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Physician Liaison Program (Community Practice Liaison Program) 
Lifespan Physicians/PSO 

Newport Hospital is dedicated to providing the best care for you and your family.

Find a physician or specialty practice affiliated with Newport Hospital by scrolling down, or jump directly to a specialty by clicking one of the following titles: 

Free parking at all locations. Valet parking available at the main Newport Hospital entrance, 20 Powel Avenue.

Lifespan Physician Group, Primary Care, Newport

50 Memorial Boulevard, Newport, RI 02840
Phone: 401-606-4510 Fax: 401-606-4544

Ralph Earp, MD, received his medical degree from the University of Missouri Columbia School of Medicine and completed his residency at the State University of New York, Upstate Medical Center in Syracuse.

David Gorelick, MD, received his medical degree from Georgetown University Medical School and completed his residency at the Naval Medical Center in San Diego.

Director of Primary Care

Stephanie Maryeski, MD, received her medical degree from The Warren Alpert Medical School of Brown University and completed her internship and residency training at the Walter Reed Army Medical Center in Washington, D.C., now the Walter Reed National Military Medical Center in Bethesda, Maryland. Following her residency, she served as Chief of Internal Medicine and Chief of the Warrior Transition Unit at Keller Army Community Hospital at the United States Military Academy at West Point, New York, and served twelve years in the military, including a 2010 deployment to Iraq. Board certified in internal medicine, Maryeski is a member of the American College of Physicians.

Jana P. Magarian, NP
Nurse Practitioner

Jana Magarian, APRN-CNP, received her MS in Nursing from the University of Rhode Island. She is board certified by the American Nurses Credentialing Center and the American Academy of Nurse Practitioners as a family nurse practitioner.

Jeanne Oliva, MD, is a board-certified internal medicine physician with decades of experience providing compassionate, comprehensive primary care. She completed her medical degree at the Geisel School of Medicine at Dartmouth, and at The Warren Alpert Medical School at Brown University. She completed her residency at Rhode Island Hospital. Prior to joining the Lifespan Physician Group primary care team, Dr. Oliva practiced at University Medicine primary care in Providence, and at Women & Infants Center for Primary Care. She is also a clinical assistant professor of medicine at the Alpert Medical School, and a member of the American College of Physicians.

Laureen Martin, APRN-CNP
Nurse Practitioner

Laureen Martin, APRN-CNP, received her MS in Nursing from the University of Rhode Island. She is board certified by the American Nurses Credentialing Center and the American Academy of Nurse Practitioners as a family nurse practitioner.

Lifespan Physician Group, Primary Care, Tiverton

711 Main Road, Tiverton, RI 02878
Ph: 401-624-1400 Fax: 401-625-5271

Kristen M. Fielding, MD, received her medical degree from the University of New Mexico Health Sciences Center and completed her residency at New Hampshire Family Medicine-Concord. 

Anne Neuville, DNP, APRN-CNP
Nurse Practitioner

Anne Neuville, DNP, APRN-CNP, received her MS in nursing and her doctorate in nursing practice from the University of Rhode Island. She is board certified by the American Nurses Credentialing Center as a family nurse practitioner. 

Jamestown Family Practice

20 Southwest Avenue, Jamestown, RI 02835
Ph: 401-423-2616 Fax: 401-423-3485

Lauren Goddard, MD, received her medical degree from The Warren Alpert Medical School of Brown University and completed her family medicine residency at Memorial Hospital of Rhode Island. She is board certified and a member of the American Academy of Family Physicians.

Nancy Jones, APRN-CNP
Nurse Practitioner

Nancy Jones, APRN-CNP, received her MS in Nursing from the University of Rhode Island. She is certified by the American Academy of Nurse Practitioners as a family nurse practitioner.  

Portsmouth Family Medicine

161 Chase Road, Portsmouth, RI 02871
Ph: 401-683-3300 Fax: 401-683-3308

Before coming to Newport Hospital, Famador, who is board certified in Family Medicine, worked for Comprehensive Community Action Program in Coventry. She is a graduate of the University of the East Ramon Magsaysay Memorial Medical Center, Quezon City, Philippines, and completed a residency in Family Medicine at the University of Pittsburgh Medical Center Shadyside.

Camille  Montes, MD is board certified in Family Medicine, Montes comes to Newport Hospital from the Comprehensive Community Action Program in Cranston. Dr. Montes is a graduate of the University of Santo Tomas, Manila, Philippines, and completed a residency in Family Medicine at the University of Pittsburgh Medical Center Shadyside.

David E. Davis, DNP, APRN-CNP
Nurse Practitioner

David E. Davis, DNP, APRN-CNP received his bachelors, masters and doctorate in nursing practice at the University of Rhode Island, where he initiated research on the influence of the built environment on health care outcomes. He is certified by the American Academy of Nurse Practitioners as a family nurse practitioner.

Newport Women's Health, Newport 

19 Friendship Street (Borden-Carey Building), Suite 220,
Newport, RI 02840
Ph: 401-848-5556 Fax: 401-519-2994

Ginny Bass, MD is an obstetrician/gynecologist at Newport Women’s Health. A graduate of the Medical University of South Carolina, Bass completed her residency at Carilion Clinic-Virginia Tech Carilion in Roanoke, Virginia. She practiced most recently at Lawrence and Memorial Medical Group in Westerly, Rhode Island. She is board certified by the American Board of Obstetrics and Gynecology and is a fellow of the American College of Obstetrics and Gynecology.

Bass’s office is located at Newport Women’s Health, 19 Friendship Street, Suite 220, Newport. She welcomes new patients and can be reached at 401-848-5556.

Lisa Licare, DO, an obstetrician/gynecologist, received her medical degree from the Lake Erie College of Osteopathic Medicine, in Erie, Pennsylvania. She completed her obstetrics and gynecology residency at Women and Children's Hospital of Buffalo and other hospitals affiliated with the Jacobs School of Medicine and Biomedical Sciences of the University at Buffalo, The State University of New York.

Dr. Licare is a junior fellow of the American Congress of Obstetricians and Gynecologists and a member of the American Medical Association and the American Osteopathic Association.

Before joining Newport Women’s Health, Dr. Licare practiced at Lawrence and Memorial Hospital in New London, Connecticut. During her residency, she was a clinical associate instructor in the Jacobs School.

Dr. Licare has been a co-investigator in several research studies and has a number of peer-reviewed publications and presentations to her credit.

Chair of OB/GYN

Gail Carreau MD is a graduate of George Washington University School of Medicine and completed her residency at the Yale University-affiliated Bridgeport Hospital in Connecticut. She is board certified by the American Board of Obstetrics and Gynecology, and is a fellow of the American Congress of Obstetricians and Gynecologists and the New England Obstetrical and Gynecological Society. She is also a member of the American Institute of Ultrasound in Medicine.

Karolyn Zambrotta, CNM
Nurse Midwife

Karolyn Zambrotta, CNM, is a board certified nurse midwife. She received her MS degree in nursing from the University of Rhode Island, and has decades of experience, first as an obstetrics nurse and then as an advanced practice nurse midwife at hospitals in Rhode Island and Massachusetts. She is a member of the American College of Nurse-Midwives and the American Nurses Association.

Newport Women's Health, Portsmouth

77 Turnpike Avenue, Portsmouth, RI 02871
Phone: 401-683-7070 Fax: 401-683-6084

Triste M. Coulombe, MD is a graduate of The Warren Alpert Medical School of Brown University and completed her residency at Maine Medical Center in Portland. She is board certified by the American Board of Obstetrics and Gynecology and is a fellow of the American Congress of Obstetricians and Gynecologists. She is also a member of the New England Obstetrical and Gynecological Society and the Rhode Island Medical Society.

Karolyn Zambrotta, CNM
Nurse Midwife

Karolyn Zambrotta, CNM, is a board certified nurse midwife. She received her MS degree in nursing from the University of Rhode Island, and has decades of experience, first as an obstetrics nurse and then as an advanced practice nurse midwife at hospitals in Rhode Island and Massachusetts. She is a member of the American College of Nurse-Midwives and the American Nurses Association.

Newport Psychiatry

19 Friendship Street (Borden-Carey Building), Suite 140,
Newport, RI 02840
Phone: 401-845-4340 office Fax: 401-845-4359

Medical Director and Chief of Psychiatry, Newport Hospital
Psychiatrist, Newport Hospital

Philip Schmitt, MD, is a multiple board-certified psychiatrist, specializing in adult psychiatry and addiction medicine. He received his medical degree from Georgetown University School of Medicine, and completed his post-doctoral training at MedStar Georgetown University Hospital, in Washington, D.C., and at The Johns Hopkins Medical Institutions in Baltimore, Maryland, where he served as chief resident. He brings decades of experience in behavioral health, seeing both child and adult patients. Before joining Newport Psychiatry and the Lifespan Physician Group, Dr. Schmitt practiced most recently at the Carolinas Health Care System Blue Ridge, in Morganton, North Carolina. He is a Distinguished Fellow of the American Psychiatric Association.

Child and Adolescent Behavioral Health

19 Friendship Street (Borden-Carey Building), Suite 240,
Newport, RI 02840
Phone: 401-845-1950 Fax: 401-519-2995

Child and Adolescent Psychiatrist

Newport Hospital Partial Hospitalization Program

19 Friendship Street (Borden-Carey Building), Suite G-20,
Newport, RI 02840
Phone: 401-845-1910 Fax: 401-848-6080

Program Director, Partial Hospitalization Program at Newport Hospital

Jon Brett, PhD, is the program director of the Partial Hospitalization Program at Newport Hospital. He completed his doctoral degree in clinical psychology at the Florida Institute of Technology and the University of Connecticut Medical Center-John Dempsey Hospital. He has decades of experience in adult behavioral health, providing individual and group therapy in both inpatient and outpatient settings. Among other positions, he previously served as director of SSTAR of Rhode Island, Inc., an inpatient substance abuse detoxification and co-occurring treatment facility.  He is a member of the Middletown Substance Abuse Prevention Council, and the recipient of a lifetime achievement award from the Aquidneck Rally for Recovery Committee (part of a national initiative to promote addiction treatment and recovery efforts) for his work in the field of substance abuse treatment.                                                  

Newport Dermatology

79 Turnpike Avenue, Portsmouth, RI 02871
Ph: 401-683-7434 Fax: 401-683-0482

Carla Evans, NP
Nurse Practitioner

Newport General Surgery

20 Powel Avenue, Newport, RI 02840
Phone: 401-619-3930 Fax: 401-619-3932

General Surgeon

Bradford Gray, MD, FACS, is a board-certified general surgeon affiliated with Newport Hospital. Dr. Gray received his medical degree from Temple University School of Medicine in Philadelphia, Pennsylvania, and completed his resident training at Abington Memorial Hospital in Abington, Pennsylvania. He is a fellow of the American College of Surgeons. Dr. Gray has interest and expertise across a broad range of surgical services, including management of benign and malignant breast conditions; thyroid surgery; endoscopic procedures; management of malignant skin conditions, including melanoma; and advanced laparoscopic surgery, including hernia repair, colon surgery and foregut surgery.

General Surgeon

Julia Tassinari, MD, is a board-certified general surgeon affiliated with Newport Hospital. Dr. Tassinari received her medical degree from Temple University School of Medicine in Philadelphia, Pennsylvania, and completed her internship and residency at St. Elizabeth’s Medical Center in Boston, Massachusetts. Among her interests and expertise are minimally invasive surgery, including hernia repair, colon and foregut surgery; breast surgery; and skin and soft tissue surgery.

Medical Director, Chair of Surgery

James Valente, MD, is a board-certified general surgeon affiliated with Newport Hospital. He received his medical degree from the Tufts University School of Medicine, and completed his residency at Morristown Memorial Hospital in Morristown, New Jersey. He spent 25 years caring for members of the U.S. military and their families, most recently as head of general surgery at Naval Health Care of New England. He has expertise across a broad range of general surgical services, including management of breast, thyroid and diseases of the intestinal tract; hernia repair; endoscopic procedures; management of skin and subcutaneous lesions; and advanced laparoscopic surgery, including gallbladder, colon surgery and surgery for acid reflux.

Newport Neurology, Newport

19 Friendship Street (Borden-Carey Building), Suite 150-160,
Newport, RI 02840
Phone: 401-845-3800 Fax: 401-845-1075

Director Stroke Program Newport Hospital

Dr. Edward Donnelly serves as medical director of Newport Hospital’s stroke program. Newport Hospital is a certified primary stroke center, meeting rigorous national standards for stroke patient care. A graduate of Dartmouth Medical School, Donnelly completed a fellowship in clinical neurophysiology at Rhode Island Hospital, where he also completed a residency in neurology. He is certified by the American Board of Psychiatry and Neurology. Dr. Donnelly’s office is located in the Borden-Carey Building at Newport Hospital. 

Newport Neurology, Portsmouth

161 Chase Road, Portsmouth, RI 02871
Phone: 401-845-3800 Fax: 401-845-1075

Newport Orthopedics

19 Friendship Street (Borden-Carey Building), Suite 130,
Newport, RI 02840
Ph: 401-401-845-1474 Fax: 401-845-1477

Rolf Langeland, MD, is a board-certified orthopedic surgeon with Newport Orthopedics, a Lifespan Physician Group practice. Dr. Langeland received his medical degree and orthopedic surgical training from the University of Connecticut School of Medicine; he continued his subspecialty training in sports medicine and joint replacement fellowship training at Duke University Medical Center in Durham, North Carolina. Prior to joining Newport Orthopedics, he practiced for 20 years with Orthopaedic Specialty Group in southern Connecticut, where he specialized in sports medicine and reconstructive joint and trauma surgery. Dr. Langeland has particular expertise in arthroscopic (minimally invasive) joint restoration of the upper and lower extremities, in addition to trauma reconstruction and reconstructive joint replacement.

Learn more about Dr. Langeland >>

Michael Mason, DO, received his medical degree from the Philadelphia College of Osteopathic Medicine. He did his internship and orthopedic surgical residency at Community General Hospital in Harrisburg, Pennsylvania and he continued his subspecialty fellowship training at Massachusetts General Hospital and Brigham and Women’s Hospital, affiliates of Harvard Medical School. Dr. Mason has designed and been involved in the development of multiple artificial joints, and has more than 20 years of experience in joint replacement and reconstructive surgery, most recently at New England Baptist Hospital in Boston.

Dr. Mason is a board-certified orthopedic surgeon with Newport Orthopedics.

Kathryn Mitchell, PA-S
Physician Assistant

Kathryn Mitchell, PA-S, is a physician assistant with Newport Orthopedics, a Lifespan Physician Group practice. She received an MS in exercise physiology from Temple University in Philadelphia, and an MS in physician assistant studies from the Massachusetts College of Pharmacy and Health Sciences in Worcester.        

Julie Woodside, PA
Physician Assistant

Julie Woodside, PA, is a physician assistant with Newport Orthopedics, a Lifespan Physician Group practice. She received her MS in physician assistant studies from the University of New England, in Portland, Maine.

Newport Physiatry

20 Powel Avenue, Newport, RI 02840
Phone: 401-845-1652 Fax: 401-845-1198

Medical Director, Vanderbilt Rehabilitation Center

Mustapha Kemal, MD is the medical director of the Vanderbilt Rehabilitation Center and a physiatrist with Newport Physiatry. Dr. Kemal received his medical degree from King Edward Medical University in Lahore, Pakistan, and completed his residency in physical medicine and rehabilitation at the Hospital of the University of Pennsylvania in Philadelphia, Pennsylvania. He is a member of the American Academy of Physical Medicine and Rehabilitation, and is board certified in physical medicine and rehabilitation.

Physiatrist

Josef Fields, DO, is part of Newport Physiatry at Newport Hospital. Fields’ interests and expertise include myofascial pain, musculoskeletal dysfunction, shoulder and knee injuries, hip, neck and back pain, neuropathic pain, rehabilitation therapy, electromyography, gait dysfunction, limb loss, wound care, and manipulative therapy.

He is a member of the American Academy of Physical Medicine and Rehabilitation, and the American Osteopathic Association, and is board certified in osteopathic medicine. Dr. Fields is a graduate of Cornell University, and received his medical degree from the Lake Erie College of Osteopathic Medicine in Bradenton, Florida. He completed an internship at St. Petersburg General Hospital in St. Petersburg, Florida, and a residency program in physical medicine and rehabilitation at New York University/Rusk Institute of Rehabilitation Medicine in New York, New York.

Newport Pulmonary Medicine

19 Friendship Street, Suites 150-160, Newport, RI 02840
Phone: 401-845-1599 Fax: 401-845-1596

Medical Director, Pulmonary Rehabilitation, Newport Hospital

Samuel Evans, MD received his medical degree from SUNY Downstate College of Medicine in Brooklyn, New York. He completed his residency and a fellowship in pulmonary and critical care medicine at The Warren Alpert Medical School of Brown University and Rhode Island Hospital. He is board certified in pulmonary and internal medicine.

Dr. Evans has interest and expertise in a wide range of pulmonary disorders, including airway problems (asthma and COPD), pleural conditions, lung cancer, shortness of breath, pulmonary vascular disease, sleep disorders, pulmonary fibrosis, occupational lung disease and diaphragm dysfunction. His procedural capabilities include bronchoscopy, thoracentesis, and pleural catheter placement.

Lauren Marvell, MSN, APRN
Nurse Practitioner

Lauren Marvell, MSN, APRN, is a certified family nurse practitioner with Newport Pulmonary Medicine, a Lifespan Physician Group practice. Marvell received her undergraduate degree from the University of Rhode Island, and her master of science in nursing from the Massachusetts General Hospital Institute of Health Professions, in Boston. She brings more than 12 years of experience in surgical, oncology and intensive care settings.

Cardiovascular Institute

19 Friendship Street (Borden-Carey Building), Suite 260,
Newport, RI 02840
Phone: 401-845-1201 office Fax: 401-845-1291

Cardiologist

George Charlton, MD is a cardiologist with the Cardiovascular Institute. His office is located in the Borden Carey Building at Newport Hospital. He is a graduate of the University of Pittsburgh School of Medicine. He completed his internship and residency in internal medicine at the University of Virginia Health System, followed by a year as an attending hospitalist at Virginia Hospital Center in Arlington, VA. He completed fellowships in both general cardiology and preventive cardiology at the Warren Alpert Medical School of Brown University with training at Rhode Island Hospital, The Miriam Hospital and the Providence Veterans Affairs Medical Center.

Charlton is board certified in cardiovascular disease and internal medicine by the American Board of Internal Medicine and is a diplomate of the National Board of Echocardiography. He is a member of the American College of Cardiology, the American Heart Association, the American Society of Echocardiography, the American Medical Association and the Rhode Island Medical Society.

Cardiologist

Joseph Weiss, MD, PhD is a cardiologist with the Cardiovascular Institute. His office is located in the Borden Carey Building at Newport Hospital. He received his MD and PhD at the New York University School of Medicine and completed his residency in internal medicine at New York-Presbyterian/Columbia University Medical Center. He also completed a fellowship in cardiovascular medicine at University of California at San Francisco as well as post-doctoral training in developmental genetics at Stanford University School of Medicine. He joined Newport Hospital after twelve years at the Oregon Health & Science University in Portland where he was an associate professor in the division of cardiovascular medicine. He is board certified in cardiovascular and internal medicine by the American Board of Internal Medicine. In addition to general adult cardiology, Dr. Weiss specializes in the care of adults with congenital heart disease.

Cardiologist

Ned Gutman, MD, is a cardiologist with the Cardiovascular Institute, with expertise in consultative cardiology, diagnostic catheterization, and noninvasive diagnostic cardiac testing. He is an assistant professor of medicine (clinical) in the department of medicine at The Warren Alpert Medical School of Brown University.

Gutman received his medical degree from the University of Maryland School of Medicine in Baltimore, Maryland. He completed his residency at The Miriam Hospital and a fellowship at The Warren Alpert Medical School of Brown University. He is board certified in internal medicine and cardiology.

Cardiologist

Joseph A. Farina, MD, is a cardiologist at the Cardiovascular Institute, with expertise in noninvasive and invasive cardiology. Farina received his medical degree from the University of Vermont College of Medicine in Burlington, Vermont, and completed his residency in internal medicine and a fellowship in cardiovascular diseases at Rhode Island Hospital. He is a fellow of the American College of Cardiology and is board certified in internal medicine and cardiovascular disease.

Lifespan Cancer Institute

20 Powel Avenue, Newport, RI 02840
Phone: 401-845-1646 Fax: 401-845-1247

Hematologist Oncologist
Chief, Hematology Oncology

Howard P. Safran, MD is the chief of hematology/oncology at the Lifespan Cancer Institute at Rhode Island, The Miriam and Newport hospitals, and the medical director for the Brown University Oncology Group. Safran is a professor of medicine at The Warren Alpert Medical School of Brown University and a nationally recognized leader in the development of new treatments for upper GI cancers. He is a member of the U.S. National Cancer Institute's pancreatic and gastrointestinal cancer task forces.

Oncologist

Randall Ingham, MD, is a hematologist/oncologist with the Lifespan Cancer Institute and is board certified in hematology oncology and internal medicine. Dr. Ingham is an assistant professor of medicine at The Warren Alpert Medical School of Brown University. He has been a research associate for the vaccine development group at ID Biomedical Corporation/GlaxoSmithKline biologics in Massachusetts. Dr. Ingham is a member of the American Society of Clinical Oncology and the American Society of Hematology.

Lifespan Comprehensive Spine Center

20 Powel Avenue, Newport, RI 02840
Phone: 401-845-1190

Attending Physician

Kyle Silva, DO, is a double board-certified physician who specializes in pain management and physical medicine and rehabilitation. He is also an assistant professor of neurosurgery at The Warren Alpert School of Medicine at Brown University.

Dr. Silva was named chief resident during his training at Montefiore Medical Center. His work has been published in a variety of peer-reviewed journals, and he has presented on both the local and national level on the topic of ultrasound-guided techniques for pain management. Dr. Silva was awarded the Leo Davidoff Society teaching award, and was a recipient of the Patient Care Trust Fund Grant for the utilization of 3-D printing in medicine and its application to the field of prosthetics. 

Dr. Silva is an avid volunteer in his community, and has provided medical coverage for a number of sporting events, including soccer, football, and ballet. He especially enjoys traveling and has volunteered abroad in Cuzco, Peru to improve global access to healthcare.  

He is a member of several professional societies, including the American Society of Interventional Pain Physicians and the American Academy of Physical Medicine and Rehabilitation. Dr. Silva currently practices at the Comprehensive Spine Center at Rhode Island and Newport hospitals. 

Medical Director, Comprehensive Spine Center; Division Director of Pain and Rehabilitation Medicine, Rhode Island Hospital

Alexios G. Carayannopoulos, DO, MPH is Medical Director, Comprehensive Spine Center, Department of Neurosurgery and Division Director of Pain and Rehabilitation Medicine, Department of Neurosurgery at Rhode Island Hospital. He is a clinical assistant professor of neurosurgery at The Warren Alpert Medical School of Brown University. He is board certified in both physical medicine and rehabilitation, as well as in pain medicine. Prior to joining Rhode Island Hospital, Carayannopoulos was the medical director of the Spine Center within the Department of Neurosurgery at Lahey Hospital and Medical Center in Burlington, Massachusetts, and medical director of the Lahey at Emerson Spine Program at Emerson Hospital in Concord, Massachusetts. He has a national reputation as a leader in both interventional spine and pain medicine.

He serves on several national committees including the American Academy of Physical Medicine and Rehabilitation, the American Society of Regional Anesthesia and Pain Medicine, and the American Society of Interventional Pain Physicians. He is on the editorial board of multiple internationally recognized pain and rehabilitation peer reviewed journals. He is a consultant in spinal cord stimulation and works with both academia and industry to advance the field of neuromodulation through research and education. He is actively involved in clinical research on spinal cord stimulation as well as stem cell therapy for degenerative disc disease.

Carayannopoulos earned his medical degree from Nova Southeastern University in Ft. Lauderdale, and completed his residency at Harvard Medical School and Spaulding Rehabilitation Hospital in Boston and a fellowship at Dartmouth Medical School and Dartmouth-Hitchcock Medical Center in Lebanon, New Hampshire. He also earned a master of public health from Johns Hopkins University in Baltimore. Additionally, he is a Harvard-trained medical acupuncturist and a U.S. Navy-trained specialist in diving medicine and radiation health.

Director, Spinal Surgical Outcomes Laboratory

Jared Fridley, MD, is a neurosurgeon subspecializing in complex spinal surgery. He is an assistant professor and director of the Spine Surgery Outcomes Research Laboratory at The Warren Alpert Medical School of Brown University.

Dr. Fridley’s work has been published in many peer-reviewed articles and book chapters. He is a member of the Congress of Neurological Surgeons and the American Academy of Neurologic Surgeons. His clinical interests include degenerative spinal disease, spinal trauma, tumors and deformities, and peripheral nerve surgery. His research interests include spinal surgery outcomes and spinal cord injury.