road, London NW1. 1993. A3 folded sheet.

Produced as a Camden Healthy Cities project, this is a posterlleaflet on back care. Advice and general principles for safe moving of people are given in diagrams and five languages (all on the same leaflet): English, Bengali, Chinese, Greek and Turkish.

It was designed for carers who are not receiving support from health or social services, and has been distributed through local libraries and health centres.

The leaflet is printed, in black and green, on recycled paper.

Physiotherapy, September 1993, vol79, no 9