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Gainesville, FL, United States

Copeland V.C.,University of Pittsburgh | Snyder K.,Malcom Randall Medical Center
Social Work in Public Health

Despite the prevalence of mental illness among low-income African American women, only a limited number seek and/or accept help from mental health service delivery systems. A qualitative analysis of 64 ethnographic interviews of low-income African American women whose children receive behavioral health services was completed to assess what barriers to care were reported for the women themselves. These African American women were interviewed as part of a larger study seeking to determine why mothers seek mental health treatment for their children, but not themselves, after many of the women (n = 32) met the baseline criteria for anxiety and/or depression. Our finding revealed that (1) the fear of losing their children, (2) economic stressors, (3) role strain, (4) perceptions of the system, and (5) violence and survival are key factors to consider when engaging low-income African American women in mental health treatment services. These factors have a negative influence on help seeking that should be considered for eliminating disparities in access to and utilization of mental health services. Copyright © Taylor & Francis Group, LLC. Source

Hess C.W.,Columbia University | Hess C.W.,University of Florida | Hess C.W.,Malcom Randall Medical Center
Frontiers in Human Neuroscience

Studies suggest that endogenous field effects may play a role in neuronal oscillations and communication. Non-invasive transcranial electrical stimulation with low-intensity currents can also have direct effects on the underlying cortex as well as distant network effects. While Parkinson's disease (PD) is amenable to invasive neuromodulation in the basal ganglia by deep brain stimulation (DBS), techniques of non-invasive neuromodulation like transcranial direct current stimulation (tDCS) and transcranial alternating current stimulation (tACS) are being investigated as possible therapies. tDCS and tACS have the potential to influence the abnormal cortical-subcortical network activity that occurs in PD through sub-threshold changes in cortical excitability or through entrainment or disruption of ongoing rhythmic cortical activity. This may allow for the targeting of specific features of the disease involving abnormal oscillatory activity, as well as the enhancement of potential cortical compensation for basal ganglia dysfunction and modulation of cortical plasticity in neurorehabilitation. However, little is currently known about how cortical stimulation will affect subcortical structures, the size of any effect, and the factors of stimulation that will influence these effects. © 2013 Hess. Source

Patel S.,University of Florida | Shrivastav R.,Malcom Randall Medical Center | Eddins D.A.,University of South Florida
Journal of Speech, Language, and Hearing Research

Purpose: In this experiment, a single comparison stimulus was developed as a reference in a perceptual matching task for the quantification of breathy voice quality. Perceptual judgments of a set of synthetic voice samples were compared to previous data obtained using multiple comparison stimuli "customized" for different voices (Patel, Shrivastav, & Eddins, 2010). Method: Five male and 5 female samples of the vowel /a/ were selected from the Kay Elemetrics Disordered Voice Database and resynthesized using a Klatt synthesizer. Eleven samples were created for each base voice by manipulating the aspiration noise level. Five samples from each continuum were evaluated in a perceptual matching task in which a single sawtooth and noise comparison stimulus was used to obtain breathiness judgments. Linear regression was used to compare measurements obtained using the new comparison stimulus against the customized comparison stimuli. Results: Results indicated that the noncustomized sawtooth comparison provides reliability and perceptual distances between stimuli similar to those obtained using customized comparison stimuli. Conclusion: A single-variable matching task using a single comparison stimulus can be used to obtain perceptual estimates of breathiness across voices and experiments in a laboratory setting. This technique will help develop models of voice-quality perception. © American Speech-Language-Hearing Association. Source

Coady-Fariborzian L.,Malcom Randall Medical Center | Coady-Fariborzian L.,University of Florida | McGreane A.,Medical Center

Background: Emergency hand service is a national problem both for civilian and veteran patients. The North Florida/South Georgia Veterans Health system began coordinating emergency hand coverage within the plastic surgery service in 2008. Consult templates were designed to facilitate access to the appropriate service. Trainees were taken out of transfer decisions. Clinic templates were designed to fast track urgent patients to 8 a.m. appointments. The purpose of this study was to evaluate the effectiveness of our templates and triage system. Methods: All consults completed by the plastic surgery service were reviewed retrospectively. Emergent and urgent hand consults were identified. Time from consult submission to the patient being seen by the plastic surgery provider was recorded. Time frames were categorized as same day, next day, within 2 days, less than or equal to 7 days, and greater than 7 days. Type of emergency (trauma or infection) and treatment plan were noted. Results: There were 1,090 consults in 2007 and 1,868 consults in 2012 that were completed by the plastic surgery service. We found the number of urgent and emergent hand consults increased by a factor of 6 (49 to 294). Furthermore, 16.3 % (8/49) of patients were seen greater than 1 week after consult submission in 2007, compared with 8.1 % (24/294) of patients in 2012. Only one patient from 2007 and two patients from 2012 went to the OR after regular operating room hours. Conclusion: A well-coordinated effort to speed access for hand emergencies can minimize expenses and improve quality of care © 2014, American Association for Hand Surgery. Source

Beck D.T.,Malcom Randall Medical Center | Martin J.S.,Lasell College | Casey D.P.,University of Iowa | Braith R.W.,University of Florida
American Journal of Hypertension

BACKGROUNDLarge artery stiffness is a major risk factor for the development of hypertension and cardiovascular disease. Persistent prehypertension accelerates the progression of arterial stiffness.METHODSForty-three unmedicated prehypertensive (systolic blood pressure (SBP) = 120-139mm Hg or diastolic blood pressure (DBP) = 80-89mm Hg) men and women and 15 normotensive time-matched control subjects (NMTCs; n = 15) aged 18-35 years of age met screening requirements and participated in the study. Prehypertensive subjects were randomly assigned to a resistance exercise training (PHRT; n = 15), endurance exercise training (PHET; n = 13) or time-control group (PHTC; n = 15). Treatment groups performed exercise training 3 days per week for 8 weeks. Pulse wave analysis, pulse wave velocity (PWV), and central and peripheral blood pressures were evaluated before and after exercise intervention or time-matched control.RESULTSPHRT and PHET reduced resting SBP by 9.6±3.6mm Hg and 11.9±3.4mm Hg, respectively, and DBP by 8.0±5.1mm Hg and 7.2±3.4mm Hg, respectively (P < 0.05). PHRT and PHET decreased augmentation index (AIx) by 7.5% ± 2.8% and 8.1% ± 3.2% (P < 0.05), AIx@75 by 8.0% ± 3.2% and 9.2% ± 3.8% (P < 0.05), and left ventricular wasted pressure energy, an index of extra left ventricular myocardial oxygen requirement due to early systolic wave reflection, by 573±161 dynes s/cm2 and 612±167 dynes s/cm2 (P < 0.05), respectively. PHRT and PHET reduced carotid-radial PWV by 1.02±0.32 m/sec and 0.92±0.36 m/sec (P < 0.05) and femoral-distal PWV by 1.04±0.31 m/sec and 1.34±0.33 m/sec (P < 0.05), respectively. No significant changes were observed in the time-control groups.CONCLUSIONSThis study suggests that both resistance and endurance exercise alone effectively reduce peripheral arterial stiffness, central blood pressures, augmentation index, and myocardial oxygen demand in young prehypertensive subjects. © 2013 © American Journal of Hypertension, Ltd. All rights reserved. Source

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