This practical handbook allows nurses, advanced practice nurses, physician assistants, and allied health professionals practicing in the fields of neurosurgery, neurology, and spinal care to quickly review essentials while in the work environment. It emphasizes procedural steps and critical elements in patient management, including intensive care, the neurological examination, differential diagnoses, and pain management. Written by a multidisciplinary team of experts, the handbook is expected to become a well-worn companion and essential aid to the busy practitioner.

'Sensational' SUNDAY TIMES NO. BESTSELLER 'Extraordinary...both exhilarating and alarming...fascinating' DAILY MAIL 'Wonderful...a testament to the tenacity of the human spirit' FINANCIAL TIMES Henry Marsh has spent four decades operating on the human brain. In this searing and provocative memoir following his retirement from the NHS, he reflects on the experiences that have shaped his career and life, gaining a deeper understanding of what matters to us all in the end.

Most individuals with brain damage experience a curtailment or loss of lifestyle without rehabilitation. Improved methods and appropriately timed medical interventions now make it possible for more individuals to survive brain insults and to be assisted by rehabilitation neuropsychologists in achieving renewed commitment to life. Damage to the brain -- the organ of human emotions and cognition -- reduces psychological functioning and realistic adaptation, and the patient and his/her family are often encapsulated in the time prior to injury. To regain part or most of the lifestyle lost, an honest, dedicated, and realistic approach is required. Neuropsychological rehabilitation can provide tools for this task, provided that the most comprehensive, elaborate and knowledge-based methods are integrated in the training, and provided that knowledge from many disciplines and from community environments and family is encompassed.
In the present book knowledge representing the development of neuropsychological rehabilitation during the past five years is collected from a conference titled "Progress in Neuropsychological Rehabilitation." The chapters are written by professionals who were invited to share their experiences from different areas within the field because of their expertise with processes involved in neuropsychological rehabilitation. After a historical review, the chapters follow a visible sequence from biology to neuropsychology and neuropharmacology. Experts discuss the most advanced medical knowledge of the effect of injury on states of the organism. The second part of the book is dedicated to the outcome and the economics of rehabilitation as well as plans for the future. Finally, a panel discussion addresses the overall concept: Is rehabilitation worthwhile and ethical? The reactions -- influenced by the cross-cultural exchange of knowledge -- shed light on the essence and practice of today's neurorehabilitation.

Clinics in Developmental Medicine No. 163

Children with craniosynostosis are born with congenital deformities of the face and skull. In severe cases associated problems are common. The child who is not properly cared for can end up blind, deaf and with severe learning difficulties. In addition, they may be left with unacceptable facial deformities. Outside specialized craniofacial units, there is at present nowhere for those involved in primary or secondary care to go for help with the many practical problems that these children present. In this book, a distinguished team of editors have assembled experts in the field to introduce the non-craniofacial specialist to what can be achieved and how they can contribute to the child's welfare. It will be essential reading for paediatricians seeking practical information about the management of these disorders, and for specialists in neurosurgery, ENT, ophthalmology, plastic surgery, maxillo-facial surgery, orthodontics, psychology, genetics, anaesthesia, audiology and speech therapy.

This new edition reflects the explosion of knowledge in basic science and clinical care for athletes with mild traumatic brain injury or concussion. Interest in management and methodology for making diagnoses and improving the clinical outcomes have changed dramatically. All U.S. states have laws dictating how sports concussion patients are cared for and require return to play decisions be coordinated with best practice methods. Epidemiology, classification, and biology of sports concussion, as well as, brain imaging,assessment tests, neuropsychological measures, and management strategies are covered. Illustrative clinical cases, correlative examples, and historical insights are featured.

Detecting residual cognitive function in disorders of consciousness (M. R. COLEMAN, J. D. PICKARD).- Rationale for hypothalamus-deep brain stimulation in food intake disorders and obesity (N. TORRES, S. CHABARDEES, A. L. BENABID).- Gustatory and reward brain circuits in the control of food intake (A. J. OLIVEIRA-MAIA, C. D. ROBERTS, S. A. SIMON, M. A. L. NICOLELIS).- SEEG-guided RF-thermocoagulation of epileptic foci: A therapeutic alternative for drug-resistant non-operable partial epilepsies (M. GU NOT, J. ISNARD, H. CATENOIX, F. MAUGUIERE, M. SINDOU).- Child abuse some aspects for neurosurgeons (B. MADEA, M. NOEKER, I. FRANKE.- Prophylactic antibiotics and anticonvulsants in neurosurgery (B. RATILAL, C. SAMPAIO).- The dural sheath of the optic nerve: descriptive anatomy and surgical applications (P. FRANCOIS, E. LESCANNE, S. VELUT) -Surgical indications and techniques for failed coiled aneurysms (C. RAFTOPOULOS; with the collaboration of G. VAZ).

Widely regarded as the definitive reference in the field, Youmans and Winn Neurological Surgery offers unparalleled, multimedia coverage of the entirety of this complex specialty. Fully updated to reflect recent advances in the basic and clinical neurosciences, the 8th Edition covers everything you need to know about functional and restorative neurosurgery, deep brain stimulation, stem cell biology, radiological and nuclear imaging, and neuro-oncology, as well as minimally invasive surgeries in spine and peripheral nerve surgery, and endoscopic and other approaches for cranial procedures and cerebrovascular diseases. In four comprehensive volumes, Dr. H. Richard Winn and his expert team of editors and authors provide updated content, a significantly expanded video library, and hundreds of new video lectures that help you master new procedures, new technologies, and essential anatomic knowledge in neurosurgery. Discusses current topics such as diffusion tensor imaging, brain and spine robotic surgery, augmented reality as an aid in neurosurgery, AI and big data in neurosurgery, and neuroimaging in stereotactic functional neurosurgery. 55 new chapters provide cutting-edge information on Surgical Anatomy of the Spine, Precision Medicine in Neurosurgery, The Geriatric Patient, Neuroanesthesia During Pregnancy, Laser Interstitial Thermal Therapy for Epilepsy, Fetal Surgery for Myelomeningocele, Rehabilitation of Acute Spinal Cord Injury, Surgical Considerations for Patients with Polytrauma, Endovascular Approaches to Intracranial Aneurysms, and much more. Hundreds of all-new video lectures clarify key concepts in techniques, cases, and surgical management and evaluation. Notable lecture videos include multiple videos on Thalamotomy for Focal Hand Dystonia and a video to accompany a new chapter on the Basic Science of Brain Metastases. An extensive video library contains stunning anatomy videos and videos demonstrating intraoperative procedures with more than 800 videos in all. Each clinical section contains chapters on technology specific to a clinical area. Each section contains a chapter providing an overview from experienced Section Editors, including a report on ongoing controversies within that subspecialty. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

This practical handbook allows nurses, advanced practice nurses, physician assistants, and allied health professionals practicing in the fields of neurosurgery, neurology, and spinal care to quickly review essentials while in the work environment. It emphasizes procedural steps and critical elements in patient management, including intensive care, the neurological examination, differential diagnoses, and pain management. Written by a multidisciplinary team of experts, the handbook is expected to become a well-worn companion and essential aid to the busy practitioner.

Advances
J. Maarrawi, P. Mertens, R. Peyron, L. Garcia-Larrea, M. Sindou: Functional exploration for neuropathic pain. - Z. H. Rappaport: The neuroscientific foundations of free will. - A. Hejcl, P. Jendelova, E. Sykova: Experimental reconstruction of the injured spinal cord. - M. Visocchi: Advances in video-assisted anterior surgical approach to the craniovertebral junction.
Technical Standards
N. Akalan: Myelomeningocele (Open spina bifida): Surgical management. - M. Stoffel, C. St er, F. Ringel, B. Meyer: Treatment of infections of the spine. - I. Massimi, F. Novegno, C. di Rocco: Chiari Type 1 malformation in children.

Preoperative Events switches the focus from post-operative rehabilitation to preoperative experiences and personal histories to lessen the consequences of brain damage. These papers document the relationship between preoperative experience and postoperative performance and discuss a variety of protective preoperative experiences that can ameliorate the deleterious effects of brain damage.

Deep brain stimulation (DBS) is a widely used therapy for movement disorders such as Parkinson's disease, essential tremor, and dystonia. Its therapeutic success has led to the application of DBS for an increasing spectrum of conditions. However, the fundamental relationships between neural activation, neurochemical transmission, and clinical outcomes during DBS are not well understood. Drawing on the clinical and research expertise of the Mayo Clinic Neural Engineering Laboratories, this book addresses the history of therapeutic electrical stimulation of the brain, its current application and outcomes, and theories about its underlying mechanisms. It reviews research on measures of local stimulation-evoked neurochemical release, imaging research on stimulation-induced neural circuitry activation, and the state of the art on closed-loop feedback devices for stimulation delivery.

Every year, an estimated 1.7 million Americans sustain brain injury. Long-term disabilities impact nearly half of moderate brain injury survivors and nearly 50,000 of these cases result in death. Brain Neurotrauma: Molecular, Neuropsychological, and Rehabilitation Aspects provides a comprehensive and up-to-date account on the latest developments in the area of neurotrauma, including brain injury pathophysiology, biomarker research, experimental models of CNS injury, diagnostic methods, and neurotherapeutic interventions as well as neurorehabilitation strategies in the field of neurotraum research. The book includes several sections on neurotrauma mechanisms, biomarker discovery, neurocognitive/neurobehavioral deficits, and neurorehabilitation and treatment approaches. It also contains a section devoted to models of mild CNS injury, including blast and sport-related injuries. Over the last decade, the field of neurotrauma has witnessed significant advances, especially at the molecular, cellular, and behavioral levels. This progress is largely due to the introduction of novel techniques, as well as the development of new animal models of central nervous system (CNS) injury. This book, with its diverse coherent content, gives you insight into the diverse and heterogeneous aspects of CNS pathology and/or rehabilitation needs.

Advances and Technical Standards in Neurosurgery was conceived in 1972byitsfoundingfathersJeanBrihaye,BernardPertuiset,FritzLoew andHugoKrayenbuuhlatacombinedmeetingoftheItalianandGerman NeurosurgicalSocietiesinTaormina. Itwasdesignedtocomplementthe Europeanpost-graduatetrainingsystemforyoungneurosurgeonsandwas ?rst published in 1974 initially through sponsorship by the European AssociationofNeurosurgicalSocieties. Allcontributionshavebeenp- lishedinEnglishtofacilitateinternationalunderstanding. Theambitionofallsuccessiveeditorialboardshasbeentoprovidean opportunityformaturescholarshipandre?ection,notconstrainedbyar- ?ciallimitsonspace. Theseriesprovidesaremarkableaccountofprogress overthepast35years,bothwithregardtoadvances,detaileddescriptions of standard operative procedures and in- depth reviews of established knowledge. Thepresentvolumeisnoexceptionandshouldappealtoboth experiencedneurosurgeonsandyoungneurosurgeonsintrainingalike. TheEditors Contents Listofcontributors...XIII Advances Present and potential future adjuvant issues in high-grade astrocytic glioma 1,2 1 1 2 1 treatment. F. LEFRANC ,M. RYNKOWSKI,O. DEWITTE,andR. KISS, Department ofNeurosurgery,ErasmeUniversityHospital,FreeUniversityofBrussels(U. L. B. ), 2 Brussels,Belgium, LaboratoryofToxicology,InstituteofPharmacy,FreeUniversity ofBrussels(U. L. B. ),Brussels,Belgium Abstract...4 Introduction...5 Naturalresistanceofmigratingmalignantgliomacellstoapoptosis (radiotherapyandchemotherapy)...6 Patternsofcelldeath...8 Autophagy:apotentialTrojanhorseformalignantgliomas...11 Therapeuticbene?tsoftemozolomide...13 Localtherapiesforglioblastomas...15 Ongoingclinicaltrialsforglioblastomas...16 Growthfactorreceptorinhibitors ...17 PI3K=Akt,mTORandNF- Binhibitors...17 Matrixmetalloproteinase(MMP)inhibitors(MMPI)...18 Angiogenesistargeting ...19 Cellularandvaccinationtherapies...20 Genetherapy...20 Reducingmalignantgliomacellmotilityinordertorestore pro-apoptoticdrugsensitivity...20 Thesodiumpumpconstitutesapotentialtargettocombat malignantgliomas...21 Thesodiumpump...22 Cardiotonicsteroids:ligandsofthesodiumpump...24 VIII Contents Thesodiumpumpisinvolvedincancercellproliferation, migrationanddeath...24 Braintumorstemcellsapotentialtargettocombatmalignantgliomas...26 Conclusions...27 References...2 8 Deepbrainstimulationforpsychiatricdisorders-stateoftheart. T. E. SCHLA APFER and B. H. BEWERNICK, Brain Stimulation Group, Department of Psychiatry and Psychotherapy,UniversityHospitalBonn,GermanyandDepartmentsofPsychiatry andMentalHealth,TheJohnsHopkinsUniversity,MD,USA Abstract...37 Introduction...38 Historyofdeepbrainstimulation...39 PrinciplesofDBS...40 NeurobiologyofdepressionandOCD...41 Neurobiologyofdepression...41 NeurobiologyofOCD...42 StudiesofDBSandpsychiatricdisorders...43 Problemsintargetselection...43 Targetsindepression...43 TargetsinOCD ...46 SafetyandadvantagesofDBS...47 EthicalaspectsandstandardsinDBS...51 Ethicalconsiderations...51 ThepathtowardsmandatorystandardsforDBSinpsychiatricdisorders...52 Conclusions...53 ThefutureofDBS...54 References...54 Standards High?owextracranialtointracranialvascularbypassprocedureforgiantan- rysms:indications,surgicaltechnique,complicationsandoutcome. H. C. PATEL and P. J. KIRKPATRICK, Department of Academic Neurosurgery, Addenbrooke's Hospital,UniversityofCambridge,Cambridge,UK Abstract...61 Introduction...62 Surgicaltechnique...67 Cranialexposure...69 Cervicalexposure...70 Saphenousveinexposure...71 Preauriculartunnel...7 2 Contents IX Anastamoses...73 Distalanastamosis...73 Externalcarotidanastamosis...74 Closureandpostoperativecare...77 Discussion...77 Comparisonofoutcomes...77 Choosingthetypeofgraft...78 Longtermpatencyofgrafts...79 Ischaemiccomplications...79 Anticoagulationrelatedmorbidity...81 Conclusion...

An easy to follow step-by-step guide to the most useful surgical skills from knot tying to simple procedures. Illustrated with colour photographs and video clips to demonstrate techniques, this book makes these practical skills as clear and easy to follow as possible. Including coverage of surgical instruments, wound management and suturing, and minor surgical procedures, it also explains how to use these essential surgical skills to make the most of a surgical placement. Healthcare students or junior professionals undertaking a placement in surgery or emergency medicine will feel confident and capable, and will be able to take an active role in surgical placements. Learning basic surgical skills is important for such placements, as well as for undertaking exams such as the Membership of the Royal College of Surgeons (MRCS).

This is truly an exciting time in the field of neuro-oncology, particularly in the area of hi- grade gliomas. The management of patients with high-grade gliomas has historically been one of the most challenging and disheartening fields in medicine, where failure is the rule and longevity is the exception. The jaded often state that despite purported advances in surgical and radiotherapeutic techniques and a myriad of clinical trials of medical therapies, the s- vival statistics for glioblastoma have not changed in the last three decades. The nihilism associated with these tumors is such that some practitioners still advise against treatment or even biopsy, recommending palliative care with the diagnosis based only on history and an MRI scan. If the current state-of-the-art in the diagnosis and management of high-grade gliomas was truly so bleak, there would be no reason to compile and publish a monograph on the subject. The fact is that we have recently entered an era where real progress is being made in our understanding and treatment of high-grade gliomas that is directly benefiting some patients. We are slowly but surely chipping away at this problem. One approach has exploited correlations between particular molecular markers and therapeutic response. The first such "breakthrough" in high-grade glioma was the observation that loss of chromosomes 1p and 19q uniformly predict chemosensitivity in anaplastic oligodendrogliomas (1).

This book represents the first interdisciplinary text on the emerging field of rehabilitative surgery, in which state of the art procedures from multiple surgical specialties are combined. It proposes a completely new framework for understanding, coordinating, and providing treatment for paralyzed or severely neurologically impaired patients and explains the potentially critical impact of surgery in creating a new baseline of functional status, thereby improving the patient's daily life. Every major aspect of reconstructive surgical treatment is considered, including anesthesia, orthopedic surgery, plastic surgery, neurosurgery, general surgery, vascular surgery, and otolaryngology. The most up-to-date and evidence-based surgeries are clearly described and evaluated, with coverage of treatment of pressure sores, placement of feeding tubes, and upper extremity interventions to improve function and hygiene. Cutting-edge protocols are presented for the surgical treatment of severe nerve injuries, spinal cord injuries, and stroke or cerebrovascular accidents, and a first description and evaluation of phrenic nerve repair to assist weaning of paralyzed patients from ventilators is provided. Both surgical and nonsurgical readers will find this book to be an ideal guide and reference.

Implement TMR with Your Patients and Improve Their Quality of Life

Developed by Dr. Todd A. Kuiken and Dr. Gregory A. Dumanian, targeted muscle reinnervation (TMR) is a new approach to accessing motor control signals from peripheral nerves after amputation and providing sensory feedback to prosthesis users. This practical approach has many advantages over other neural-machine interfaces for the improved control of artificial limbs. Targeted Muscle Reinnervation: A Neural Interface for Artificial Limbs provides a template for the clinical implementation of TMR and a resource for further research in this new area of science.

After describing the basic scientific concepts and key principles underlying TMR, the book presents surgical approaches to transhumeral and shoulder disarticulation amputations. It explores the possible role of TMR in the prevention and treatment of end-neuromas and details the principles of rehabilitation, prosthetic fitting, and occupational therapy for TMR patients. The book also describes transfer sensation and discusses the surgical and functional outcomes of the first several TMR patients. It concludes with emerging research on using TMR to further improve the function and quality of life for people with limb loss.

With contributions from renowned leaders in the field, including Drs. Kuiken and Dumanian, this book is a useful guide to implementing TMR in patients with high-level upper limb amputations. It also supplies the foundation to enable improvements in TMR techniques and advances in prosthetic technology.

Contemporary spinal surgeons, whether orthopedic or neurosurgeons, are increasingly recognizing minimally invasive spine surgery (MISS) as a valuable option for managing advanced degenerative diseases. MISS techniques minimize blood loss and surgical site pain, while speeding recovery. Thus, the combination of MISS with adult spinal deformity was a natural choice. Currently, the techniques, technologies, and education of surgeons have finally reached a point where MISS deformity surgeries are becoming commonplace. Nevertheless, the field is young enough (and still evolving) that no comprehensive texts have addressed the unique challenges it poses for surgeons. This book fills that gap.

Up to date and evidence-based answers to a wide range of spinal surgical questions that could be asked in the FRCS (Tr & Orth) Viva exam. Using a clear, case-based structure key points emphasise the core information that will improve the performance of every surgical in training. Sections cover all the key areas of Trauma, Degenerative spinal pathology, Spinal cord injury, Spinal deformity, Primary bone tumours, Metastatic disease, Paediatric spinal surgery, Basic sciences, and other topics. Suitable for use by trainees at all levels in orthopaedic surgery and neurosurgery, both in the UK and internationally, and those with an interest in spinal surgery.

Kumar and colleagues' Neurocritical Care Management of the Neurosurgical Patient provides the reader with thorough coverage of neuroanatomical structures, operative surgical approaches, anesthetic considerations, as well as the full range of known complications relating to elective and non-elective neurosurgical procedures. Drawing upon the expertise of an interdisciplinary team of physicians from neurosurgery, neurology, anesthesiology, critical care, and nursing backgrounds, the text covers all aspects intensivists need to be aware of in order to provide optimal patient care. Expert Consult eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, images, and references from the book on a variety of devices. Over 100 world-renowned authors from multispecialty backgrounds (neurosurgeons, neuro-interventionalists, and neurointensivists) and top institutions contribute their unique perspectives to this challenging field. Six sections cover topics such as intraoperative monitoring, craniotomy procedures, neuroanesthesiology principles, spine and endovascular neurosurgery, and additional specialty procedures. Includes 300 tables and boxes, 70 line artworks, and 350 photographic images. Clinical pearls pulled out of the main text offer easy reference.

Offering in-depth coverage of an often-neglected topic, Revision Lumbar Spine Surgery identifies clinical problems and discusses recent major advances in this challenging area. Dr. Robert F. Heary and a team of international experts share their knowledge and experience with even the most difficult lumbar cases, helping you provide optimal outcomes for your patients. You'll find authoritative guidance on indications, diagnosis, approaches, and follow-up, with a focus on the significant advances that have occurred over the past two decades in this fast-changing field. Identifies the clinical problems related to unsuccessful back spine surgery as well as indications, diagnosis, and new treatment options and advances in this complex area. Provides in-depth information on the multiple options that exist for most clinical situations: anterior, posterior, lateral, and combined anterior and posterior approaches. Covers methods of fixation, the use of interbody grafting, and surgical planning related to scar tissues, bleeding, and spinal fluid leaks. Discusses critical follow-up topics such as key clinical procedures, radiography, patient reported outcomes, and pain management. Includes timely chapters on robotics, bone density issues, medical fitness concerns, instrumentation options, imaging considerations, and much more. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

A thorough review of the surgical procedures and technologies currently available for the treatment of various movement disorders, this guide illustrates strategies for the management of conditions such as Parkinson's disease, essential tremor, dystonia, Tourette's syndrome, hemifacial spasm, and cerebral palsy-emphasizing surgical indications and outcomes, as well as methods of complication prevention and avoidance.

Get a fair and balanced perspective on schizophrenia!
Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice is a comprehensive overview of schizophrenia and its treatment from a variety of approaches. The book presents a balanced look at the most influential theoretical perspectives based on empirical research, clinical descriptions, and narrative histories. Dr. Glenn Shean, author of "Schizophrenia: An Introduction to Research and Theory," examines neurocognitive and neurodevelopmental models of brain dysfunction, psychodynamic and family factors, up-to-date pharmacological advances, and successful community programs for discharged patients suffering from this debilitating disorder.
Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice presents a comprehensive review of evidence concerning the epidemiology and course and outcome of schizophrenia based on theoretical groupings and levels of analysis. The book examines the evolution of diagnostic criteria and guidelines, as well as stress-vulnerability and diathesis-stress models, providing critical reviews of biological, genetic, cognitive-behavioral, and phenomenological, approach to understanding and treating schizophrenia.
Topics addressed in Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice include: the history of the concept of schizophrenia the writings of Emil Kraepelin and Eugene Bleuler changes in diagnostic guidelines in the last 50 years General System Theory Perspective diagnostic and statistical manuals Schneider's first rank symptoms and much more! Understanding and Treating Schizophrenia: ContemporaryResearch, Theory, and Practice is an essential resource for undergraduate and graduate students working in psychology, psychiatry, nursing, social work, and social policy.

Get a fair and balanced perspective on schizophrenia!
Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice is a comprehensive overview of schizophrenia and its treatment from a variety of approaches. The book presents a balanced look at the most influential theoretical perspectives based on empirical research, clinical descriptions, and narrative histories. Dr. Glenn Shean, author of "Schizophrenia: An Introduction to Research and Theory," examines neurocognitive and neurodevelopmental models of brain dysfunction, psychodynamic and family factors, up-to-date pharmacological advances, and successful community programs for discharged patients suffering from this debilitating disorder.
Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice presents a comprehensive review of evidence concerning the epidemiology and course and outcome of schizophrenia based on theoretical groupings and levels of analysis. The book examines the evolution of diagnostic criteria and guidelines, as well as stress-vulnerability and diathesis-stress models, providing critical reviews of biological, genetic, cognitive-behavioral, and phenomenological, approach to understanding and treating schizophrenia.
Topics addressed in Understanding and Treating Schizophrenia: Contemporary Research, Theory, and Practice include: the history of the concept of schizophrenia the writings of Emil Kraepelin and Eugene Bleuler changes in diagnostic guidelines in the last 50 years General System Theory Perspective diagnostic and statistical manuals Schneider's first rank symptoms and much more! Understanding and Treating Schizophrenia: ContemporaryResearch, Theory, and Practice is an essential resource for undergraduate and graduate students working in psychology, psychiatry, nursing, social work, and social policy.