Unable to load your collection due to an error, Unable to load your delegates due to an error. Our goal is to cultivate an awareness of muscle use and develop a therapy program of regular exercises designed specifically to your needs. Epub 2022 May 16. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement was followed. Disclaimer. Provider offers services at multiple medical facilities; schedule availability may vary by location. Myofunctional therapy (oropharyngeal exercises) for obstructive sleep apnoea. In addition, the therapy has been used in other conditions. I studied at UCLA for my anesthesiology training and went to USC for a comprehensive pain fellowship. Myofunctional therapy and prefabricated functional appliances: An overview of the history and evidence. Would you like email updates of new search results? Sleep Sci. It focuses on only releasing the appropriate amount of tissue in order to maximize the tongue's mobility. Submit below for more info as soon as registration becomes available! Zaghi and others also promote myofunctional therapy, sometimes in conjunction with frenuloplasty, as a treatment for obstructive sleep apnea. 93010, 5601 Desoto Ave Just as physical therapy helps to train our bodies back into optimal shape after an injury, Myofunctional therapy helps by training the soft tissues of the face, neck, and mouth to function at the height of their ability. The exercises prescribed are often modified and individually-tailored as appropriate according to a step-by-steptreatment plan under the guidance of an experienced therapist. Life (Basel). Case study 3 year-old girl with sleep-disordered breathing, swallow, and speech issues treated with myofunctional therapy and minor surgical procedure (tongue-tie and lip-tie release). TLDR: Dr. Zaghi lectures for the International Surgical Sleep Society (ISSS) in support of Myofunctional Therapy and Functional Frenuloplasty as a safe and e. Video: Experts discuss research on myofunctional therapy to treat obstructive sleep apnea. sharing sensitive information, make sure youre on a federal We are grateful to be in a position to help patients connect with our doctors and therapists online to discuss symptoms, answer specific questions, or to get an expert second opinion, meanwhile honoring social distancing and staying in the comfort of their own home. Kaiser Permanente uses the same quality, member experience, or cost-related measures to select practitioners and facilities in Marketplace Silver-tier plans as it does for all other Kaiser Foundation Health Plan (KFHP) products and lines of business. But Baldassari says there isn't sufficient. SOROUSH ZAGHI, MD - 56 Photos & 29 Reviews - 10921 Wilshire Blvd, Los Angeles, California - Ear Nose & Throat - Phone Number - Yelp Restaurants Home Services Soroush Zaghi, MD 29 reviews Claimed Ear Nose & Throat, Surgeons, Sleep Specialists Closed 8:00 AM - 5:00 PM See hours Write a review Add photo Photos & videos See all 56 photos See All 56 Having a myofunctional therapist assist during surgery, as well as preparing the patient for surgery and then post-op as well, is just an excellent way to practice. Review methods: Federal government websites often end in .gov or .mil. Minor complications occurred in <5% of cases including complaints of prolonged pain or bleeding, temporary numbness of the tongue-tip, salivary gland issues, minor wound infection or inflammation, and need for revision to excise scar tissue. I graduated from Harvard Medical School in 2010 and completed a 5 year residency in Head and Neck Surgery at UCLA from 2010-2015. Los Angeles CI, confidence interval; MT, myofunctional therapy; SD, standard deviation; Tx, treatment. Clipboard, Search History, and several other advanced features are temporarily unavailable. Dr. Zaghi and our team at The Breathe Institute are proud to be continuing to provide online consultations for those suffering from airway issues, nasal obstruction, snoring, sleep apnea, tongue-tie and anyone seeking a healthier roadmap to better breathing and overall wellness. Efficiency of oro-facial myofunctional therapy in treating obstructive sleep apnoea: A meta-analysis of observational studies. Lack of nasal breathing or sleep disordered breathing may lead to the tongue moving or resting forward and pushing against the teeth (static). 91365, 5601 De Soto Ave, Woodland Hills, CA 91367, Measuring care quality in our hospitals(PDF). 2023 Feb 9;12(4):1378. doi: 10.3390/jcm12041378. Exercise 5: Push Tongue Right - Stick out your tongue and move it as far as you can to the right and hold for 10 seconds, then relax. Orofacial Myofunctional Disorders (OMDs)affect the functions and muscles of the mouth and face. Rueda JR, Mugueta-Aguinaga I, Vilar J, Rueda-Etxebarria M. Cochrane Database Syst Rev. Data sources: Adult premyofunctional and postmyofunctional therapy outcomes for lowest oxygen saturation (percent). Fernando C. Tongue TieFrom Confusion to Clarity: A Guide to the Diagnosis and Treatment of Ankyloglossia. 2022 Soroush Zaghi, M.D. Video:UCLA Research Presentation. Saturday. Closed a complete and effective release of tethered oral tissues by incorporating a multidisciplinary protocol that integrates myofunctional therapy (and sometimes physical therapy) both before, during, and after surgery. Meghpara S, Chohan M, Bandyopadhyay A, Kozlowski C, Casinas J, Kushida C, Camacho M. Expert Rev Respir Med. Lingual frenuloplasty and myofunctional therapy are considered to be less effective in patients without adequate oral volume for tongue space. Exercise 6:Roll Tongue - Roll your tongue by folding the edges toward the middle lengthwise, so it looks like the end of a taco shell. Myofunctional therapy for OSA: a meta-analysis. Repeat 10 times. Dr. Zaghi is particularly interested in studying the impact of tethered-oral tissues (such as tongue-tie) andoral myofascial dysfunction on maxillofacial development,upper airway resistance syndrome, and obstructive sleep apnea. Myofunctional therapy, functional evaluation of tongue mobility as related to sleep disorders. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy may benefit those who suffer from a variety of ailments, including: Mouth breathing can completely alter how your child looks which is the skeletal development of a child, and completely disrupts airway development which affects the amount of oxygen the body requires for proper function. doi: 10.1002/14651858.CD013449.pub2. 2022 Sep 28;19(19):12347. doi: 10.3390/ijerph191912347. Dr. Loria is the first recipient of the Dr. Soroush Zaghi Award for application of evidence-based protocols to the community at the AAPMD's . Correa EJ, O'Connor-Reina C, Rodrguez-Alcal L, Benjumea F, Casado-Morente JC, Baptista PM, Casale M, Moffa A, Plaza G. J Clin Med. Our team at the Breathe Institute heard you loud and clear, and we're so excited to finally announce The Breathe Oral Habits Program, fantastic new course offerings for providers with Carla Lejarraga and Anna Gross! Do not place the handle between your teeth. Pediatrics Accessibility Kaiser Permanente uses the same geographic distribution consideration to select hospitals in Marketplace plans as it does for all other Kaiser Foundation Health Plan (KFHP) products and lines of business. To systematically review the literature for articles evaluating myofunctional therapy (MT) as treatment for obstructive sleep apnea (OSA) in children and adults and to perform a meta-analysis on the polysomnographic, snoring, and sleepiness data. Carminatti M, Nicoloso GF, Miranda PP, Gomes E, de Araujo FB. We are honored to be considered emerging leaders in airway and breathing health, that beingsaid, we have an extraordinary responsibility to give our all during tremendous uncertainty. 8600 Rockville Pike Myobracefocuses on treating the underlying causes, unlocking natural growth and development. Dr Ankita Shah, directly trained under Dr. Zaghi in Los Angeles and is The Breathe Institute's Only Indian Ambassador. Lingual frenuloplasty with myofunctional therapy for the treatment of mouth breathing, snoring, clenching, and myofascial tension in appropriately selected patient candidates. In-person, telephone, video, and alternative modes of communication are available. 5601 De Soto Ave, Woodland Hills, CA 91367. Exercise 10:Hold a Button -For children and adults who are not at risk of swallowing a button, tie one to a piece of string at least 10 cm in length. 2022 Jul;49(7):734-745. doi: 10.1111/joor.13325. We are grateful to be in a position to help patients connect with our doctors and therapists online to discuss symptoms, answer specific questions, or to get an expert second opinion, meanwhile honoring social distancing and staying in the comfort of their own home. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. In children, establishing this good resting tongue posture is critical for good facial growth and airway development. Heis an invitedlecturer, author, and journal reviewer for topics relating to the diagnosis and management ofsleep-disordered breathing and tongue-tie disorders. Our bodies rely on a specific amount of incoming oxygen and outgoing carbon dioxide to remain in a healthy state. PMC Repeat 10 times. 2015 Associated Professional Sleep Societies, LLC. Fill out an online application to be admitted to the course. Dr. Kezirian \"encourage[s] practitioners to perform research\" yet subsequently tries to belittle the 3-year long research project we accomplished alongside an expert team of clinicians and researchers. 2020 Nov 3;11(11):CD013449. Restoration Smiles Dental . To better understand the importance of establishing, To clearly identify and illustrate the importance of. From square nots to horizontal mattresses and more, join Dr. Kevin Coppelson (Oral Maxillofacial Surgeon) for this engaging program designed for anyone wanting to improve their needlework. , CA People with trouble speaking clearly, swallowing problems, or muscle weakness of the mouth may benefit from these exercises. Medi-Cal Members: Enhanced Care Management and Community Supports services require prior authorization and are limited to members who meet specific eligibility criteria. 2019 Mar 10;2019:3408053. doi: 10.1155/2019/3408053. The interaction between orofacial structural growth and muscle activity starts early in development, and the physiologic functions of suction, mastication, swallowing and nasal breathing in infancy play an important role in stimulating subsequent growth. Myofunctional therapy may be an attractive alternative treatment for sleep apnea. Four hundred twenty consecutive patients (ages 29 months to 79 years) treated with myofunctional therapy and lingual frenuloplasty for indications of mouth breathing, snoring, dental clenching, and/or myofascial tension were surveyed. The searches were performed through June 18, 2014. Zhang F, Tian Z, Shu Y, Zou B, Yao H, Li S, Li Q. J Oral Rehabil. This continuing education activity has been planned and implemented in accordance with the standards of the ADA Continuing Education Recognition Program (ADA CERP) through joint efforts between GLOH Education and <> GLOH Education designates this activity for XX credit hour/s of continuing education credit.". Find Dr. Zaghi's phone number, address and more. eCollection 2019. Sign In CI, confidence, Adult premyofunctional and postmyofunctional therapy outcomes for Epworth Sleepiness Scale. If you have questions, please call us at 1-800-464-4000 (toll free). Dr. Soroush Zaghi, MD, is a Plastic Surgery specialist practicing in Los Angeles, CA with 13 years of experience. Patient Portal If you request it, your request for hard copies of the provider directory remains until you leave Kaiser Permanente or request that hard copies be discontinued. Functional Appliances like the Myobrace is used in conjunction with myofunctional therapy in order to aid in elimination of bad habits and help restore proper nasal breathing through strengthening of the muscles of the airway including the lips, the cheeks and the tongue. Myofunctional therapy could serve as an adjunct to other obstructive sleep apnea treatments. Orthod Craniofac Res 2017;20:237244. Photos are taken in neutral position, tongue elevated to the central incisors, and while in suctionhold (i.e., lingualpalatal suction, cave). 2022 Apr 8;12(4):558. doi: 10.3390/life12040558. Correa EJ, O'Connor-Reina C, Rodrguez-Alcal L, Benjumea F, Casado-Morente JC, Baptista PM, Casale M, Moffa A, Plaza G. J Clin Med. FOIA Because of the very brief nature of the many arousals triggered by snoring, patients with UARS are typically unaware of these awakenings and generally do not know that they may be snoring if it were not for the witnessed reports from a bed partner or family member. Try to keep it parallel to the floor. The results of this therapy is proper function which helps grow and develop the jaws, the face and most importantly the AIRWAY! Events Polysomnography snoring decreased from 14.05 4.89% to 3.87 4.12% of total sleep time, P < 0.001, and snoring decreased in all three studies reporting subjective outcomes. The .gov means its official. Sarah Hornsby receives financial compensation as owner of Faceology - an online myofunctional therapy practice that treats patients with orofacial myofunctional disorders and related symptoms. Resource #2:Stanford Sleep Medicine- Myofunctional Therapy Blogspot. Baseline images obtained after preparation with preoperative myofunctional therapy, immediately prior to surgical release. Repeat 10 times. Dentistry by Dr. David 563 Main Street . In the first study of 14 children, the AHI decreased from 4.87 3.0/h to 1.84 3.2/h, P = 0.004. Further studies with objective measures are merited. Precision Diagnostics and Treatments for Snoring and Sleep Apnea. Medi-Cal Members: This directory includes Kaiser Permanentes outpatient pharmacies. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Myofunctional Therapy:Additional Exercises. What a great analogy, they do NOT replace myofunctional therapy . The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Int J Environ Res Public Health. The regimen includes: The Leadership series is a comprehensive training program focused Practice recommendations for the role of physiotherapy in the management of sleep disorders: the 2022 Brazilian Sleep Association Guidelines. Individualswith predominantmouth breathing (or insufficient habitual nasal breathing) often develop maladaptive habits andpatterns oforofacial functionthat may impact various conditions including: Facial skeletal growth (maxillofacialdevelopment), Sleep-disordered breathing (including snoring and sleep apnea). Assessment of posterior tongue mobility using lingual-palatal suction: Progress towards a functional definition of ankyloglossia. Myofunctional therapy is also an important adjunct to numerous orofacial surgeries such as frenuloplasties, and mandibular advancements. Therapy for adult patients is typically efficient. J Dent Child (Chic). Dr. Zaghi and our team at The Breathe Institute are proud to be continuing to provide online screenings for those suffering from nasal obstruction, snoring, sleep apnea, tongue-tie or for anyone seeking a healthier roadmap to better breathing and overall wellness. Accessibility of medical offices and medical centers in this directory: All Kaiser Permanente facilities are accessible to members. The focus of his sub-specialty training is on the comprehensive treatment of tongue-tie, nasal obstruction, mouth breathing, snoring, and obstructive sleep apnea. Dr. Zaghi also offers updates to a functional classification for ankyloglossia, including assessment of posterior tongue-mobility and compensation patterns. so far, just 2 weeks afterwards. Dr. Zaghi is a sought after lecturer, author, and journal reviewer for topics relating to the diagnosis and management of sleep-disordered breathing and tongue-tie . Bookshelf ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. It is essentially a combination of frenectomy and myofunctional therapy that promotes proper healing and recovery following the treatment. Realize that your attitude determines your altitude, and that you can do anything you. online program intended for the entire team. Obstructive Sleep Apnea A potentially serious sleep disorder in which breathing repeatedly stops and then starts again during sleep. document.getElementById( "ak_js_1" ).setAttribute( "value", ( new Date() ).getTime() ); Monday.. 8:00 am - 5:00 pm and transmitted securely. 3. pubmed.ncbi.nlm.nih.gov/30921479/ Zaghi S, et al. Related To The Airway, Sleep, Breathing, Health, Growth & Development. It does not have to be a Kaiser Permanente network pharmacy. N,, Adult premyofunctional and postmyofunctional therapy, Adult premyofunctional and postmyofunctional therapy outcomes for apnea-hypopnea index (events per hour). Learn the most up-to-date and research-driven protocols in the field of myofunctional therapy, presented by Sarah K Hornsby and the MyoMentor team. Purse your lips tightly and pull out on the string, not letting it to slip out. related to the airway, sleep, breathing, health, growth & development. Nasal Valve Collapse- A relatively common cause of nasal obstruction characterized by collapse of the cartilaginous part of the nasal tip with inspiration. The site is secure. Govardhan C, Murdock J, Norouz-Knutsen L, Valcu-Pinkerton S, Zaghi S. Case Rep Otolaryngol. Call us for courtesy pricing. Level of evidence: -, Yoon A, Zaghi S, Ha S, Law C, Guilleminault C, Liu S. Ankyloglossia as a risk factor for maxillary hypoplasia and soft palate elongation: a functionalmorphological study. National Library of Medicine Frenectomy for the Correction of Ankyloglossia: A Review of Clinical Effectiveness and Guidelines [Internet]. The regimen includes: Stanford Sleep Medicine- Myofunctional Therapy Blogspot. Flow diagram demonstrating myofunctional therapy for obstructive sleep apnea (OSA) study selection. , Video: Introduction to Orofacial Myofunctional Therapy, Individualswith predominantmouth breathing (or insufficient habitual nasal breathing) often develop maladaptive habits andpatterns oforofacial functionthat may impact various conditions including, Proper diagnosis allows for targeted and effective physical therapy exercises for oral posture retraining to promotebetter health with goals toimprove breathing, reduce pain,and enhance quality of life. Laryngoscope Investigative Otolaryngology published by Wiley Periodicals, Inc. on behalf of The Triological Society. They discuss how myofunctional therapy can . Arena M, Micarelli A, Guzzo F, Misici I, Jamshir D, Micarelli B, Castaldo A, di Benedetto A, Alessandrini M. Acta Otorhinolaryngol Ital. Thursday 8:00 am - 5:00 pm We as an Institute wholeheartedly believe that studying this topic systematically will benefit everyone(VISIT: https://www.thebreatheinstitute.com/blog/in-support-of-myofunctional-therapy-and-lingual-frenuloplasty-open-access-lecture TO CONTINUE READING) Orofacial myofunctional therapy is also appropriate for adults. A low tongue rest posture habit can be lasting even if the causative factors are corrected ie. HHS Vulnerability Disclosure, Help The following exercises should be repeated 10 times and ideally the entire set should be done at least 4 times per day. Repeat 10 times. Effect of myofunctional therapy on children with obstructive sleep apnea: a meta-analysis. Epub 2022 Nov 25. 105 likes, 7 comments - The Breathe Institute (@breathe_institute) on Instagram: "Dr. Zaghi and et al. 2023 May;37(5):620-635. doi: 10.1177/02692155221141395. FOIA TMD/Head & Facial Pain . Lip strain with flattening or wrinkling of chin when lips are closed, Accentuated cupids bow appearance of upper lip, One or both jaws recessed from ideal position. Oct 2005 - Jun 20093 years 9 months. New York, NY, USA: Tandem Publications; 1998. CI, confidence interval; MT, myofunctional therapy; SD, standard deviation; Tx, treatment. To always think positive, live life to its fullest, and to look for the best in everyone and everything. The approach to therapy emphasizes training in the correct resting postures of the tongue and lips all with the goal of facilitation proper nasal/diaphragm breathing. (2) Review results from Dr. Zaghi published and un-published data collection for frenectomy in the treatment of sleep and breathing issues. Exercise 3: Touch Chin - Stick out your tongue and try to lick the bottom of your chin and hold for 10 seconds, then relax. This information is not available at this time. PMC The followingexercises are provided as an introduction and general overview for educational purposes only. Federal government websites often end in .gov or .mil. 2022 Jan 15;89(1):3-10. If you want to find a Medi-Cal pharmacy outside of Kaiser Permanente, you can use the Medi-Cal Rx Pharmacy Locator online at www.Medi-CalRx.dhcs.ca.gov. Conclusion: A low tongue position can contribute to improper muscle functioning and can lead to airway obstruction. Therapy for adult patients is typically efficient. Laryngoscope Investigative Otolaryngology Zaghi et al. Any time the nasal breathing is impaired, temporarily or chronically, the jaw drops and the tongue positions itself low and forward to open up the upper airways. Kaiser Permanente enrollees have full and equal access to covered services, including enrollees with disabilities as required under the Federal Americans with Disabilities Act of 1990 and Section 504 of the Rehabilitation Act of 1973. It is a highly effective . - Listen to #71.Audrey.La nutrition artificielle by OrthosPower instantly on your tablet, phone or browser - no downloads needed. make the centerfold #ENTToday #Literaturereview #otolaryngolog . Case example: 6yearold girl with restless sleep, nail biting, dental grinding, and open mouth breathing presenting with grade 3 compensating to grade 2 tongue mobility. 2019 The Authors. can help correct the tongue resting position - creatingbetter habitsforbetter health. Lowest oxygen saturations, snoring, and sleepiness outcomes improve in adults. For example, you may be able to avoid the use ofcontinuous positive airway pressure (CPAP)or evensurgery. Web of Science, Scopus, MEDLINE, and The Cochrane Library. Any time the nasal breathing is impaired, temporarily or chronically, the jaw drops and the tongue positions itself low and forward to open up the upper airways. Her myofunctional training is with MyoMentor by Sarah K. Hornsby and research founded by Dr. Zaghi of The Breathe Institute. Adults of all ages are capable of achieving success in treatment. Effectiveness of Myofunctional Therapy in Ankyloglossia: A Systematic Review. Myofunctional therapy is a program used to correct the improper function of the tongue and facial muscles. This site needs JavaScript to work properly. Epub 2021 Nov 22. Department, 2620 Las Posas Rd POOR ORAL HABITS RESTRICTING PROPER GROWTH & DEVELOPMENT, Monday.. 8:00 am - 5:00 pm, Tuesday.. 8:00 am - 5:00 pm, Wednesday. 8:00 am - 5:00 pm, Thursday 8:00 am - 5:00 pm, Friday 8:00 am - 2:00 pm, Saturday. Closed, Sunday Closed, Sunday. Closed, Friday Closed, Myofunctional Therapy Soroush Zaghi, MD, To better understand the importance of establishing, To clearly identify and illustrate the importance of, Gastroesophageal reflux disease (GERD)or heartburn. From problems breastfeeding, stunted facial skeletal growth and development, disordered chewing, swallowing, speech impediments, malocclusion, temporomandibular joint movement/disorders, poor oral hygiene, stability of orthodontic treatment, facial esthetics, and more.Many people mouth-breathe more than they should. Toward a functional definition of ankyloglossia: validating current grading scales for lingual frenulum length and tongue mobility in 1052 subjects. For the hearing and speech impaired: 1-800-464-4000 (toll free) or TTY 711 (toll free). HighlyEffective Physical TherapyExercises to ImproveBreathing, Bite, and Orofacial Posture. Before Use of computed tomography imaging to assess for tongue space in the assessment of candidates for lingual frenuloplasty. Note that despite both patients having similarly restricted amount of posterior airway space, the patient on left has no space between the tongue and the palate (poor candidate), while the patient on the right has a significant amount of space between the tongue and the palate (better candidate). Myofunctional Therapy: Role in Pediatric OSA Authors Yu-Shu Huang 1 , Shih-Chieh Hsu 2 , Christian Guilleminault 3 , Li-Chuan Chuang 4 Affiliations 1 Department of Child Psychiatry and Sleep Center, Chang Gung Memorial Hospital and College of Medicine, No. During the swallow, instead of pushing up to the palate the tongue moves forward or laterally, called anterior, bi-lateral, unilateral or bi-maxillary tongue thrust (dynamic). After your application is accepted, Register for the course. You can also call the Medical Board of California at 916-263-2382, orvisit their website. Functional Approach to ENT - Sleep and Breathing: Please Note: The information on this site is solely for purposes of general patient education, and may not be relied upon as a substitute for professional medical care. Bookshelf Kaiser Permanente may ask whether your request for a hard copy is a one-time request or if you are requesting to receive the provider directory in hard copy permanently. Sleep Breath 2017;21:767775. Tonguetie. (Summer clinical research introduction to unique strategies,specialized methods,and remarkable opportunities of patient-oriented research). Learn more. These may include bilingual providers, staff, and healthcare interpreters. -. Don't hesitate to contact uswith any medical questions you may have. Most Kaiser Permanente network pharmacies are Medi-Cal Rx pharmacies. 2022 Dec 27;12(1):201. doi: 10.3390/jcm12010201. At Inspirewell, we provide Myofunctional Therapy and Buteyko Breathing re-education assessments. Sadly, failure to nasal breath affects your overall health. Exercise 1:Push Up the Tongue - Place the tip of the tongue against the hard palate on the roof of the mouth, just behind the top teeth, and push upwards and hold for 5 seconds. Tuesday.. 8:00 am - 5:00 pm Doctor Portal Proper diagnosis allows for targeted and effective physical therapy exercises for oral posture retraining to promotebetter health with goals toimprove breathing, reduce pain,and enhance quality of life. -----------Dr. Zaghi was recently invited to present and contribute to a debate about the pros and cons of myofunctional therapy and frenuloplasty as part of a series of online lectures developed for the International Surgical Sleep Society (ISSS).For those who are not aware of the ongoing controversy, a previous blog post by Dr. Eric Kezarian claimed that: There is no proven benefit to oral myofunctional therapy or frenuloplasty for the treatment of obstructive sleep apnea in adults as it is commonly practiced in the United States. Horton CE, Crawford HH, Adamson JE, Ashbell TS. hakeem jeffries' brother, marlyne barrett bethel,
