Each year in the United States, an estimated 40,000 persons lose a limb. Of these amputees, approximately 30% lose a hand or an arm. This loss is most frequently related to trauma occurring in the healthy young adult male and is often work related. Approximately 3% of all amputees are born with congenital limb absence. In children, the ratio of congenital to acquired amputation is 2: 1, and the ratio of upper-limb to lower-limb amputees is 1. 2: 1. Therefore, since relatively few amputations result in upper-limb loss, only a small number of health practitioners, even those specializing in amputee rehabilitation, have the opportunity to provide services for a significant number of arm amputees. As a result, clinicians need to share their experiences so that the full range of options for optimum care and rehabilitation of the patient population may be considered. To meet this challenge for wider communication of clinical experience, a group of upper-limb amputee specialists met in Houston, Texas, in 1981 to serve as the core faculty for a course entitled "Contemporary Issues in Upper Extremity Amputation and Prosthetic Function. " This program provided the opportunity for surgeons, physiatrists, engineers, prosthetists, social workers, psychologists, occupational therapists, and physical therapists from the United States and Canada to discuss their extensive experience in working with upper extremity amputees. A second conference continuing the discussion of upper limb amputee rehabilitation was held one year later."

Pulmonary rehabilitation programmes are a fundamental part of the clinical management of patients with chronic respiratory diseases. This comprehensive reference book places pulmonary rehabilitation within the wider framework of respiratory disease. Now in six parts, it includes new sections on the development of PR as a discipline, global perspectives on quality control, new chapters on early PR post exacerbation and personalized rehabilitation, innovative approaches to exercise, PR in interstitial lung disease and lung transplantation, and the latest research into the application of music, dance and yoga. Key Features Global contributions compare practice around the world where differences have developed. New six Part structure covers new approaches to exercise testing, interstitial lung diseases and other diseases, and add-on interventions drawing on new technologies. Contains recommendations of the large collaborative ERS/ATS task forces on guidelines for PR as well as suggested policies for its implementation and use. Covers the important topic of balance impairment as a focus of rehabilitation for the at-risk patient and a new chapter on monitoring physical activity. The voices of patients and caregivers describe the impact of chronic respiratory disease on their lives. Features an exclusive chapter on COVID-19 that discusses the short- and long-term pathophysiological consequences, provides information about the potential role of physiotherapy in the management of hospitalized patients with confirmed or suspected COVID-19, and details on who, where, and how to deliver programs to COVID-19 and non COVID-19 patients in the lockdown and post lockdown era.

Re-EngineeringoftheDamagedBrainandSpinalCord isdedicatedtoTetsuoKanno, M. D. ProfessorofNeurosurgery Bypresenting theoriginal papers thatmakeupthis thefeaturesofthelocalmedicallandscapeinthe- third supplement we wish to make a further contri- gionswheretheyareenacted. Whatismore, progr- bution to the issue of functional rehabilitation, this sivenew?ndingsmustbealsosubjectedtoafrequent soimportantandfascinatingmodernareaofresearch revision. Ontopofthis, itshouldnotbeforgottenthat inthe?eldofneurosciences. Thecongresspaperswe even when committal therapy guidelines are c- haveselectedconstituteagoodre?ectionofthetrans- sistentlyapplied, thereareconsiderablevariationsin disciplinary objectives. The literature references are therangeofpotentialcomplicationsandintheo- designedasaguidetoleadtheinterestedreadertoa comeofprospectivecontrolledmulti-centreandmul- deeperandmoredetailedunderstandingoftheindi- nationalstudiesontheissueofqualitymanagement. vidualissues. Functionalrehabilitationhasbeenanoriginaltask The demand for ''evidence-based medicine'' is well ofneurosurgeryfromtheveryoutset. The1990shave justi?ed; however, it rapidly comes up against the enteredtheannalsofbrainresearchasthe''Decadeof limitsoffeasibility, especiallywherecontrolledthe- theBrain''. Sincethentherehasbeenaneverstronger peuticstudiesareconcerned. TheCochrancollection growthofneuroscienti?cinterestworldwide, accom- of high-quality evidence-based healthcare databases paniedbysubstantial?nancialengagement. Thishas hasthusfarbeenofnohelptousindrawingupthe- primarily resulted in advances in basic neuro- peutic recommendations for the re-engineering of biologicalandneurophysiologicalresearchandalsoin brain and spinal-cord lesions. Today as ever, the thegrowthofneuroscienti?cknowledgeaboutbasic opinion of experts and empirically based medical mechanismsformotor control, paincontrol, aware- treatment and posttraumatic neurorehabilitation ness, cognition, learning and memory. The conse- continuetooccupyanindispensablepositionforthe quencemustbetoensurethattheadvancesmadeinthe everydayclinicalpracticeofneurosurgicalandneu- neuroscienti?cresearchareaareadequatelyexpanded traumatological therapies. Promising adjunct - intopracticalneurosurgicalcareandre-engineeringof proachesincludeneuropharmacology, forcascadesof brainandspinalcordlesionsandtoensureuponnew molecular interactions are known to be underlying approaches. Following this a fundamental path will activity-dependent plasticity and skills learning, as resultinanimprovedandmoree cientpreventionin many of these processes involve the major tra- thefuture, themeasuresthatstandrightatthefore- mitters. Furthermore, biologicalinterventionsby- front of all rehabilitation principles, meaning that ingendogenousneuronsandgliaaswellasexogenous conventionalconceptsmustbemodi?edtokeeppace stemcells, bone-marrowcells, macrophages, andother withthemoretask-speci?c, intensive, andprogressive types may promote the regeneration of nerve cells, demands. In this connection a series of guidelines, tissue, and neural circuitry. Class one studies have recommendations, and expert opinions and also beenmade, andnowclasstwostudieshavebeeni- algorithms have been elaborated by national and tiated, for example in connection with acute spinal international expert panels and multidisciplinary as- cord injury (SCI). The clinical application of fu- sociationsfortheacutemedicalcareofpatients."

With all of the misinformation regarding the effects of creatine supplementation on health and sports performance, this book brings together the information on how creatine affects body composition, exercise performance, and health. Supported by the International Society of Sports Nutrition, this volume is timely and vital for all professionals in the field of sports nutrition.

A practical roadmap for teaching graduate counseling courses from start to finish. Written for the soon-to-be, novice, or adjunct counselor educator, this is an accessible, practical guide to preparing and teaching a graduate counseling course from start to finish. Authored by skilled counselor educators who found themselves woefully unprepared to teach upon obtaining their first faculty positions, the book proffers their hard-earned wisdom to help new faculty confidently take over the role of instructor. The hands-on guide provides convenient overviews of each course and day-to-day, content-specific strategies for designing and teaching integral course content that is culturally sensitive and developmentally appropriate.Offering diverse strategies and activities, the book addresses how to teach courses taught in most CACREP-accredited programs and covers such topics as identifying theoretical orientation; diagnosis, assessment, and treatment planning: developing therapeutic presence; group leadership; genograms; diversity; basic counseling skills, school shootings; suicide; white privilege; and much more. It addresses course objectives, evaluation of student learning, current research, classroom management, use of technology, do's and don'ts, and advising students. Discussion points and merits of activities are informed by the concept of andragogy, a theory specifically for adult learning. Multicultural and social considerations are woven throughout each chapter. Activities and assignments were developed with feedback from students. Key Features: Provides a practical roadmap for preparing and teaching a graduate counseling course from start to finish Delivers in-depth practical information on how to teach new material and conduct day-to-day lectures Discusses content-specific teaching strategies and advice Guides new faculty members in understanding how all of the courses in the curriculum influence each other Includes multicultural and social considerations in each chapter Informed by the concept of andragogy, a theory specifically for adult learning.

International experts present in this volume advances in reconstructive neurosurgery focusing on the fields of neurotrauma and neurodegenerative disorders. The highlights include building an international strategy for risk reduction, documentating an multidisciplinary approach towards restoration of function in paraplegic spinal cord-injured patients, describing a new approach for statistical analysis in traumatic brain injury trials, describing blood flow changes in diffuse brain injury, discussing rehabilitation programs in Germany following acute brain injury, describing research data form Taiwan on neurotrauma, showing the neuropsychiatric effects from deep brain stimuation fro ovement disorders, difining the role played by imanging for deep brain stimulation targeting in mental illness, using radiosurgery in decompresssion in the treatment of trigeminal neuralgia, describing the development of radiosurgery from brain to the spine, listing new transgenic animal models of Parkinson's disease, discussing gene therapy for neuropathic pain and Parkinson's disease, and finally, discussing constrained-induced movement therapy fro stroke patients, and endovascular therapy for cerebrovenous disorders.

This book investigates the growing and ever-changing health issues for girls and women who lead an active lifestyle and participate in sports and exercise. Easy to read, the volume provides an educational foundation for understanding how disordered eating, amenorrhea, and osteoporosis can be interrelated while also looking at image disorders and reproductive health. It contains thorough analysis of common prevention and management techniques, and provides useful links to resources on the internet for additional screening tools.

All over the world research is going on to improve the outcome of the treatment of peripheral nerve lesions. Yet, there exist many questions, such as: Is the autologeous nerve grafting still the golden standard in bridging defects? Have alternative techniques to overcome defects reached a level to replace autografting? What can be expected from end to side coaptation? The contributions in this book give answers to all of these questions.

This book is the first to view the effects of development, aging, and practice on the control of human voluntary movement from a contemporary context. Emphasis is on the links between progress in basic motor control research and applied areas such as motor disorders and motor rehabilitation. Relevant to both professionals in the areas of motor control, movement disorders, and motor rehabilitation, and to students starting their careers in one of these actively developed areas.

Psychoprosthetics is defined as the study of psychological aspects of prosthetic use and of rehabilitative processes in those conditions that require the use of prosthetic devices. Psychoprosthetics: State of the Knowledge brings together, into one easily accessible volume, the most recent and exciting research and knowledge in this new field

This book was stimulated by the third Cambridge Workshop Series on Universal Access and Assistive Technology held in April 2006; the contributors represent leading researchers in the fields of Inclusive Design, Rehabilitation Robotics, Universal Access and Assistive Technology. Contributions focus on design issues for a more inclusive world; enabling computer access and the development of new technologies; assistive technology and rehabilitation robotics; and understanding users and involving them in design.

This text provides an overview of vocational rehabilitation (VR) practice, making it the perfect companion for students and practitioners with an interest in supporting people back to work and improving their sense of health and well-being. The book is divided into three parts: the first covers the policy context of VR in the UK, defining VR, outlining the development of national standards in the sector, and looking at issues such as the economy and worklessness, and the legal background. The second part examines models of VR practice and relevant standards. It explores the nature of developing services in the public and private sectors, illustrated by case studies from a range of disciplinary backgrounds. The final part presents a detailed introduction to the knowledge and skills required in providing a VR service, including consideration of the multidisciplinary processes and stages involved. Introduction to Vocational Rehabilitation includes numerous case studies and a dedicated chapter of issues and questions to aid reflection. Comprehensive and evidence-based, this is the first multidisciplinary textbook for students and practitioners from a range of backgrounds, including occupational therapy and health, physiotherapy, human resources, nursing, social work and health psychology.

Neuromuscular Ultrasound demonstrates the use of ultrasound as an alternative to electrodiagnosis in the evaluation of neuromuscular disorders through detailed descriptions and clear illustrations. Drs. Francis Walker and Michael S. Cartwright discuss techniques for visualizing muscles and nerves without painful testing for better patient compliance and more efficient diagnosis. Color illustrations, pearls for the clinician, and ultrasound videos online at www.expertconsult.com, ensure that you'll be able to apply this technology effectively in your practice. Access the fully searchable text online at www.expertconsult.com, along with ultrasound videos that demonstrate ultrasound evaluation in real time. Diagnose and manage your patients more quickly and easily by visualizing muscles and nerves without painful testing. Master the nuances of using ultrasound through the visual instruction of clear images and illustrations. Minimize patient discomfort while maximizing optimal patient evaluation with a practical focus that covers using ultrasound as a screening tool, provides clinical pearls, and includes comparisons to electrodiagnosis. Apply the full range of ultrasound applications, including interventional uses (such as ultrasound-guided botulinum toxin and steroid injections), ultrasound of polyneuropathies (often found in diabetics), and more. Neuromuscular Ultrasound covers the use of ultrasound as an alternative to electrodiagnosis for the evaluation of neuromuscular disorders-using illustrations to compare and contrast the two techniques. It provides lucid descriptions of how the clinical and electrodiagnostic examinations can be refined, improved, and enhanced to minimize patient discomfort and to maximize the optimal patient evaluation

Innovations in paediatric rehabilitation engineering can serve as a springboard to education, psychosocial, social, physical and cognitive development for children and youth with disabilities. Instead of providing an overview of rehabilitation engineering, Paediatric Rehabilitation Engineering focuses on the uniqueness of the paediatric subspecialty via an international sampling of methods and techniques currently in use or in development. The book is divided into three complementary components. The first group of chapters is broadly concerned with connecting individuals to their environment and to the people around them. The second group revolves around paediatric technologies that compensate for compromised or missing function. The final group of chapters is about machines and environments which provide stimulating and interactive platforms for therapy and research. Topics include: Microswitch-based occupational, recreational and rehabilitation programs Emerging access technologies, like infrared thermal imaging and vocal cord vibration detection Communication technologies to enable children to communicate in a variety of everyday environments Accessible graphical user and Web-based interface design Postural and upper and lower extremity compensation, such as customized chairs and prostheses Global efforts in the area of robotics for autism research Virtual reality and other interfaces to mitigate motor, communication, and physical control difficulties Paedriatric rehabilitation engineering offers endless possibilities for future research with implications across the fields of physical and cognitive rehabilitation, medicine, computer science, and policy. It is the harmonizing of the expertise and energies of rehabilitation professionals such as teachers, families, paediatric rehabilitation engineers, and other stakeholders that will ensure that children are optimally supported as they embark on their journey from disability to possibility.

by A. Berthoz The publication of this volume, edited by Adriano Ferrari and Giovanni Cioni, is a major event for several reasons. Most importantly, it concerns an area of child pathology that has yet to be fully explored. In this context, the authors' efforts to compile their observations as well as those of other clinicians and to elaborate their theories have resulted in an ess- tial step in the field of cerebral palsy (CP). The originality of the book is its very clear focus, while at the same time the authors have encouraged the book's contributors to express their ideas and personal opinions. This leads sometimes to redundancy, but this is precisely one of the benefits of the book - cause the same problems are then exposed from different points of views. The reader is thus spared the normative attempts of many other pathology books, in which the compl- ity of a given disease is hidden by the authors' or editors' desire to impose a rigid taxo- my or epidemiology.

Providing content that is conveniently embedded within current school-based delivery models, this text delivers a workbook of effective, easily applied cognitive-behavioral counseling strategies focused on helping children and adolescents with common mental health issues. School-based practitioners will learn the nuts and bolts of applied practice for fostering meaningful student outcomes, especially related to improving their patterns of thought, behavior, and emotional regulation skills.The second edition adds value by offering new content on mindfulness interventions, acceptance and commitment therapy, habit reversal training, and behavioral activation. Step-by-step CBT applications are described in greater detail, and two additional case studies help readers to better grasp CBT techniques. Additional new features include enhanced coverage of culturally responsive CBT research, scholarship, and applied practice tips, along with 50 practical worksheets. The book is distinguished by its in-depth coverage of CBT counseling skills along with an enhanced session-ready application approach for delivering effective interventions in the K-12 context. It offers specific strategies and session sequence based on behavioral diagnosis, and it includes numerous counseling tools such as therapy worksheets, schematics of core concepts, and software apps for use in session or as homework. Also provided are tools for teaching core CBT concepts to children, worksheets to reinforce them, and parent handouts. New to the Second Edition: Provides new interventions such as mindfulness, acceptance and commitment therapy, habit reversal training, and behavioral activation Describes step-by-step CBT applications in greater detail for ease of understanding Includes two new case studies with detailed progress monitoring and therapy closure Translates current clinical CBT practice in depth for the school-based audience Offers enhanced coverage of culturally responsive CBT research, scholarship, and applied practice tips Includes 50 worksheets for use in planning, structuring and conducting therapy Reflects current gold-standard treatment protocol Key Features: Focuses specifically on counseling within K-12 school-based setting using multi-tiered systems of support Delivers proven support strategies for common mental health needs of children and youth Offers detailed guidance on case conceptualization, session planning, and therapy closure Includes CBT teaching diagrams and worksheet for counseling sessions including online content for customization Based on the DSM 5 and contextualizes services delivery within a MTSS model

Vitamin C holds a unique place in scientific and cultural history. In this book, a group of leading scientific researchers describe new insights into the myriad ways vitamin C is employed during normal physiological functioning. In addition, the text provides an extensive overview of the following: the rationale for utilizing vitamin C in the clinic, updates on recent uses of vitamin C in cancer treatment through high-dose intravenous therapies, the role vitamin C plays in the treatment of sepsis and infectious disease, management of the ways vitamin C can improve stem cell differentiation, as well as vitamin C use in other important health situations. Features Includes chapters from a team of leading international scholars Reviews the history and recent research on the functions, benefits, and uses of vitamin C Focuses special attention on the way vitamin C can be used in the treatment of cancers Discusses how vitamin C can be employed against infectious disease

Contemporary Perspectives is the first book to address social work practice in the field of brain injury (BI). Contributions are written by social work authors from around the world, and highlight the diversity of social work practice and theory within this field. Chapters range from practice spanning interventions with families caring for a child with BI; interventions to assist the adjustment of families facing the challenge of supporting an adult relative with BI during the inpatient rehabilitation or post-acute community phase; work with parents with BI who are caring for children deemed to be at risk; and a literature review outlining the impact of a BI on siblings. Other chapters detail a program for self-advocacy; investigate the impact of violence-related BI; evaluate a peer-support program for people with BI; report on the role of support people in facilitating return to work after BI; and examine the role of social work within the interdisciplinary rehabilitation team. The volume highlights the valuable role social work makes to the field of BI and contributes to the knowledge base informing evidence-informed practice within this field. This book was originally published as a special issue of the Journal of Social Work in Disability & Rehabilitation.

From a disadvantaged childhood to becoming one of our best-loved clinical neuropsychologists, this exceptional book tells the life story of Barbara A. Wilson, who has changed the way we think about brain injury rehabilitation. Barbara's story shows how it is possible to have a fulfilling career alongside a successful family life, even when faced with the deepest of personal tragedies; the death of her adult daughter Sarah. Clinical and neuropsychologists will recognise Barbara's influence on rehabilitation practice and her tireless aim to get what is best for people needing neuropsychological rehabilitation. It will inspire those with brain injury and their families who may struggle to make life meaningful, as well as encourage readers to stick to their beliefs and triumph in the face of obstacles.

Disorders of the Achilles tendon are universal, affecting people in a wide range of age groups. Because the Achilles tendon is one of the most pow- ful musculotendinous structures in the body, the impact of an injury to the Achilles tendon becomes magnified. There is a wide range of disorders or problems that can involve the insertional region, where pathology may rest with bone, tendon, or bursae. A completely different set of pathologic entities resides in the noninsertional region, one of which may include the frustrating degenerative tendinopathy. As our growing population ages but remains phy- cally active longer into life, the incidence of these disorders will continue to increase. I am proud to be given the opportunity to write the foreword to this text, which is intended for foot and ankle surgeons worldwide. Seldom does a book on a single entity become a current concepts review, as this work has. Too often, textbooks are not published for several years after the chapters have been written, making them obsolete upon publication. Not so with this book, which deals with timely topics on the Achilles tendon. Dr. James Nunley has compiled this work in slightly over a year, thus providing the reader with sta- of-the-art material. Dr. Nunley had the foresight to create a much needed techniques-oriented book dealing with the complexities of the Achilles tendon. His approach was to develop a comprehensive guide to managing Achilles tendon problems.

This core introductory text, with a focus on clinical application, combines the knowledge and skills of counseling psychology with current theory and research in grief and bereavement. The third edition is updated to address issues related to the developmental aspects of grief, including grief in children and young people, grief as a lifespan concept, and grief in an increasingly aging demographic. It describes new therapeutic approaches and examines the neurological basis of grief as well as with trauma from disruption and loss. Also emphasized is the role of diversity, along with cultural considerations in grief counseling. Instructor's resources now include a test bank, an Instructors Manual, and updated Power Point slides. User-friendly, while grounded in the latest research and theoretical constructs, the text offers such pedagogical aids as learning objectives, practice examples, glossary terms, and questions for reflection in each chapter. Above all, the book addresses grief counseling and support in a way that is informed, practical. The content explores concepts relevant to complicated grief, while differentiating the normal human experience of grief from mental disorders. Print version of the book includes free, searchable, digital access to entire contents! New to the Third Edition: Twenty-five percent of text contains completely new information Updated research and content on attachment and grieving styles Expansion of social issues impacting grief including political changes, environmental concerns, cultural differences, and exposure to terrorism New theory, research, and practice for grief in non-death losses New information on diversity and grief, the role of grounding and contemplative practices, and grief and developmental perspectives across the lifespan Use of technology in both professional and informal grief support New case studies with additional case scenarios for real-world application "Practice examples" containing snippets of clinical application information in each chapter Key Features: Focuses on clinical application Combines the knowledge and skills of counseling psychology with current theory and research in grief and bereavement Written in easy-to-understand language, with emphasis on practical application Includes learning objectives, practice examples, glossary terms, and questions for reflection

Examining the growth trend towards community rehabilitation in neurology, this book is directed towards all clinicians involved with neurorehabilitation. The study analyzes community rehabilitation needs from diverse international perspectives that include the views of disabled people, rehabilitation clinicians and service providers. Many examples of community rehabilitation plans are presented, and supplemental case studies highlight the main issues. Chapters also cover the disabled child in the community and neuropsychological rehabilitation.

Petty's Principles of Musculoskeletal Treatment and Management provides an up-to-date, evidence-based and person-centred guide to musculoskeletal practice. Edited by leading experts Kieran Barnard and Dionne Ryder, with contributions by highly regarded physiotherapists from across the UK, it provides a comprehensive overview of the principles underpinning physiotherapy for musculoskeletal conditions. It covers basic principles for treating muscles, nerves and joints, as well as anatomy and physiology, clinical reasoning and rehabilitation skills. This book is a companion to Petty's Musculoskeletal Examination and Assessment, and together both volumes cover everything students need to know to examine, assess and treat patients. Packed with reflective exercises, illustrations and case studies to bring learning to life Written with students in mind - easy to follow and understand Drawings and photographs to visually enhance descriptions in the text New chapters on serious pathology, vascular presentations and advancing clinical practice Expanded content on patient management Chapter summary podcasts New learning outcomes and reflective exercises throughout

This book examines the role of everyday technology throughout the life cycle in order to demonstrate the wide acceptance and impact of everyday technology and how it is facilitating both practitioners and patients in contemporary practices. In response, then, this text speaks to a number of audiences. Students writing for undergraduate and postgraduate dissertations/proposals will find the array of works insightful, supported with a vast number of references signposting to key texts. For academics, practitioners and prospective researchers this text offers key empirical and methodological insight that can help focus and uncover originality in their own field. We anticipate that readers will find the collection of empirical examples useful for informing their own work, but also, it attempts to ignite new discussions and arguments regarding the application and use of everyday technology for enhancing health internationally. Explores the multifaceted use and application of each 'everyday technology' that impact on diagnosis, treatment and management of individuals. Examines an array of everyday technologies and how these that can either enhance and/or hinder patient/service user outcomes i.e. handheld devices, computer workstations, gamification and artificial intelligence. Discusses technologies that are intended to facilitate patient diagnosis, practitioner-patient relations, within an array of health contexts. Provides readers with an overview with future direction of everyday technologies and its limitations.

To improve quality of life for cancer patients has been the endeavour of the author for the past 25 years in rehabilitation and palliation. This goal is the guiding theme through out the book. The book contains experiences of the author and specific instructions how to assess, treat, and evaluate rehabilitation and palliation in cancer patients.
To maintain quality of life is an important challenge not only for health aftercare service, but also in palliative and terminal situations The invasiveness of some of the current therapies and the restricted life expectancy of many patients led to the change in therapeutic paradigms. Rehabilitation and palliation have become an essential part of modern comprehensive cancer care. There are many excellent text books in cancer management which provide therapeutic recommendations thereby influencing the disease. However, this book focuses on improving well being of cancer patient versus curative measures.
Quality of life is now the second parameter after survival used to evaluate the effectiveness of first line oncologial therapies and is still the first parameter of most therapies in the case of recurrence. "How much therapy, and which one" not only requires oncological expertise. Ethical competence and communication skills are just as important. Under no circumstances should therapeutical decisions be made exclusively depending on response in terms of likelihood of remission; Goals such as reduction of physical symptoms, emotional stabilisation, and maintenance of daily activities are pre-eminent and are the focus of the book. This book contains experiences of the author and specific instructions how to assess, treat and evaluate rehabilitative and palliative measures.