Designing inclusively is no longer an option for companies. It is a business essential. Global populations are getting older, legislation is increasingly prohibitive of unnecessary exclusion and consumer attitudes are beginning to change. Exclusivity is out, inclusivity is in. Research communities the world over are responding to this change in design emphasis. Conferences such as the Cambridge Workshops on Universal Access and Assistive Technology (CWUAAT) offer a forum for researchers from diverse and varied disciplines to bring their perspectives on inclusive design together. This book has been inspired by the second CWUAAT, held in Cambridge, England in March 2004. It contains chapters from an international group of leading researchers in this field. Contributions focus on the following topics: design issues for universal access and assistive technology; enabling computer access and new technologies; and, assistive technology and rehabilitation robotics. This series of conferences is aimed at a broad range of interests, with a general focus on the development of products and solutions. Numerous case studies are used to raise awareness of the challenges faced in developing truly inclusive products, along with examples of good practice for design for a more inclusive world.

Over the last two decades, the increasing use of noninvasive ventilation (NIV) has reduced the need for endotracheal ventilation, thus decreasing the rate of ventilation-induced complications. Thus, NIV has decreased both intubation rates and mortality rates in specific subsets of patients with acute respiratory failure (for example, patients with hypercapnia, cardiogenic pulmonary edema, immune deficiencies, or post-transplantation acute respiratory failure). Despite the increased use of NIV in clinical practice, there is still a need for more educational tools to improve clinicians knowledge of the indications and contraindications for NIV, the factors that predict failure or success, and also what should be considered when starting NIV. This book has the dual function of being a "classical" text where the major findings in the literature are discussed and highlighted, as well as a practical manual on the tricks and pitfalls to consider in NIV application by both beginners and experts. For example, setting the ventilatory parameters; choosing the interfaces, circuits, and humidification systems; monitoring; and the "right" environment for the "right" patient will be discussed to help clinicians in their choices."

This book provides a hands-on resource for the development of essential skills and competencies in clinical neuropsychology. On a very practical level it addresses a question frequently asked by students, trainees, interns, and newly qualified psychologists: what do I need to know in order to perform the everyday tasks involved in clinical neuropsychology? The authors distil, from a vast knowledge base, the practical skills and knowledge needed to lay the foundations for working with brain-injured patients, especially within the developed and developing world where time and resources are limited.

The book is divided into three main sections: Basic Foundations, Clinical Practice, and Professional Issues. Together these sections cover 18 fundamental topics, each representing a key part of the life of a practitioner. Each chapter contains practical tips, points for reflective practice, and suggested further reading, with a particular emphasis on issues pertaining to working in under-resourced clinical environments. The book draws upon landmark academic papers and textbooks, and also the authors’ experiences of working in state hospitals in both South Africa and the National Health Service in the United Kingdom.

Working with Brain Injury will be essential reading for clinical psychology trainees and their supervisors, for newly qualified psychologists in clinical settings, and for students and practitioners in other clinical professions seeking an introduction to clinical neuropsychology.

Table of Contents

Section 1: Basic Foundations 1. Identifying a knowledge base2. Neuroanatomy3. Neuropathology4. Psychopathology5. Psychopharmacology6. Neuropsychological Theory7. Special InvestigationsSection 2: Clinical Practice 8. Clinical Assessment in Neuropsychology9. Neuropsychological Testing10. Formulation11. Neuropsychological Rehabilitation12. Psychotherapy Approaches13. Record KeepingSection 3: Professional Issues 14. Ethics15. Professional Practice16. Supervision17. Research and Audit18. Management

An increasing number of psychologists who were trained in clinical psychology, health psychology, or another specialty are gravitating toward rehabilitation psychology, but many of them have little or no experience with rehabilitation populations. With the explosion of interest in traumatic brain injury (TBI), many neuropsychologists are taking jobs in rehabilitation settings that treat people with TBI but also care for persons with the array of other disabling conditions such as spinal cord injury, stroke, MS, and amputation. In Specialty Competencies in Rehabilitation Psychology, Drs. Cox, Cox, and Caplan provide a guide to the knowledge and skills required by competent rehabilitation psychologists, with an emphasis on the evidence base of the specialty. The volume will be valuable to those preparing for the Board Certification Examination in Rehabilitation Psychology and will also be valuable to newcomers to the field and to clinicians working on an outpatient basis with individuals with a wide variety of chronic conditions. Series in Specialty Competencies in Professional Psychology Series Editors Arthur M. Nezu and Christine Maguth Nezu As the field of psychology continues to grow and new specialty areas emerge and achieve recognition, it has become increasingly important to define the standards of professional specialty practice. Developed and conceived in response to this need for practical guidelines, this series presents methods, strategies, and techniques for conducting day-to-day practice in any given psychology specialty. The topical volumes address best practices across the functional and foundational competencies that characterize the various psychology specialties, including clinical psychology, cognitive and behavioral psychology, school psychology, geropsychology, forensic psychology, clinical neuropsychology, couples and family psychology, and more. Functional competencies include common practice activities like assessment and intervention, while foundational competencies represent core knowledge areas such as ethical and legal issues, cultural diversity, and professional identification. In addition to describing these competencies, each volume provides a definition, description, and development timeline of a particular specialty, including its essential and characteristic pattern of activities, as well as its distinctive and unique features. Written by recognized experts in their respective fields, volumes are comprehensive, up-to-date, and accessible. These volumes offer invaluable guidance to not only practicing mental health professionals, but those training for specialty practice as well.

An injury to the brain can affect virtually any aspect of functioning and, at the deepest level, can alter sense of self or the essential qualities that define who we are. In recent years, there has been a growing body of research investigating changes to self in the context of brain injury. Developments in the cognitive and social neurosciences, psychotherapy and neurorehabilitation have together provided a rich perspective on self and identity reformation after brain injury. This book draws upon these theoretical perspectives and research findings to provide a comprehensive account of the impact of brain injury on self-identity. The second half of this book provides an in-depth review of clinical strategies for assessing changes in self-identity after brain injury, and of rehabilitation approaches for supporting individuals to maintain or re-establish a positive post-injury identity. The book emphasizes a shift in clinical orientation, from a traditional focus on alleviating impairments, to a focus on working collaboratively with people to support them to re-engage in valued activities and find meaning in their lives after brain injury. Self-Identity after Brain Injury is the first book dedicated to self-identity issues after brain injury which integrates theory and research, and also assessment and intervention strategies. It will be a key resource to support clinicians and researchers working in brain injury rehabilitation, and will be of great interest to researchers and students in clinical psychology, neuropsychology, and allied health disciplines.

It was a great pleasure and honour to have been invited to attend this Seminar and to present a final impression. The association in this field between the Chester Beatty Research Institute and Dr. Rosenberg's School at East Lansing is something which I specially value and many would doubtless like to know how it came about. In the course of its work in carcinogenesis and on chemotherapy over many years, the Chester Beatty Research Institute was frequently drawn to the importance of many metals - as for example lead, iron, metalloid arsenic and the metalloid quali ties of the carcinogenic hydrocarbons. Interest started in platinum many years ago, following the possibility, c1aimed by others, that various complexes between the metal and mercaptopurine might possess significant chemotherapeutic properties. Va rious attempts to confirm such findings ended, however, in complete failure. Interest in platinum was revived by the fresh observations of Dr. Rosenberg and his collea gues, and here the outcome was entirely different. Very soon it was possible to con firm the intense growth-inhibitory properties of cis-platinum (II) diamminedi chloride and related substances. After communicating these results to Dr. Rosenberg, it was a pleasure to welcome hirn in London where he gave a Seminar which greatly engaged the interest of many of the staff. Later, several of these were to enjoy Dr. Rosenberg's hospitality at an international conference on the subject to be held in East Lansing, where many rapidly developing aspects were open for discussion."

While evidence-based practice (EBP) has greatly influenced rehabilitation in the past decade, it continues to evolve and practitioners need guidance to implement evidence into their practice. Evidence-Based Rehabilitation: A Guide to Practice, the best-selling text providing step-by-step EBP guidance for rehabilitation professionals, has been updated into an expanded Third Edition. In Evidence-Based Rehabilitation, Third Edition Drs. Mary Law and Joy MacDermid, along with their contributors, explain evidence-based rehabilitation, the concepts underlying EBP, and build the reader's knowledge and skills through specific learning. The text is organised by the steps of the EBP process-introduction to EBP, finding the evidence, assessing the evidence, and using the evidence. EBP focuses first and foremost on making the best decisions for each client and using the best information available. For many rehabilitation practitioners, building skills in EBP is best done one step at a time. Evidence-Based Rehabilitation helps the rehabilitation student and practitioner develop his or her knowledge and skills to implement evidence-based rehabilitation in practice. Benefits of the Third Edition: All chapters have been updated with new information and resources New chapters about systematic reviews, and knowledge transfer Extensive guide available with specific student activities and answers for faculty use Critical review forms included for student use-these forms have been used by practitioners and researchers around the world for 10 to 20 years Recognition throughout the book that EBP in rehabilitation means bringing together research evidence, clinical reasoning of the therapist and client values and goals Fits the standard 3-unit course design with 11 to 12 sessions Instructors in educational settings can visit www.efacultylounge.com for additional materials to be used for teaching in the classroom. Designed and written by an occupational therapist and a physical therapist with extensive research, education, and practice experience, Evidence-Based Rehabilitation: A Guide to Practice, Third Edition will guide both occupational therapy and physical therapy students and practitioners as they incorporate evidence-based practice into their work.

Traumatic brain injury (TBI) can seriously disrupt the social and communication skills that are basic requirements for everyday life. It is the loss of these interpersonal skills that can be the most devastating for people with TBI and their families. Although there are many books that focus upon TBI, none focus on communication and communication skills specifically. This book fills this important gap in the literature and provides information ranging from a broad overview of the nature of pathology following TBI and its effects on cognition and behaviour, through to the latest evidence about ways to assess and treat social and communication disorders. Much has changed in the field of communication disorders and TBI since the first edition of this book was published in 1999. There have been advances in neuroimaging, providing more accurate understanding of how the brain is damaged in TBI and also insights into its repair. There has been a burgeoning interest in social cognition, and advances in how communication is conceptualized, with a particular focus on the role of how context facilitates or impedes communicative ability. Most importantly, much has changed in the arena of rehabilitation. There is now a growing evidence base of treatments aimed at improving communication problems following TBI, new resources for accessing this information and renewed interest in different kinds of methods for demonstrating treatment effects. Bringing together a range of expert international researchers interested in understanding the nature and treatment of TBI this book covers topics from understanding how the brain damage occurs, how it affects social and communication skills and how these problems might be treated. As such it will be of great interest to clinicians, postgraduate and undergraduate students and researchers in neuropsychology, speech and language pathology.

In this new volume, Dr. Gregory Fanelli, of the Geisinger Medical Center and a reknowned expert on knee injuries, provides orthopaedic surgeons with an unprecedented review of the most recent and advanced knowledge needed to successfully diagnosis and treat PCL injuries. This comprehensive and practical volume covers everything from biomechanics and anatomy, evaluation and non-operative treatment to the latest surgical treatments of PCL injuries using arthroscopy, grafts and synthetic ligament substitutes. In addition, contributions from such well-known specialists as Drs. M. Malek, Roger Larson and Fred Flandery make this an essential text for every orthopaedic surgeon.

Sleep and Rehabilitation: A Guide for Health Professionals is a concise reference for the health professional looking to further understand sleep and how sleep science may impact particular areas of various rehabilitation disciplines. Dr. Julie M. Hereford and her contributors present Sleep and Rehabilitation: A Guide for Health Professionals in an easy-to-read manner by dividing the text into four main sections. The first section provides a review of the basic scientific understanding of sleep. While there are many other publications that present a basic scientific understanding of sleep, Sleep and Rehabilitation systematically gears this information toward the rehabilitation professional with commonly used terminology, descriptions of sleep architecture, and information concerning sleep hygiene. The final sections of Sleep and Rehabilitation describe disordered sleep and how it pertains to patients seen in the rehabilitation setting. It guides the health professional to recognise the manifestations and consequences of disordered sleep and teaches the rehabilitation professional how to interpret a sleep study in order to provide guidance in clinical decision making. Finally, Sleep and Rehabilitation provides the ever-important practical application of the theoretical principles in sleep rehabilitation. Features include: Discussion on the science of polysomnography Sleep and sleep dysfunction from a rehabilitation perspective Sleep dysfunction as it relates to the clinical needs of a patient undergoing the rehabilitation process Discussion on the particular concerns that sleep and sleep dysfunction can hold for rehabilitation patients and issues to be addressed by the provider Presentation of unique issues that disordered sleep may present in the rehabilitation process such as on pain, pain management, motor learning, and memory and performance enhancement Tools to assess quality and quantity of a patient's sleep Discussion on methods in which sleep may be manipulated in order to optimise a patient's physical performance Sleep and Rehabilitation: A Guide for Health Professionals is a one-of-a-kind reference that will help the health professional incorporate the science of sleep into the rehabilitation process.

The twu-day sympusium held un the campus uf Augustana Cullege, Ruck Island, Illinuis, April 5 and 6, 1967, explured the interrelatiunship between the life sciences and engineering and attempted tu make the scientific cummunity mure aware uf an interdisciplinary appruach tu engineering. The sympusium suught tu stimulate new mechanical engineering cuncepts perhaps nut pussible utilizing data available unly thruugh ideas derived frum the traditiunal physical sciences. Devuted tu clused luup biomechanical systems in which biulugical furces and feedback influence mechanical, physical, and chemical systems, this first Ruck Island Arsenal Biumechanics Sympusium was cuspunsured by Ruck Island Arsenal, u. S. Army Weapuns Cummand, U. S. Army Research Office Durham, and Augustana Cullege. It strived fur academic excellance, and the spunsurs are indebted tu the Advisury Cummittee in pruviding the guidance and participatiun required tu achieve this ubjective as reflected in these pruceedings. Persunal thanks are extended tu Drs. Russ C. Bean, Geurge Bugliarellu, Rubert G. Gesteland, Warren S. MCCulluugh, Lawrence M. Patrick, Ali Seirig, and Heinz Vun Fuerster. The planning cummittee, which included Pruf. Juhn E. Ekblad, Edwin M. Vaughan, Alan G. Galbavy, and the editurs, are also. tu be cummended fur their ef- furts in arranging this successful sympusium.

The subtitle of this book - A Holistic Approach to Rehabilitatio- underscores our fundamental point of view regarding spinal ailments. The patient with his ailments should be at the focus of attention, yet the subtitle combines two important elements, namely, "rehabilitation" and "holistic approach. " It is only by combining both concepts to show that they do belong together that the door to successful treatment of persons with vertebral problems can be opened. Holistic medicine does not require an ideological classification of its own, but should be under stood as a unified, optimal form of medicine which encompasses the whole person: his health and his illnesses in all their aspects. Too often, there is an automatic, senseless separation of the two concepts. Purists in one or the other camp need to recognize the common ground and to eliminate the barriers that have been erected by extreme positions and attacks. When we look back into history, we can see that there have always been schools of medical thought that have promulgated one or another direction. Evaluations and interpretations change in accordance with our knowledge and the times themselves, but that which is most valu able remains in end effect, forming the starting point for following gen erations. It should be noted that the entire body of medical knowledge had its beginnings in empiricism, whose ideas could not be confirmed and supported until much later, parallel with the developments in research technology."

The European Organization for Research into Cancer Treatment (OERTC), founded in 1962 initially under the name Groupe Europeen de Chimiotherapie Anti cancereuse (GECA), is an extramural European Institute for collecting, co-ordinating and encouraging the work of scientists researching into cancer treatment at 16 European institutes: 3 in W. Germany, 2 in Italy, 2 in Belgium, 3 in the Netherlands, 2 in the United Kingdom, 1 in Switzerland and 3 in France. The first President of OERTC was Professor GEORGES MATHE, now succeeded by Professor SILVIO GARATTINI of Milan. The organization has a Board of 20 Directors, responsible for co-ordinating the entire range of activities and guiding research and experimental studies on animals, also the first human trials of new therapeutic agents which have been fully tested on animals. The Co-operating Groups carry out com plementary testing involving large numbers of patients. Thus, OER TC is not a "learned society" but an agency for co-ordinating work. OER TC's annual plenary meeting for 1968 was held in Paris on 22nd and 23rd March. It was given over to an intensive study of the scientific basis of chemotherapy in the treatment of cancer in man. These two working sessions brought together members of all groups, both directing and co-operating. The first day was in effect a teaching seminar, open to all practitioners wishing to use chemotherapy in cancer, and explaining the scientific basis of such treatment. This seminar constitutes the present monograph."

Triennial the Division of Biomedical Engineering of the Institute of Textile Technology and Chemical Engineering, Denkendorf, is organizing conferences on specific topics in the field of polymeric materials for use in the biomedical areas. The aim is to bring together scientists from allover the world working on this speci fic topic, to present the newest state of the art and to discuss their problems in a more concentrated atmosphere and at last to create and intensivate their cooperation. Following two conferences on "Polyurethanes in Biomedical Engi neering" (1983 and 1986), the Institute of Textile Technology and Chemical Engineering set a theme, which is very closely related to its own task: "Medical Textiles for Implantation". As technical materials, textiles can be classified in two fields of application: - first, textiles used for highly flexible, strong, but only tension load bearing systems, e.g. tows; - second, textiles manufactured to flat shaped devices to separate two regions more or less semipermeable, e.g. clothing; - a combination of both are reinforced systems like tubular fabrics e.g.; here pressure load will be transformed to tensile load, the separation may be performed by a coating. In the biological systems the classification can be used in the same manner: - Tension load bearing structures are ligaments and tendons, semipermeable separation is realized by cell membranes as well as by cell layers, for example the skin. - The combination of both of the principles can be found for example in arteries and the trachea.

During the past five years there has been a reawakening of interest in the psychotherapy of patients with medical disorders characterized as psychosomatic. For three decades, psychoanalysis and psychoanalytic psychotherapy were used extensively to treat and study psychosomatic disorders. Early in the 1960s, interest in this approach to these conditions faded, and the .Psychosomatic Service. in most hospitals became the .Consultation Liaison Service. (Lipowski, 1967). The recent focus of biofeedback on psychosomatic conditions provides a new technique with which the physician or psychiatrist may treat these patients (Rickles, 1981). In addition, the successful application of biofeedback training to a variety of complaints such as those presented in this volume has heralded the addition of biofeedback to the treatment modalities used for medical complaints. Frequently, psychological factors can still be seen; for example, when biofeedback treatment may require lifestyle changes on the part of the patient, the exploration of secondary gains or resistances before the disorder can be success fully treated, and the establishment of rapport and empathy which is so important for truly effective biofeedback training. Aside from certain psychological dimensions that are always present in biofeed back training, in this case biofeedback is being used in a primarily medical setting for primarily medical complaints."

In his review of the Proceedings of the First International Workshop on Respiratory Muscles in Chronic Obstructive Pulmonary Disease, organized in Montescano in 1986, Thomas K. Aldrich stated that "there is little information on nutrition". We felt that the need to supplement the evaluation of respiratory muscles by studying nutritional problems was an important enough matter to justify producing a specific study on the subject. This book is the result of the efforts made in this direction. Since 1986, many of the problems associated with nutrition and ventilatory function have been elucidated, and we hope that the contents of this book may contribute towards spreading interest and knowledge in this sector, particularly among those working in the field of respiratory rehabilitation. The physiological and clinical aspects of nutritional problems and the therapeutic approaches adopted in different disease conditions are dealt with in these pages by some of the best-known researchers in the field, providing abundant evidence, if any should be needed, that rehabilitation is not merely exercise. The picture strongly emerging over these last few years is that rehabilitation is not merely a matter of knowledge of lung or respiratory muscles, but also of heart-lung interaction, metabolic equilibrium and nutrition. So much for recent developments, but what does the future hold in store? May 1992 RENATO CORSICO Preface Nutrition and ventilation are inextricably related.

While emphysema and chronic bronchitis are primarily lung di seases, one of their major consequences is to deeply affect the function of the respiratory muscles. Lung hyperinflation shortens the inspiratory muscles due to increased airways resistance, more of their effort is demanded and changes in nutritional status wea ken them further. Their malfunction can lead to severe dyspnea and to failure of the ventilatory pump. Over the last 10 years we have witnessed an explosion of information of how respiratory muscles function in health and disease, new techniques for their evaluation have been created, the concept of fatigue, weakness, and failure was developed, and their rest or training was attemp ted. The implication of respiratory muscles malfunction in respi ratory medicine has reached a prominent place. It seems remarkable that while some aspect of skeletal muscles function requires molecular biology techniques to find new an swers, we still know little on respiratory muscles interaction, stra tegies of coordination, their role in dyspnea, chronic hypercapnia or how to effectively improve their function in patients. This workshop was organized and held at the Medical Center of Rehabilitation in Montescano and represents an attempt to focus on how the newly adquired wealth of information can eventually be trasformed into medical care. The particpants in this workshop brought forward challenging thoughts and we are most grateful for their participation. This book represents a report of the proceedings and also provides the most updated information in this field.

G. MATHE and R. K. OLDHAM' Institut de Cancerologie et d'Immunogem tique, Hopital Paul Brousse, Villejuif Since the last war, cancer chemotherapy has been the object of very intensive and expensive research. Nevertheless, its development has been very slow, and its ultimate potential is today somewhat in doubt. In doubt because it does not cure any cancer patients except a) females carrying placental choriocarcinoma, a semi-allogenic tumor, in which case, cure may be in fluenced by immune rejection, and b) children suffering from Burkitt's tumor, where the probable reason for the cure is that all the neoplastic cells are in the cycle, which is a unique condition among all the human tumor varieties. Whether the long term survivors in acute leukemia, lymphomas, certain sarcomas and certain testicular tumors are "cures" will require longer follow-up. The idea that chemotherapy does not cure most cancer patients because all their neoplastic cells are not in cycle has led to the use of drug combinations. Whatever they are, "cocktail combinations" which are made up of drugs given according to any timing, or scientific combinations, based on pharmacodynamics, pharmaco kinetics or cell kinetics data, are more toxic than single drugs, and are all the more toxic as the number of drugs in the combination is increased."

The human personality is inextricably bound up with, among other things, the function of the central nervous system. Diseases and malfunctions of the brain, head injuries and neurosurgical operations can all result in permanently altered behaviour patterns. This interrelation between brain and behaviour is most clearly demonstrated in cases involving functional neurosurgery and severe traumatic lesions. Despite the fact that this interrelation represents an everyday challenge to the neurosurgeon, it is a question which receives less attention than it deserves in neurosurgical meetings. Given the scope and complexity of this topic, it is not possible to cover every aspect of it here: hence, discussion is limited to the impact on personality of injuries, language, epilepsy and psychosurgery. However, before considering the medical aspects, it was deemed necessary to try and arrive at a definition of "personality." This question was discussed by a number of philosophers representing various perspectives. Their diversity of viewpoints and conceptions greatly enriched the discussions.

Over the past 10-20 years there has been an explosion of work on the disturbance of motor control that is manifested as "spasticity." This work has been based on new insights from animal experiments into the basis of normal motor control and the development of experimental techniques that could be used in patients with neurological disturbances. For this reason, on the initiative of Alfred Thilmann, the editors of this volume organized a workshop on spasticity, held in Essen, Germany, in November, 1992. The intention of the meeting was to bring together leading scientists in an atmosphere that would generate discussion and hopefully consensus and ideas for future work. The attendance was restricted and deliberately selective, with a mix of basic scientists, clinical scientists and practicing clinicians. The product of their presentations and deliberations is this volume. The book is organized in the same sequence as the workshop, so that the discussion sessions could be summarized by the appropriate chairman.

Up until two decades ago, clinical interest in the etiopathogenetic interpretation of lumbo-radicular syndromes was prevalently concentrated on the pathology of the inter vertebral disc. This vision gradually changed and grew as a result of the affirmation of the concept of pathological narrowing of the osteoligamentous vertebral canal as a cause of compression of the lumbar nervous structures. Finally, in the last ten years, lumbar stenosis has become more and more a subject of current interest not only as a result of problems related to nosography, diagnosis, and therapy, but also as a result of the increasing frequency with which vertebral canal or nerve root canal stenosis syndromes are recognized and treated. At the same time there was a tendency to include in stenotic pathology other pathological conditions responsible for lumbo-radicular syndromes. This led to dilation of the concept of stenosis, which perhaps no longer responded to reality, and which was not useful from a practical point of view. The need to define stenotic pathology and to correctly locate it within the vast field of lumbar pathology inspired the writing of this volume. This monograph gathers many diagnostic and therapeutic concepts matured at our In stitution over the years. Some of these concepts have already been defined in scientific meet ings or in publications."

The volume contains papers presented at a workshop of held from September 28 - October 1st in Eibsee near Munich, Germany.
The aim of the workshop was to present results of interdisciplinary research which aims to help handicapped persons suffering from paraplegia or hemiplegia to regain the capability to stand or walk. The contributions cover both fundamental research and clinical applications.

In-patient treatment for alcoholism going beyond physical withdrawal from the drug has been available in Germany for more than 130 years. Particularly since the Second World War, treatment has broadened and changed in various ways. There are several reasons for this development. The recognition of alcoholism as a disease by the Supreme Court had widespread financial and administrative consequences. Since then in patient treatment has been funded mainly by the pension insurance institutions. Another reason is the strengthened influence of different psychotherapeutic schools on practice in treatment. At the present time in the Federal Republic of Germany there are about 250 treatment facilities (Suchtfachkliniken, or addiction centres), where around 25000 patients a year receive in-patient treatment. In addition to these, there are the addiction units in psychiatric and general hospitals, of which some offer withdrawal treatment, while others also offer rehabilit ation treatment. For out-patient treatment there are about 450 special addiction counselling and treatment centres, out-patient facilities available at local health authorities and university hospitals and, further to all this, there are thousands of self-help groups of various kinds. This system of interlocking treatment facilities of various kinds, from the first contact to the after-care stage, is called a treatment network or chain.

Language depends on a normally functioning left hemisphere. This central fact of human cerebral dominance was well established by 19th century aphasiologists and has been repeatedly confirmed by subsequent investiga tions. Predominance, however, does not imply exclusivity. As demonstrated by the commissurotomy patients studied by Eran Zaidel and associates, the right hemisphere is also capable of subserving some linguistic functions. The question, then, is not whether the right hemisphere can process language, but how and when it does so. This volume focuses on the right hemisphere's contribution to one important aspect oflanguage, lexical semantics. Although the right hemisphere may well be involved in other linguistic functions, such as prosody, the greatest evidence for right hemisphere language competence has been obtained for the processing of word meanings. In addition, cognitive psychology and psycho linguistics have provided us with well-developed models of the lexicon and lexical access to guide our inquiry. Finally, there are techniques available for studying lateralized lexical processing in the normal as well as in the brain injured hemispheres. For these reasons, a focus on the lexicon is likely to yield the greatest number of insights about right-hemisphere language processing."

The management of and attitudes toward children and adults with Down syndrome have undergone considerable changes in the course of the condi tion's long history (Zellweger, 1977, 1981, Zellweger & Patil, 1987). J. E. D. Esquirol (1838) and E. Seguin (1846) were probably the first physicians to witness the condition without using currently accepted diagnostic designa tions. Seguin coined the terms furfuraceus or lowland cretinism in contradis tinction to the goiterous cretinism endemic at that time in the Swiss Alps. Esquirol, as well as Seguin, had a positive attitude toward persons who were mentally ill or mentally subnormal. Esquirol pioneered a more humane treatment in mental institutions and Seguin created the first homes in France, and later in the United States, aimed at educating persons who were mentally subnormal. The term mongolian idiocy was coined by J. H. L. Down in England (1866). The term is misleading in several respects: (1) Down identified the epicanthic folds seen in many children with Down syndrome with the additional skin fold in the upper lid occurring particularly in people of Oriental (Mongolian) descent; and (2) Down also erred by assuming that Down syndrome represented regression to an ethnic variant of lower cultural standing. Such an interpretation might have been understandable at a time when the myth of Anglo-Saxon superiority was widely accepted by the British. Charles Darwin's then highly acclaimed theory of origin of the species may have contributed to such a concept."