1
|
Galindo-Aldana G, Torres-González C. Neuropsychology and Electroencephalography in Rural Children at Neurodevelopmental Risk: A Scoping Review. Pediatr Rep 2023; 15:722-740. [PMID: 38133433 PMCID: PMC10747224 DOI: 10.3390/pediatric15040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/03/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
Children from rural areas face numerous possibilities of neurodevelopmental conditions that may compromise their well-being and optimal development. Neuropsychology and electroencephalography (EEG) have shown strong agreement in detecting correlations between these two variables and suggest an association with specific environmental and social risk factors. The present scoping review aims to describe studies reporting associations between EEG features and cognitive impairment in children from rural or vulnerable environments and describe the main risk factors influencing EEG abnormalities in these children. The method for this purpose was based on a string-based review from PubMed, EBSCOhost, and Web of Science, following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA). Qualitative and quantitative analyses were conducted from the outcomes that complied with the selected criteria. In total, 2280 records were identified; however, only 26 were eligible: 15 for qualitative and 11 for quantitative analysis. The findings highlight the significant literature on EEG and its relationship with cognitive impairment from studies in children with epilepsy and malnutrition. In general, there is evidence for the advantages of implementing EEG diagnosis and research techniques in children living under risk conditions. Specific associations between particular EEG features and cognitive impairment are described in the reviewed literature in children. Further research is needed to better describe and integrate the state of the art regarding EEG feature extraction.
Collapse
Affiliation(s)
- Gilberto Galindo-Aldana
- Laboratory of Neuroscience and Cognition, Mental Health, Profession, and Society Research Group, Autonomous University of Baja California, Hwy. 3, Col. Gutierrez, Mexicali 21725, Mexico;
| | | |
Collapse
|
2
|
Bush SS, Dutt A, Fernández AL, Łojek E, McDonald S, Schrieff-Brown L. Ethical issues in clinical neuropsychology: International diversity perspectives. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-17. [PMID: 37972552 DOI: 10.1080/23279095.2023.2278153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
OBJECTIVE Much of the information about the ethical practice of clinical neuropsychology has focused on North America. Additionally, of the scholarly publications on the intersection of ethical issues and cultural diversity practices in neuropsychology, most have focused on North America. The extent to which practitioners in other parts of the world are aware of, and find useful, such information is largely unknown. Similarly, the extent to which North American neuropsychologists are familiar with ethical issues and challenges encountered around the world is unknown. The purpose of this article is to advance the discussion of ethical issues in clinical neuropsychology from an international diversity perspective. METHOD The article presents, via a panel interview format, the thoughts and experiences of a small sample of neuropsychologists who represent all continents except North America (and Antarctica). RESULTS Neuropsychologists across continents share an ethical commitment to providing services that are beneficial, and not harmful, to the recipients of the services. Professional competence is at the heart of such services. CONCLUSIONS Through continued and expanded dialogue about ethical issues with neuropsychology colleagues around the world, the potential exists for improvement in the provision of effective and compassionate care in our own towns.
Collapse
Affiliation(s)
- Shane S Bush
- Department of Psychology, University of Alabama, Tuscaloosa, AL, USA
- Long Island Neuropsychology, Lake Ronkonkoma, NY, USA
| | - Aparna Dutt
- Neuropsychology & Clinical Psychology Unit, Duttanagar Mental Health Centre, Kolkata, India
| | - Alberto Luis Fernández
- Universidad Católica de Córdoba, Córdoba, Argentina
- Universidad Nacional de Córdoba, Córdoba, Argentina
| | - Emilia Łojek
- Faculty of Psychology, Head of the Neuropsychological Section Polish Psychological Association, Vice-Dean for Research, University of Warsaw, Warsaw, Poland
| | | | | |
Collapse
|
3
|
Salvadori E, Pantoni L. Teleneuropsychology for vascular cognitive impairment: Which tools do we have? CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 5:100173. [PMID: 37457663 PMCID: PMC10299844 DOI: 10.1016/j.cccb.2023.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 06/14/2023] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
The halt of clinical activities imposed during the COVID-19 pandemic forced clinicians to find alternative strategies to provide continuity of care and services, and led to a renewed interest in use of teleneuropsychology (TNP) to remotely assess patients. Recent TNP guidelines recommend maximizing the reproduction of standard in-person assessment, particularly through videoconferences. However, consistency of the adaptations of usual cognitive tests to videoconference needs further elucidation. This review aims at critical reviewing which cognitive tests could be recommended for a remote evaluation of patients with vascular cognitive impairment (VCI) among those widely recognized as reference standards. Current evidence supports the use of global cognitive efficiency (MMSE and MoCA), verbal memory (Revised Hopkins Verbal Learning Test), and language tests (phonemic and semantic verbal fluencies, Boston Naming Test), while there is a lack of strong validity support for measures of visuospatial functions (Rey-Osterreith Complex Figure), and executive functioning and processing speed (Trail making Test, and Digit symbol or Symbol digit tests). This represents a major limitation in the evaluation of VCI because its cognitive profile in often characterized by attention and executive deficits. At present, a videoconference TNP visit appears useful for a brief evaluation of global cognitive efficiency, and to 'triage' patients towards a second level in person evaluation. In future, hybrid models of TNP based on data collected across multiple modalities, incorporating both adaptation of usual cognitive tools and new computerized tools in the supervised videoconference setting, are likely to become the best option for a comprehensive remote cognitive assessment.
Collapse
Affiliation(s)
- Emilia Salvadori
- NEUROFARBA Department, Neuroscience Section, University of Florence, Florence, Italy
| | - Leonardo Pantoni
- Neuroscience Research Center, Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | | |
Collapse
|
4
|
Wilson S, Milanini B, Javandel S, Nyamayaro P, Valcour V. Validity of Digital Assessments in Screening for HIV-Related Cognitive Impairment: a Review. Curr HIV/AIDS Rep 2021; 18:581-592. [PMID: 34820750 PMCID: PMC8612826 DOI: 10.1007/s11904-021-00585-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 10/31/2022]
Abstract
PURPOSE OF REVIEW While traditional neuropsychological tests are the gold standard in screening for HIV-related cognitive impairment, computerized neuropsychological assessment devices (CNADs) offer an alternative to these time- and resource-intensive batteries and may prove to be particularly useful for remote assessments or longitudinal monitoring. This review seeks to describe the benefits, limitations, and validity of CNADs in the evaluation of HIV-associated neurocognitive disorder (HAND). RECENT FINDINGS We identified eight CNADs that have undergone validity testing for cognitive impairment in the setting of HIV. Included among these are batteries that have been modeled after the traditional neuropsychological exam, as well as others that implement new technologies, such as simulated reality and daily ecological assessments in their testing. Currently, these digital batteries do not yet have the ability to supplant gold standard neuropsychological tests in screening for HAND. However, many have the potential to become effective clinical screening tools.
Collapse
Affiliation(s)
- Samuel Wilson
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
| | - Shireen Javandel
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
| | - Primrose Nyamayaro
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA
- Faculty of Medicine and Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | - Victor Valcour
- Memory and Aging Center, Department of Neurology, University of California, San Francisco, 675 Nelson Rising Lane, Suite 190, San Francisco, CA, 94158, USA.
- Global Brain Health Institute, University of California, San Francisco, San Francisco, CA, USA.
| |
Collapse
|
5
|
Lawson DW, Stolwyk RJ, Ponsford JL, Wong D. Evaluating telehealth delivery of a compensatory memory rehabilitation programme following stroke: A single-case experimental design. Neuropsychol Rehabil 2021; 32:897-921. [PMID: 33678132 DOI: 10.1080/09602011.2020.1843500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Rehabilitation of memory remains an unmet need for many stroke survivors. Telehealth methods may provide a solution, however evidence supporting the efficacy of remotely-delivered therapy is needed. A non-concurrent multiple baseline design was used with randomized onset of intervention across five individuals with chronic stroke-related memory complaints. A six-week compensatory memory skills programme was delivered individually via internet videoconferencing. Target behaviours of frequencies of self-reported lapses of everyday and prospective memory were measured weekly across baseline, intervention, and follow-up phases. A secondary outcome of functional goal attainment was measured once per phase, with participants setting two personal rehabilitation goals. Data were analysed visually and statistically. Improvements in memory functioning were statistically significant on at least one measure of target behaviour for four out of five participants at intervention or follow-up. Visual evidence of level change indicated at least modest improvements for all participants by follow-up. All participants attained at least one functional goal by follow-up. High rates of treatment adherence and participant satisfaction were observed. Technological issues were minimal and did not impact content delivery or engagement. These results provide preliminary support for the efficacy of a telehealth-delivered rehabilitation programme in improving memory function and achieving memory-related goals for stroke survivors.
Collapse
Affiliation(s)
- David W Lawson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Dana Wong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| |
Collapse
|
6
|
Allott K, Brewer W, Mcgorry PD, Proffitt T. Referrers' Perceived Utility and Outcomes of Clinical Neuropsychological Assessment in an Adolescent and Young Adult Public Mental Health Service. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2010.00002.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- Kelly Allott
- Orygen Youth Health Research Centre, Centre for Youth Mental Health
| | - Warrick Brewer
- Orygen Youth Health Research Centre, Centre for Youth Mental Health
| | | | - Tina‐marie Proffitt
- Orygen Youth Health Research Centre, Centre for Youth Mental Health
- Department of Psychology, The University of Melbourne, Parkville, Melbourne
- School of Psychology and Psychiatry, Monash University, Clayton, Victoria, Australia
| |
Collapse
|
7
|
Lawson DW, Stolwyk RJ, Ponsford JL, Baker KS, Tran J, Wong D. Acceptability of telehealth in post-stroke memory rehabilitation: A qualitative analysis. Neuropsychol Rehabil 2020; 32:1-21. [PMID: 32677539 DOI: 10.1080/09602011.2020.1792318] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Despite evidence of the efficacy of telerehabilitation post-stroke, uptake has lagged behind the development of available technology, slowed by low confidence in user experience. We aimed to explore the issue of acceptability by characterizing the experience of telerehabilitation for service providers and consumers of a memory rehabilitation program. Semi-structured interviews were conducted with nine clinicians (Mage = 33.29; SD = 7.37; range 25-44) and 25 stroke survivors with memory difficulties (Mage = 54.12; SD = 10.99; range 36-82) following a 6-week compensatory memory skills program delivered via in-home videoconferencing. Thematic analysis identified a range of perspectives under three overarching themes: (1) Content and Delivery; (2) Relationship and Connection; and (3) The Role and Benefits of Telerehabilitation. Reports from both respondent groups were overwhelmingly positive about the telerehabilitation experience and identified the benefits of increasing service availability. Videoconferencing technology was usable and occasional reliability issues were not a barrier. Users identified a range of benefits and challenges regarding communication, rapport building, and integration of rehabilitation in the home environment. Furthermore, most stroke survivors reported benefit from the intervention, via the acquisition of memory strategies and improved self-confidence through better understanding of their deficits. Overall, telerehabilitation of memory was acceptable to users.
Collapse
Affiliation(s)
- David W Lawson
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Jennie L Ponsford
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Katharine S Baker
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Joanna Tran
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| | - Dana Wong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.,School of Psychology and Public Health, La Trobe University, Melbourne, Australia.,Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Australia
| |
Collapse
|
8
|
Abstract
OBJECTIVE Rehabilitation of memory after stroke remains an unmet need. Telehealth delivery may overcome barriers to accessing rehabilitation services. METHOD We conducted a non-randomized intervention trial to investigate feasibility and effectiveness of individual telehealth (internet videoconferencing) and face-to-face delivery methods for a six-week compensatory memory rehabilitation program. Supplementary analyses investigated non-inferiority to an existing group-based intervention, and the role of booster sessions in maintaining functional gains. The primary outcome measure was functional attainment of participants' goals. Secondary measures included subjective reports of lapses in everyday memory and prospective memory, reported use of internal and external memory strategies, and objective measures of memory functioning. RESULTS Forty-six stroke survivors were allocated to telehealth and face-to-face intervention delivery conditions. Feasibility of delivery methods was supported, and participants in both conditions demonstrated treatment-related improvements in goal attainment, and key subjective outcomes of everyday memory, and prospective memory. Gains on these measures were maintained at six-week follow-up. Short-term gains in use of internal strategies were also seen. Non-inferiority to group-based delivery was established only on the primary measure for the telehealth delivery condition. Booster sessions were associated with greater maintenance of gains on subjective measures of everyday memory and prospective memory. CONCLUSIONS This exploratory study supports the feasibility and potential effectiveness of telehealth options for remote delivery of compensatory memory skills training after a stroke. These results are also encouraging of a role for booster sessions in prolonging functional gains over time.
Collapse
|
9
|
Delagneau G, Bowden SC, van-der-El K, Bryce S, Hamilton M, Adams S, Burgat L, Killackey E, Rickwood D, Allott K. Perceived need for neuropsychological assessment according to geographic location: A survey of Australian youth mental health clinicians. APPLIED NEUROPSYCHOLOGY-CHILD 2019; 10:123-132. [PMID: 31303056 DOI: 10.1080/21622965.2019.1624170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Recent studies have shown that neuropsychological assessment is a scarce resource in youth mental health settings. The need for neuropsychological assessment might differ in metropolitan and nonmetropolitan areas due to characteristics inherent to these different regions. However, no formal studies have investigated this question. The aim of this research was to investigate whether need for neuropsychological assessment in youth mental health settings varies by geographic location. A cross-sectional online survey was completed by clinicians (N = 532) treating or assessing adolescents and young adults attending Australian primary care mental health (headspace) centers. Results indicated a similar need for neuropsychological assessment across the geographic areas. However, neuropsychological assessment was significantly less available to clients in outer regional, remote and very remote areas compared to major cities. Exploratory analyses further revealed that there were significantly fewer clinicians with a postgraduate degree and more clinicians with a bachelor degree in outer regional, remote and very remote areas than in major cities. Given the negative impact of cognitive impairments in youth with a mental illness, these findings reveal a necessity to enhance the availability and access to neuropsychological assessment in rural settings. Several plausible avenues to achieving increased access include increasing the funding available for this resource; providing nonmetropolitan clinicians with sufficient neuropsychological consultation, including rural training and rotations in neuropsychologists' postgraduate training; and exploring the use of tele-health in the provision of neuropsychological assessments in nonmetropolitan settings.
Collapse
Affiliation(s)
- Garance Delagneau
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Stephen C Bowden
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Australia
| | - Kristi van-der-El
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Shayden Bryce
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Matthew Hamilton
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Sophie Adams
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia.,Orygen Youth Health, Parkville, Australia
| | - Liz Burgat
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Eoin Killackey
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Debra Rickwood
- Headspace National Youth Mental Health Foundation, Melbourne, Australia.,Faculty of Health, University of Canberra, ACT, Australia
| | - Kelly Allott
- Orygen, The National centre of Excellence in Youth Mental Health, Parkville, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| |
Collapse
|
10
|
Abstract
AIM To re-examine and expand understanding of the concept 'lack of anonymity' as a component of rural nursing theory. BACKGROUND Early healthcare literature reports lack of anonymity as part of social and working environments, particularly rural nursing. Rural nursing theory included the first published concept analysis on lack of anonymity but lacked empirical referents. Workforce, societal and rural healthcare changes support an updated analysis. To further understand lack of anonymity, its present day use and applicability to diverse environments, research from multiple disciplines was reviewed. DESIGN Concept analysis. DATA SOURCES A literature search using eight terms in eleven databases was conducted of literature published between 2008-2013. METHOD Walker and Avant's concept analysis methodology guided the analysis. RESULTS The previous concept analysis is supported in part by current literature. The defining attributes, 'identifiable', 'establishing boundaries for public and private self and interconnectedness' in a community were updated. Updated antecedents include: (i) environmental context; (ii) opportunities to become visible; (iii) developing relationships and (iv) unconscious or limited awareness of public or personal privacy. Consequences are: (i) familiarity; (ii) visibility; (iii) awareness of privacy and (iv) manage or balance of lack of anonymity. Cases were constructed and empirical referents identified. CONCLUSION The concept of lack of anonymity was updated; portions of the original definition remain unchanged. Empirical referents reveal the defining attributes in daily life and may guide future research on the effect of lack of anonymity on nursing practice. This analysis advances the conceptual understanding of rural nursing theory.
Collapse
Affiliation(s)
- Marilyn A Swan
- School of Nursing, Minnesota State University, Mankato, MN, USA
| | - Barbara B Hobbs
- College of Nursing, South Dakota State University, Rapid City, SD, USA
| |
Collapse
|
11
|
Tussey CM, Marcopulos BA, Bush SS. Evolving Roles, Innovative Practice, and Rapid Technology Growth: Remaining Ethical in Modern Clinical Neuropsychology. PSYCHOLOGICAL INJURY & LAW 2015. [DOI: 10.1007/s12207-015-9240-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
|
12
|
Panyavin IS, Goldberg-Looney LD, Rivera D, Perrin PB, Arango-Lasprilla JC. Perception of Ethical Misconduct by Neuropsychology Professionals in Latin America. Arch Clin Neuropsychol 2015; 30:413-23. [DOI: 10.1093/arclin/acv026] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/02/2015] [Indexed: 11/13/2022] Open
|
13
|
Turner TH, Horner MD, VanKirk KK, Myrick H, Tuerk PW. A Pilot Trial of Neuropsychological Evaluations Conducted via Telemedicine in the Veterans Health Administration. Telemed J E Health 2012; 18:662-7. [DOI: 10.1089/tmj.2011.0272] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- Travis H. Turner
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
- Division of Neurology, Department of Neurosciences, Medical University of South Carolina, Charleston, South Carolina
| | - Michael D. Horner
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Kathryn K. VanKirk
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Hugh Myrick
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| | - Peter W. Tuerk
- Mental Health Service Line, Ralph H. Johnson Department of Veterans Affairs Medical Center, Charleston, South Carolina
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina
| |
Collapse
|
14
|
Osborn A. Juggling personal life and professionalism: Ethical implications for rural school psychologists. PSYCHOLOGY IN THE SCHOOLS 2012. [DOI: 10.1002/pits.21642] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|