2023 Convention Program

DAY AT-A-GLANCE

 

7:45 AM - 8:45 AM

Breakfast

 

8:45 AM - 10:00 AM

Program Sessions

Addressing Community Violence
Speaker: James Dean, PhD 

When Police Involved Interactions Become Deadly for People of Color: A Look at Police Training and Practices in the United States Versus Other Countries 
Speakers: Vaschele L. Williams, PsyD; Kayla Nelson, PsyD; Carolyn Springer, PhD 

 

9:45 AM - 10:45 AM

Coffee break

 

10:30 AM - 11:15 AM

PAPER PRESENTATION

 

10:30 AM - 11:45 AM

PROGRAM SESSIONS

 

11:45 AM - 12:15 PM

lunch

 

12:15 PM - 1:30 PM

Keynote Presentation

 

1:30 PM - 5:30 PM

FREE TIME

 

5:30 PM - 6:30 PM

Exhibitor Reception

 

6:30 PM - 8:30 PM

NYSPA Awards Banquet

 

8:30 PM - 10:30 PM

NYSPA AWARDS Afterparty

 

---

FULL PROGRAM DESCRIPTIONS

 

8:45 AM - 10:00 AM

Addressing Community Violence
Speaker: James Dean, PhD

Description

The rise of deaths in the area of law enforcement is prompting a renewed discussion of how to best to address violence in low-income communities. This presentation will review systemic failures in police departments. Alternatives to addressing crime in especially economically disadvantaged areas will be examined.

Objectives

Participants will be able to:

· Identify systemic failures in addressing crime.

· Identify factors contributing to crime.

· Identify community interventions to decrease crime.

8:45 AM - 10:00 AM

When Police Involved Interactions Become Deadly for People of Color: A Look at Police Training and Practices in the United States Versus Other Countries
Speakers: Vaschele L. Williams, PsyD; Kayla Nelson, PsyD; Carolyn Springer, PhD

Description

Despite the public outcry and demand for police reform in recent years, there continues to be a high incidence of people of color who are seriously injured or killed during police involved interactions. This symposium will examine police practices that result in civilian deaths, particularly among people of color during police encounters. This symposium will also compare training procedures, best practices, and disciplinary actions of police departments within the United States compared to practices in other countries.

In addition, this symposium will raise awareness of the trauma and other mental health issues people of color experience following repeatedly witnessing the serious injury or death of individuals during interactions with police officers whether directly or indirectly (e.g. in the news and social media outlets).

Objectives

Participants will be able to:

· Raise awareness of the ongoing high incidence in which people of color continue to become seriously injured or killed during police involved interactions

· Discuss the trauma and other mental health issues associated with repeatedly witnessing people of color being seriously injured or killed during police encounters

· Examine best practices of police training from other countries that may help inform the future of police training in the United States

 

10:30 AM - 11:15 AM

PAPER PRESENTATION

Child and Adolescent Trauma: Sexual Abuse

Speaker: Ms. Isabella Hall

Description

Child and adolescent dating violence is a very prevalent problem in the U.S. and addressing this issue can prevent a lot of lifelong complications and mental health issues that victims often suffer. The aim of this conference presentation is to explain what child and adolescent sexual abuse is and how disorders like post-traumatic stress disorder (PTSD) follow with trauma. Recognizing prevalence of the issue within the U.S. as well as the correlations to suicide rates which are higher among adolescents with trauma making it the second leading cause of death for ages 10-24 and 25-34, and possible interventions and preventions that can be made to help reduce risk and effects of trauma in children and adolescent focusing on a school-based intervention approach as well as a broader outreach to lower income settings and minority populations.

Objectives

Participants will be able to:

· Provide awareness to this issue

· Notice signs of trauma and causes if untreated

· Identify ways to prevent and intervene this issue

 

10:30 AM - 11:45 AM

Disaster Mental Health Response to the Sandy Hook School Shooting: A 10 Year Retrospective
Speaker: James Halpern, PhD

1.25 Continuing Education Credits Approved

Description

The purpose of this course is to provide an understanding of the DMH response to the Sandy Hook School Shooting in 2012 from a 10-year post event perspective. The presenter is a psychologist and volunteer with the American Red Cross who provided crisis and grief counseling in the immediate aftermath of the shooting. Topics will highlight key disaster mental health elements unique to responding to a high-profile mass casualty event, including helping family members to be and feel safe, protecting families from negative social support, early grief and crisis counseling, psychologist self-care, and more recently, how survivors have been coping with harassment. The presenter will discuss how lessons learned can inform effective clinical responses to future high-profile tragedies and disasters.

Objectives

Participants will be able to:

·  Provide at least three (3) strategies when developing a self-care plan before responding to a mass casualty event.

· Describe at least three (3) basic and effective skills to support survivors, particularly family members, of children killed in a school shooting or other tragedies.

·  Identify at least two (2) ways that high-profile events create unique mental health challeneges, including helping survivors deal with the media and with local and national politicians.

Speaker

James Halpern, Ph.D. is Emeritus Professor of Psychology and Counseling and Founding Director of the Institute for Disaster Mental Health (IDMH) at SUNY New Paltz. He is co-author of: Disaster Mental Health Case Studies: Lessons Learned from Counseling in Chaos (2019), Disaster Mental Health Interventions: Core Principles and Practices (2017) and Disaster Mental Health: Theory and Practice (2007).  He has received Federal and NYS grants to develop curriculum and to provide training in DMH. He has consulted for the United Nations on Assisting Victims of Terror and has developed training modules for the United Nations Emergency Preparedness and Support Teams and UN mission leaders. As an American Red Cross volunteer, he has provided direct service to disaster survivors and served in a leadership role at both large-scale national and local disasters.

 

10:30 AM - 11:45 AM

Doctors Without Borders: Advocating for the Interjurisdictional Practice of Psychology in New York State
Speakers: Barbara Meehan Reyes, PhD; Laura Myhr, PhD; Mary Beth Covert, PsyD, ABPP; Alan Hack, PhD

1.25 Continuing Education Credits Approved

Description

The Covid-19 pandemic dramatically changed the national landscape of psychological practice with the majority of psychologists, including those in New York, offering at least some services via telehealth. State membership in PSYPACT, the interjurisdictional practice compact for psychology, also witnessed a surge in the number of states that pursued PSYPACT membership. PSYPACT has indeed broadened access to mental health services among diverse populations and improved continuity of care. Although PSYPACT’s advantages are obvious, becoming a PSYPACT member state requires specific legislation be enacted, which can be a lengthy and challenging process. Recognizing the importance of PSYPACT to NY psychologists, NYSPA formally added PSYPACT membership to its list of legislative priorities and advocacy efforts are currently underway. This presentation will describe PSYPACT as well as special considerations in interjurisdictional practice, including: legal and regulatory concerns, technical aspects, risk management and professional liability matters, ethical dilemmas, and ensuring culturally competent service provision to diverse communities. Presenters will also describe the legislative advocacy process in New York and ways in which NYSPA members can become involved.

Objectives

Participants will be able to:

· Identify and describe at least one component of each of the following aspects of the interjurisdictional practice of psychology in New York: legal, clinical/practical, and technical.

· Describe at least one strategy for ensuring culturally competent mental health service in interjurisdictional practice.

· Describe at least one component of effective legislative advocacy.

 

10:30 AM - 11:45 AM

Healthy Connections Psychological Services and NYC Department of Education Schools Increase Mental Health Equity Among Bronx Public School Students via a Multi-Level Hybrid School-Based and Online Psychological Services Model
Speakers: Frank J. Corigliano, PhD; Mario Gonzalez, Bilingual School Psychology, Doctoral Student; Brittany A. Drygas, LMSW

1.25 Continuing Education Credits Approved

Description

This program will1) DESCRIBE the Urgent need for psychological services among Bronx Public School Students_2) Discuss The barriers to access to mental health Services For low-income Communities of Color, 3) Review the development and implementation of innovative hybrid (telemental health and onsite) psychological Services Model. 4) Layout the 5 core services Collaboratively developed mental Health services with NYC DOE Schools, Students, families, and mental health professionals. Healthy Connections Psychological Services.

Healthy Connections Psychological Services and NYC Department of Education Schools develop an innovative school and online psychological services to increasing mental health equity among Bronx Students.                                                                                    

Developing an Innovative hybrid model of psychological services. Providing onsite services at school and online services at school, home, or place that the student and family chooses. Remove barriers such as stigma, limited diversity, language. Stakeholder-codeveloped programing Actively involving students, families, teachers, counselors, administration and psychologists. Present 5 services (Individual/family, DYADs, Full-Class Workshops, Parent/Family Events, Teacher Professional Development, Counselor Coaching, Administration INSIGHTS.                                                                                                                                                           

Adapting Evidenced-based Interventions to 3K, Elementary, Middle, and High Schools.  Diversity in team by telemental health. Linguistically diverse students and team.

Objectives

Participants will be able to:

· State one (1) benefit of a hybrid online/onsite model of psychological services.

· Identify a benefit of Dyads.

· Identify one (1) way that telemental health removes barriers to psychological services for members of black and brown communities.

 

12:15 PM - 1:30 PM

KEYNOTE PRESENTATION

Description

NAMI has told us that the average delay between the onset of mental health symptoms and mental health treatment in the U.S. is 11 years. Why?

Because approximately 150 million Americans reside in mental health professional shortage areas (HPSAs). And, despite the passage of the Mental Health Parity and Addictions Equity Act of 2008, more than 30 million adults and youth living with mental illness in the US went without treatment in 2020. While there are approximately 106,000 licensed clinical psychologists, there are less than a quarter of that number, just 25,000 psychiatrists, in the workforce. 60% of U.S. Counties have no psychiatrists. The Federal government estimates that we need an additional 45,000 psychiatrists to meet the prescriptive mental health needs of our citizens. The shortage is exacerbated by the fact that more than half of those currently licensed as psychiatrists are older than 55. Because of the shortage of psychiatrists, a large percentage of psychotropic medications are prescribed by someone other than a psychiatrist. Fully 79% of antidepressants, 87% of anxiolytics, and 57% of antipsychotics are prescribed by medical providers who are highly competent but most often have relatively little specialized training in the diagnosis and treatment of mental illness. It’s not surprising, therefore, that 50% of depression diagnoses are missed by primary care physicians and 50% of patients who are treated by PCP’s are still depressed after a year of treatment.

Healthcare is forever changed in our country. Prescribing psychologists are coming to be seen as providing optimal clinical care in every private and public healthcare setting, treating the underserved and the most at-risk vulnerable members of our community.

Prescribing psychologists are and will continue to be strong leaders in our state of Illinois, throughout our country and around the globe. Prescribing psychologists have the potential to increase access to care by 100% within the next twenty years.

Dr. Rom-Rymer will describe how she and her team of passionate and determined Illinois psychologists passed Prescriptive Authority legislation in Illinois and how New York psychologists can do the same!

Objectives

Participants will be able to:

· Describe the successful process that Illinois pursued for securing legislative authority for prescribing psychologists.

· Discuss the statutory requirements for Illinois licensed prescribing psychologists.

· State a proposal for the passage of prescriptive authority legislation in New York State.

Speaker

Dr. Rom-Rymer has been a pioneer throughout her life.  She was in the first class of women undergraduates at Princeton University (Class of ’73); created the first Victim-Witness Assistance Unit, Florida’s 2nd District State Attorney’s Office; co-founded/became the first Board President of Refuge House, a shelter for domestic violence survivors, Tallahassee, Florida, 1977-1979.  Dr. Rom-Rymer helped to create the field of forensic geriatrics in 2000; taught at several Universities, in the Departments of Psychiatry, including The University of Chicago and Northwestern University. Dr. Rom-Rymer led the 2014 successful Illinois legislative Movement for Psychologists’ Prescriptive Authority; continues to implement Prescriptive Authority legislation in Illinois; consults with State Psychological Associations, nationwide, and with international psychologist leaders, on legislative advocacy campaigns. Dr. Rom-Rymer is completing a book, to be published by APA Press, "The Revolution in Healthcare:  How Prescribing Psychologists are Changing the Healthcare Delivery System," and running for APA President-Elect in 2024.

DAY AT-A-GLANCE

 

7:30 AM - 8:30 AM

BREAKFAST

 

8:15 AM - 11:15 AM

PROGRAM SESSIONS

Practicing a Politics of Equity: True Sliding Scale Psychotherapy
Speaker: Silvia Dutchevici, MA, LCSW
3 Continuing Education Credits Approved

 

8:30 AM - 9:45 AM

PROGRAM SESSIONS

The Impact of the COVID-19 Pandemic on Teens and Young Adults
Speaker: Barbara Kapetanakes, PsyD

Making Meaning in the Face of Change: Spirituality, Security, and Serenity
Speakers: Tobi Abramson, PhD; Julie P. Shaw, PhD, EdD; Rev. Mark Chaffin, Interfaith Chaplain, Interfaith Spiritual Director; Amy Schaffer, PhD
1.25 Continuing Education Credits Approved

Workplace Risk: Triggers and Consequences of Violence and Organizational-Based Solutions
Speakers: Taylere Markewich, PhD; Carolyn Springer, PhD; Thomas Diamante, PhD
1.25 Continuing Education Credits Approved

9:30 AM - 10:30 AM

COFFEE BREAK

 

10:00 AM - 11:15 AM

PROGRAM SESSIONS

Exploration of Paths to Develop an Ecological and Climate-Conscious Coaching, Consulting and Psychological Practice
Speakers: Christine M Allen, PhD; Carolyn AlRoy, PsyD

The Science of Reading: Social Justice Perspectives for Clinical Psychologists
Speaker: Jennifer A. Bremser; Gwen Steltz
1.25 Continuing Education Credits Approved

Targeting Racial Trauma & Stigma-Based Stressors in Psychosis: Recent Findings and the Power of Community-Based Participatory Research
Speaker: Joseph Salvatore DeLuca, PhD
1.25 Continuing Education Credits Approved

 

11:30 AM - 2:30 PM

ETHICS / PROFESSIONAL BOUNDARIES PRESENTATION

Ethics & Risk Management: Navigating Patient Boundaries and Professional Conduct in 2023
Presented by Matthew S. Feldman, Esq.; Sarah N. Rodman, Esq. - Feldman Kieffer LLP
3 Continuing Education Credits Approved

Boxed lunch to be served.

 

---

FULL PROGRAM DESCRIPTIONS

 

8:15 AM - 11:15 AM

Practicing a Politics of Equity: True Sliding Scale Psychotherapy
Speaker: Silvia Dutchevici, MA, LCSW

3 Continuing Education Credits Approved

Description

Whether it is fee setting, or deciding how much a psychotherapy session is worth, the topic of money is a difficult one for therapists and patients alike. This interactive workshop will introduce an equitable sliding scale model that also provokes therapeutic conversations around money, wealth, power, capitalism and economic justice.

Objectives

Participants will be able to:

· Learn two (2) things about the history of money in psychotherapy.

· List three (3) unconscious associations with money.

· Identify two (2) personal beliefs about money and capitalism.

· Be able to identify and describe critical therapy's sliding scale model and how it is different than the traditional sliding scale models currently practiced in psychotherapy.

 

8:30 AM - 9:45 AM

Description

While the COVID-19 pandemic has been difficult for the entire global population, those at certain stages of development have experienced particular struggles. Adolescence and young adulthood are points of transition where a lot of emotional growth occurs. Between 2016 and 2020, there were already significant increases in children diagnosed with anxiety and depression, and after the onset of the pandemic there were significant year-over-year increases in children diagnosed with behavioral or conduct problems with a concomitant decrease in preventive medical care visits.

Objectives

Participants will be able to:

· Identify specific ways that adolescents and young adults have been affected by the pandemic

· Identify specific stressors reported regarding young adults beginning college during the pandemic

· Identify ways to fill the needs highlighted by the global pandemic

 

8:30 AM - 9:45 AM

 

Description

Recent events remind those working with adults, particularly older adults, of the many challenges that accompany change. Through this session you will have the opportunity to integrate knowledge of resiliency with multiple transitions with aging.  The resiliency and robustness of a strong ego identity can mitigate the onslaught of losses and the experiences of trauma that one may encounter throughout the lifespan. The panelists will focus on diverse populations and the various perspectives on key life changes using professional descriptions, data, and first-hand experiences. This session will focus on an integrative view of identity, highlighting constructions for personal meaning that lend themselves to resiliency; the use of psychotherapy to identify and resolve psychological blocks which impede the development of serenity in older adults; how spirituality supports people at the end of life; and how psychologists can help clients maintain a secure base in the face of threatening change a coherent sense of self through potential great loss.

Objectives

Participants will be able to:

· Provide at least one (1) definition of ego strength in an operative way.

· Identify at least two (2) specific signs of identity strength and differentiate at least two (2) types of identity weaknesses.

· Describe three (3) psychological blocks which impede the development of serenity in older adults the use of psychotherapy in identifying and resolving these blocks.

· Identify at least two (2) ways to assess and strengthen the internal religious and spiritual coping resources of elders.

· Identify at least two (2) challenges faced in late-life and understand how therapeutic interventions can assist the client in achieving gerotranscendence.

 

8:30 AM - 9:45 AM

Workplace Risk: Triggers and Consequences of Violence and Organizational-Based Solutions
Speakers: Taylere Markewich, PhD; Carolyn Springer, PhD; Thomas Diamante, PhD

1.25 Continuing Education Credits Approved

Description

In 2022, workers lost their lives in schools, supermarkets, medical centers, and an employee breakroom. There are events leading up to these events that can help us, as psychologists, identify and prevent future tragedies.  Three NYSPA psychologists will present their research, practice and understanding of workplace violence through a psychological perspective inclusive of real world management practices. Presenters will review up-to-date research on gender-based violence, workplace violence, and the relationships between perception of organizational justice and violence. Presenters will also discuss causes and consequences as well as interventions that help to reduce workplace violence. Specifically, what organizations can do to ensure safety through HR policy design, management, promoting equity perceptions, fairness, and supporting staff at risk for violence outside of the office. The presentation will end with a Q&A and a call to action will ask participants to get involved and help end this endless, senseless, constant crisis of violence.

Objectives

Participants will be able to:

·Identify at least three (3) ways that workplace violence has become a pervasive problem from a systems-perspective, including gender-based considerations, individual differences, intersectional identities, and group dynamics.

·Identify at least two (2) antecedents to workplace violence, specifically how fairness perception, HR policies and procedures, and or lack of perceived holistic support for individuals can increase likelihood of workplace violence, beyond individual pathology or gun control measures.

·Identify at least two (2) solutions that psychologists can implement to help counter this crisis.

Speakers

10:00 AM - 11:15 AM

Exploration of Paths to Develop an Ecological and Climate-Conscious Coaching, Consulting and Psychological Practice
Speakers: Christine M Allen, PhD; Carolyn AlRoy, PsyD

Description

We are facing unprecedented challenges as humans in the 21st century. According to the APA, a crucial part of its mission is to utilize psychology to make a positive impact on critical societal issues. Climate change is the most critical national security and existential threat to life we face as humans today. And yet the topic of climate change evokes denial, guilt, anxiety, but not sufficient action. How can psychologists become actively engaged in the requisite dialogue and paradigm shift necessary to ensure that our planet is habitable for future generations? This is a thorny issue because as coaches, consultants, and therapists, we typically focus on the issues clients bring and work to help them solve those problems. How do we ethically and skillfully help clients engage with these critical issues that we all face today?

Objectives

Participants will be able to:

· Develop a deeper understanding of their beliefs, fears, and concerns about the climate crisis.

· Explore ways to ethically bring a wider lens to client engagements so that they can develop a climate-conscious psychology practice.

· Strategize new ways that psychologists can help to generate and use our collective intelligence to contribute to the future well-being of all humans and of our planet.

 

10:00 AM - 11:15 AM

Description

In the US, 2 out of 3 children cannot read proficiently (NCES, 2019). The likelihood of being a proficient reader varies as a function of race, socio-economic, and disability status. As a result, there is little question that literacy is a social justice and equity issue deserving our attention and action. Over the course of the session, we will examine the science of reading, common practices schools use to teach children to read, and what we currently know and don't know about the students that struggle and why early identification of reading disorders and accessibility to evidence based interventions are critical to improving the odds of becoming a proficient reader.

Objectives

Participants will be able to:

·Define "science of reading" (SOR), and identify at least one (1) way it can be applied to effective reading instruction, and at least one (1) way it can be applied to the identification of reading disorders.

· Distinguish at least two (2) differences between the IDEA definitions of Specific Learning Disability and the current DSM-5 criteria that falls under Specific Learning Disorder (SLD).

· Identify at least two (2) systemic barriers to the accurate identification of students with SLDs.

· Identify at least two (2) consequences of secondary social and emotional consequences of reaching failure, including difficulties with emotional management as well as risk of incarceration.

· Recognize three (3) ways in which psychologists can promote social justice by advocating for more inclusive and equitable access to evidence based instructional resources that support literacy development for ALL children.

 

10:00 AM - 11:15 AM

Targeting Racial Trauma & Stigma-Based Stressors in Psychosis: Recent Findings and the Power of Community-Based Participatory Research
Speaker: Joseph Salvatore DeLuca, PhD

1.25 Continuing Education Credits Approved

Description

Over the past two decades, there have been significant efforts geared toward early intervention for psychosis (i.e., targeting adolescents and young adults). However, significant racial and ethnic inequities exist within early-stage psychosis prevention efforts and programs, such that youth from minoritized groups may not consistently receive culturally sensitive care or achieve comparable treatment outcomes to White youth. Further, upwards of 50-70% of youth from minoritized groups in the US report experiencing racial discrimination, and racism and other stigma-based stressors (e.g., mental illness stigma) are common worries among individuals with psychosis-spectrum experiences. This is an important societal and clinical concern, since stigma and experiences of racial discrimination and other race-based stressors, collectively known as racial trauma, are associated with distressing psychotic experiences and other negative mental health outcomes.

In this presentation, we will (1) discuss historical and recent research on the intersection of psychosis, race, and stigma, (2) share practical clinical and research tools, and (3) share preliminary findings from a community-based participatory research project focused on educating providers about racial trauma, stigma, and early psychosis.

(Two young adults with lived mental health experience will be co-presenters with Dr. DeLuca).

Objectives

Participants will be able to:

· Understand at least two (2) commonly-accepted definitions or conceptualizations of racial trauma and stigma in the context of early psychosis work.

· Describe at least two (2) examples of racial trauma and stigma-related experiences in the context of mental health and wellness for young people experiencing psychosis.

· Identify where to find, and how to use, at least two (2) practical clinical and research tools for racial trauma and stigma-based stressors.

Speaker

Joseph Salvatore DeLuca, PhD, is an Assistant Professor in the Department of Psychological and Brain Sciences at Fairfield University. He is also an Assistant Clinical Professor in the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai in NYC, primarily working in the Psychosis-Risk Program. Dr. DeLuca is a licensed psychologist (New York State) with expertise in youth mental health, serious mental illness, and stigma. His research is aimed at understanding intersectional stigma and addressing equity issues in services for youth with psychosis-spectrum experiences. He completed a joint BA/MA degree in Forensic Psychology at the City University of New York (CUNY) - John Jay College, and a PhD in Clinical Psychology from the CUNY Graduate Center. Dr. DeLuca then completed a predoctoral internship at the University of Maryland School of Medicine, followed by a National Institute of Mental Health T32 Postdoctoral Research Fellowship at Mount Sinai.

 

 

11:30 AM - 2:30 PM

ETHICS / PROFESSIONAL BOUNDARIES PRESENTATION

Ethics & Risk Management: Navigating Patient Boundaries and Professional Conduct in 2023
Presented by Matthew S. Feldman, Esq.; Sarah N. Rodman, Esq. - Feldman Kieffer LLP

3 Continuing Education Credits Approved
Boxed lunch to be provided.

Description

Mr. Feldman and Ms. Rodman will provide a three (3) hour workshop for professionals addressing information to help them remain compliant with respect to professional conduct regulations and ethical challenges that face psychologists concerning patient boundaries. Specifically, this workshop will provide the steps a psychologist must take to protect the psychologist-patient relationship and provide clarity as to steps a psychologist must take to avoid professional misconduct, including with respect to preparing accurate medical records and appropriate discharge of patients when treatment must be terminated.

This workshop is primarily directed to psychologists in private practice but is applicable to all sites where health services are provided. This workshop is applicable to those who provide services to adults, as well as children.

Objectives

By the end of the workshop participants will:

• Be able to state whether or not they must comply with legal subpoenas and proceedings, and why.
• List three (3) steps they can take to avoid the dangers of dual relationships when relating to patients in more than one context.
• Describe two (2) ways to prevent overstepping of ethical boundaries during a session.
• Demonstrate the use of at least three (3) tools or strategies available to redirect patients who may challenge a professional boundary.
• Be able to describe at least two (2) appropriate procedures for avoiding abandonment when terminating a patient relationship, including unilateral termination of a patient.

Speakers