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Death and dying are woven throughout the work of home care aides, and yet the care they provide at the end of life (EOL) remains poorly understood. This is due in part to the multiple circumstances under which aides provide EOL care. In this paper, we elucidate the EOL care experiences of aides working in home care agencies in New York City. We conducted in-depth interviews with 29 home care aides, and we analyzed these data using inductive, team-based methods. Our findings show that aides may not be aware of or accept a client's EOL status, and they may avoid EOL care. These conditions shape EOL care, and we detail the committed forms of care aides provide when they are aware and accepting. We recommend improved training, support systems, and policy change to enhance aides' contributions to EOL care, while protecting aides' health and well-being. [ABSTRACT FROM AUTHOR]

The paper examines the work of groups established by chapters of the American Association of Social Workers in the 1920s to develop a systematic and empirically based understanding of the interactional dynamics of the interview in social casework. Now largely forgotten, this work had influence beyond social work. The paper goes on to explore the call by the Chicago sociologist Ernest Burgess to use the ‘verbatim interview’ as a focus of common interest by sociologists and social workers. [ABSTRACT FROM AUTHOR]

Participatory research methodologies have expanded the opportunities for critical, emancipatory and democratic health and social work research. However, their practical application in research with vulnerable participants has historically been challenging due to ethical, practical and theoretical concerns. Individuals who are homeless are typically seen as 'hard-to-reach', transient, 'hidden' and even chaotic participant populations. Unsurprisingly, examples of the use of innovative participatory research techniques with those groups have been relatively scarce. This paper aimed to address this gap by discussing the application of one such technique – the mobile phone diary in research with multiply disadvantaged homeless adults. Diary methods are situated within the qualitative research on health, illness and social marginality, and the enhanced capabilities of the mobile phone diary are highlighted. The author illustrates the application of the mobile phone diary in his participatory research on the everyday life narratives of adults with serious mental illness (SMI) who were homeless. The process of designing the mobile phone diary is detailed. Following this, participant testimonies of their use of the mobile phone diary are presented. They demonstrate the participatory and inclusive nature, as well as the cathartic and empowering potential, of this technique. The methodological contributions and challenges and the theoretical generativity of the mobile phone diary method are discussed. The mobile phone diary is a feasible approach for eliciting evocative, contextualised and nuanced accounts of the lived experience of homelessness, social isolation, coping and recovery. [ABSTRACT FROM AUTHOR]

This paper draws data from a 5-year ethnographic study of young multilingual (Mixteco/Spanish/English) children in their early childhood classrooms. In this paper, we focus on two of the children and their distinctive paths as they develop language and literacy. Using a sociocultural and multimodal theoretical framework we examine how these two children participate in and negotiate a balanced literacy curriculum. [ABSTRACT FROM PUBLISHER]

Introduction: The COVID-19 pandemic has disproportionately affected some New York City (NYC) neighborhoods that primarily consist of Black, Indigenous, and Latinx residents. In comparison to the rest of NYC, these neighborhoods experienced high hospitalization and COVID-related death rates, which has been attributed to a longstanding history of structural racism and disinvestment. While stay-at-home orders were implemented to reduce the spread of COVID-19, this may have also affected access and utilization of non-COVID related healthcare services. This study aims to assess the prevalence of and reasons for the disruption of non-COVID related healthcare services during the first 18 months of the pandemic. Methods: From September 30, 2021 to November 4, 2021, the NYC Health Department administered the COVID-19 Community Recovery Survey to a subset of residents who were part of the NYC Health Panel a probability-based survey panel. This cross-sectional survey, which included closed and open-ended questions, was either self-administered online or completed via CATI (Computer Assisted Telephone Interviewing) in English, Spanish, and Simplified Chinese. Descriptive statistics were used to summarize responses and unweighted, weighted, age-adjusted percentages, and 95% Confidence Intervals (CIs) were calculated. Results: With a response rate of 30.3% (N = 1358), more than half of participants (54%) reported disruption to either routine physical healthcare or mental health services. Concern about getting COVID-19 (61%), stay-at-home policies (40%), belief that care could safely be postponed (35%), and appointment challenges (34%) were among reasons for delaying routine healthcare. Concern about getting COVID-19 (38%) and reduced hours of service (36%) were primary reasons for delaying mental healthcare. Reported reasons for the sustained delay of care past 18 months involved COVID concerns, appointment, and insurance challenges. Conclusions: Due to the pandemic, some disruption to healthcare was expected. However, most study participants either avoided or experienced a delay in healthcare. The delay of non-COVID related healthcare throughout the pandemic may result in the further widening of the health inequity gap among NYC residents dealing with a higher chronic disease burden before the start of the COVID-19 pandemic in March 2020. Findings from this study can support equitable COVID-19 recovery, and guide efforts with health promotion. [ABSTRACT FROM AUTHOR]

Background: Despite the importance of accurate prognostic understanding in patients with advanced cancer, there is little consensus around how to conceptualize and measure the multidimensional construct. Most studies focus on single aspects of prognostic understanding (e.g., curability) that clinicians have identified as important; no previous research has asked patients how they define "prognosis." Aim: The present study examined how patients with advanced cancer conceptualize their "prognosis." It also explored how patients assigned value to prognostic information and the impact of prognosis on life perspectives. Design: A phenomenological approach was used to analyze semi-structured interviews with individuals with advanced cancer to examine how patients define prognosis. Setting/participants: English and Spanish-speaking patients with advanced cancer (N = 29) were recruited from ambulatory clinics at a comprehensive cancer center in New York City. Results: To conceptualize prognosis, patients focused on concrete medical data, anticipated survival and quality of life, impact on meaningful life events, uncertainty, and physician affect. They discussed the importance of maintaining normalcy despite prognosis, knowledge as a form of coping, information reframing, and altered decision-making as means of coping with prognostic information. Conclusions: Given the range of ways patients define prognosis and assign value to prognostic information, clinicians should incorporate a thorough assessment of patient information preferences, values, and coping styles when engaging in end-of-life discussions. Trainings should emphasize the importance of nonverbal cues (i.e., affect management, body language) in prognostic disclosure. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to help community stakeholders develop a shared understanding of the opioid crisis through qualitative system dynamics (SD) modeling to inform local strategies for prevention and treatment. Methods: As part of the HEALing Communities Study-New York State, we used secondary qualitative data from community stakeholder interviews and coalition meeting notes to develop qualitative SD models that elucidate the interdependencies and feedback structures underlying the opioid epidemic in each community. Results: The synthesized model revealed multiple balancing and reinforcing feedback loops that influenced the adoption and reach of evidence-based practices to reduce opioid overdose and fatality. Conclusion: SD modeling is a novel approach to helping community stakeholders to see the inter-connectedness of actors, factors and sectors and the need for multiple mutually reinforcing strategies to avert opioid overdose and fatality. Social workers could play a key role in linking actions across sectors in such a complex system. [ABSTRACT FROM AUTHOR]

Background: The patient-centered medical home (PCMH) model, an important component of healthcare transformation in the United States, is an approach to primary care delivery with the goal of improving population health and the patient care experience while reducing costs. PCMH research most often focuses on system level indicators including healthcare use and cost; descriptions of patient and provider experience with PCMH are relatively sparse and commonly limited in scope. This study, part of a mixed-methods evaluation of a multi-year New York State initiative to refine and expand the PCMH model, describes patient and provider experience with New York State PCMH and its key components. Methods: The qualitative component of the evaluation included focus groups with patients of PCMH practices in 5 New York State counties (n = 9 groups and 67 participants) and interviews with providers and practice administrators at New York State PCMH practices (n = 9 interviews with 10 participants). Through these focus groups and interviews, we elicited first-person descriptions of experiences with, as well as perspectives on, key components of the New York State PCMH model, including accessibility, expanded use of electronic health records, integration of behavioral health care, and care coordination. Results: There was evident progress and some satisfaction with the PCMH model, particularly regarding integrated behavioral health and, to some extent, expanded use of electronic health records. There was less evident progress with respect to improved access and reasonable wait times, which caused patients to continue to use urgent care or the emergency department as substitutes for primary care. Conclusions: It is critical to understand the strengths and limitations of the PCMH model, so as to continue to improve upon and promote it. Strengths of the model were evident to participants in this study; however, challenges were also described. It is important to note that these challenges are difficult to separate from wider healthcare system issues, including inadequate incentives for value-based care, and carry implications for PCMH and other models of healthcare delivery. [ABSTRACT FROM AUTHOR]

Background: Urinary incontinence is prevalent among patients receiving home hospice and presents multiple care management challenges for nurses and family caregivers. Aim: This study sought to understand how urinary incontinence influences the psychosocial care of patients receiving home hospice and the strategies that nurses employ to maximize patient and family comfort. Design: Qualitative descriptive study using semi-structured interviews. Setting/participants: Nurses employed at a large not-for-profit hospice agency in New York City. Results: Analyses of 32 interviews revealed three primary themes. First, nurses considered urinary incontinence to be associated with multiple psychosocial issues including embarrassment for patients and caregiver burden. Second, nurses described urinary incontinence as a threat to patient dignity and took steps to preserve their continence function. Third, nurses assisted patients and their families to cope with urinary incontinence through normalization, reframing incontinence as part of the disease process, mobilizing caregiving assistance, and encouraging use of continence supplies such as diapers and liners. Conclusion: Urinary incontinence influences the psychosocial care of patients receiving home hospice and nurses employ strategies to maximize patient and family comfort. Additional research is needed to examine the psychosocial benefits of facilitated discussions with patients and family members about incontinence, provision of caregiving support, and distribution of comprehensive incontinence supplies to patients with fewer resources. [ABSTRACT FROM AUTHOR]

Purpose: A trauma-informed educational support group pilot addressed traumatic stress, substance use disorders (SUDs), and child-rearing for clients who were pregnant and/or parenting young children. Methods: Seeking Safety was adapted with parenting content and delivered at two intensive residential rehabilitation facilities. An explanatory sequential mixed methods approach was used to evaluate the pilot. Forty-eight participants completed starting assessments (intention-to-treat) and 31 graduates completed postgroup surveys (per protocol). Focus group sessions were completed with 19 graduates. Results: Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy. There were no statistically significant differences on lifestyle behaviors, parenting skill, and parenting confidence. Most participants found the intervention acceptable and felt supported to improve their parenting. Discussion: Trauma-informed parenting education support in inpatient rehabilitation settings may offer an important complement to existing SUD and parenting programming. [ABSTRACT FROM AUTHOR]

Social cohesion has varying effects on health. We investigated the association of perceived neighborhood social cohesion with HIV viral suppression using individual-level data from the New York City HIV registry and surveillance-based interviews (n = 92). Suppression was achieved within 12 months of HIV diagnosis by 60 percent of persons perceiving low cohesion and 71 percent of those perceiving high (p = 0.31). Controlling for demographic and clinical characteristics and neighborhood poverty, per proportional hazards regression, cohesion was not associated with suppression (adjusted hazards ratio (95% confidence interval) for high versus low cohesion: 0.79 (0.49–1.28)). Cohesion may have heterogeneous effects on HIV medication adherence. [ABSTRACT FROM AUTHOR]

There is significant literature on the importance of addressing social determinants of health (SDOH) to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded Medicare Advantage plans ability to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. This article summarizes an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 29 home care social workers between January 2013 and May 2014 in the New York City metropolitan area. Results indicate social workers believe the lack of SDOH coverage, including social work, in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and rehospitalizations; increased caregiver burden; and exacerbation of patients' mental health and substance abuse needs. Policymakers are urged to consider adding coverage of social work and SDOH to Medicare home health. [ABSTRACT FROM AUTHOR]

There is significant literature on the importance of addressing social determinants of health (SDOH) in order to improve health care outcomes. In response, the Centers for Medicare and Medicaid Services (CMS) has expanded the ability of Medicare Advantage plans to cover SDOH-related services. Medicare home health does not cover SDOH-related services. A literature review indicates no studies on the nature, significance, or impacts of the lack of SDOH coverage in Medicare home health. The current study is an initial, exploratory study to address the literature gap, based on interviews of a convenience sample of 37 home care nurses between January 2013 and May 2014 in the New York City metropolitan area. Results indicate that nurses believe the lack of SDOH coverage in Medicare home health results in exacerbation of existing patient conditions; creation of new, additional patient conditions; increased home care readmissions and re-hospitalizations; increased caregiver burden; and exacerbation of patients' mental health and substance abuse needs. [ABSTRACT FROM AUTHOR]

It has been argued that individuals living in poverty are shamed, and thus, experience it in various social and institutional spaces. However, little is known about this dynamic in the United States. This study examined the relationship between poverty and shame among individuals living in poverty. Individual semistructured interviews were conducted with 60 participants in New York, NY. The results reveal that participants experience shame, anger, and frustration in their roles as (a) caregivers when being unable to provide material items and trying to keep up with others in society and (b) social welfare recipients when at the welfare office and accessing welfare benefits. Despite experiencing such debilitating emotions, participants formulated and used strategies to manage these feelings and situations. These findings point to the role of social and institutional practices in shaping emotions. [ABSTRACT FROM AUTHOR]

This article highlights findings from a mixed-method evaluation of two pilot programs that utilized Home Health Aides (HHAs) as health coaches for home care patients with chronic illness, including (1) a dedicated health coaching program for patients with heart failure and (2) an integrated program for HHAs working with chronically ill patients. Interviews were conducted with HHAs and staff to understand their experiences implementing program activities. Data from clinical assessments and surveys were employed to examine the characteristics and outcomes of patients. HHAs viewed health coaching positively and described it as an informative process that is dependent on patient motivation and willingness to change. Patients in both programs reported improvement in self-care maintenance. Patients in the chronic illness program also reported improved quality-of-life. [ABSTRACT FROM AUTHOR]

Background: Many long-term studies have looked at outcomes after anterior cruciate ligament reconstruction (ACLR), but none have correlated long-term outcomes with postoperative laxity greater than 5 mm. It has been stated previously that more than 5 mm of postoperative graft laxity constituted a procedural failure. Purpose: To directly compare tight grafts (<3 mm) and loose grafts (>5 mm) to determine the effect of graft laxity, as measured by KT-1000 arthrometer, after ACLR on long-term clinical outcomes. Study Design: Cohort study; Level of evidence, 2. Methods: The study included 171 consecutive patients who had undergone transtibial bone–patellar tendon–bone ACLR between 1992 and 1998. At 6, 12, and 24 months postoperatively (the immediate postoperative period), patients were evaluated. Group A included patients with a maximal side-to-side (STS) difference in the immediate postoperative period of less than 3 mm (tight grafts), and group B included patients with a maximal STS difference of greater than 5 mm (loose grafts). Any patient with a history of ipsilateral or contralateral ACLR or ACL injury, meniscectomy, or cartilage restoration was excluded. Patients were prospectively followed to long-term follow-up, when a telephone interview was conducted regarding knee function and to document Lysholm, Tegner, Knee injury and Osteoarthritis Outcome Score (KOOS), and International Knee Documentation Committee (IKDC) subjective outcome scores. Results: Eighty-seven patients met inclusion criteria: 66 tight grafts (group A) and 21 loose grafts (group B). The mean ± SD time to follow-up was 16.3 ± 1.5 years in group A (n = 46) and 16.8 ± 1.3 years in group B (n = 15). Tegner (P = .77), Lysholm (P = .85), KOOS (P = .96), and IKDC (P = .42) were found to have no statistically significant difference between groups at long-term follow-up. Both Tegner and Lysholm scores significantly improved in tight and loose grafts in the immediate postoperative period as well as at long-term follow-up compared with preoperatively. There were 2 ACL revisions in group A and none in group B. Eleven of 46 patients (24%) in group A required subsequent procedures versus 1 of 15 patients (6.7%) in group B (P = .146). Conclusion: Postoperative laxity of greater than 5 mm STS difference as measured by KT-1000 arthrometer does not appear to place patients at a worse clinical outcome at long-term follow-up, nor does it lead to significantly more subsequent procedures. In addition, transtibial ACLR can provide excellent clinical results at long-term follow-up. [ABSTRACT FROM AUTHOR]

Reflecting the wide range of consensual unwanted sexual experiences, researchers often have contrasting views of the impact of these incidents on young women. Some scholars support a normalizing view of these as fairly harmless and ordinary aspects of relationships, akin to other forms of willing compromises between partners. Other researchers problematize unwanted sexual experiences, framing them in terms of gender inequalities and detrimental effects. In the current study, we were interested in how young women themselves characterized their unwanted sexual experiences and whether these accounts varied according to a woman’s social location. We interviewed 41 young women (18–22 years old) from three groups: affluent undergraduates, low-income undergraduates, and low-income nonstudents. Almost all of the affluent undergraduates framed their unwanted sexual experiences in normalizing terms, representing such events as relatively harmless incidents and outgrowths of developmental experimentation. In contrast, the low-income students and nonstudents both articulated more ambivalent positions and were more inclined to link their experience to sources of vulnerability, including personal adversity (e.g., trauma, social, and material insecurity) and social norms and stigma. Participants’ sexual histories, life circumstances, and standpoints at the intersection of gender and class were reflected in their experiences of unwanted sex, reinforcing that contextualized analyses and interventions are essential to advancing women’s sexual rights and well-being. Online slides for instructors who want to use this article for teaching are available on PWQ's website at http://pwq.sagepub.com/supplemental [ABSTRACT FROM AUTHOR]

Currently, there are 2.5 million children in the United States who suffered the loss of a parent. Grieving children are more likely to experience symptoms of depression and anxiety compared with their nongrieving peers. Adults (N = 19) who experienced a loss during childhood were interviewed to assess what was most helpful and most harmful in coping through the years following the death. The qualitative descriptions were coded and analysis of common themes determined. Five theoretical constructs were found: adjustment to catastrophe, support, therapy, continuing a connection with the deceased parent, and reinvestment. The findings have clinical applications for bereaved children, their families, and clinical programs targeting this population. The unique insights provide an emotionally salient expression of their experiences and provide a framework for how best to support this group. [ABSTRACT FROM AUTHOR]

Background: There is a developing emphasis on intuition and affect in the illness risk perception process, yet there have been no available strategies to measure these constructs in non-English speakers. This study examined the comprehensibility and acceptability of translations of cancer risk beliefs in Haitian-Creole and Spanish. Method: An established, iterative, team-based translation process was employed. Cognitive interviews (n = 20 in Haitian-Creole speakers; n = 23 in Spanish speakers) were conducted in an inner-city primary care clinic by trained interviewers who were native speakers of each language. Use of an established coding scheme for problematic terms and ambiguous concepts resulted in rewording and dropping items. Results: Most items (90% in the Haitian-Creole version; 87% in the Spanish version) were highly comprehensible. Discussion: This work will allow for further research examining health outcomes associated with risk perceptions across diverse, non-English language subgroups, paving the way for targeted risk communication with these populations. [ABSTRACT FROM AUTHOR]

Why do workers participate in their own exploitation? This article moves beyond the situational production of consent that has dominated studies of the labor process and outlines the relational production of labor’s surplus value. Using a case of unpaid women who perform valuable work for VIP nightclubs, I present ethnographic data on the VIP party circuit from New York, the Hamptons, Miami, and Cannes, as well as 84 interviews with party organizers and guests. Party promoters, mostly male brokers, appropriate surplus value from women in four stages: recruitment, mobilization, performance, and control. Relational work between promoters and women, cemented by gifts and strategic intimacies, frames women’s labor as leisure and friendship, and boundary work legitimizes women’s work as distinct from sexual labor. When boundaries, media, and meanings of relationships do not appropriately align, as in relational mismatches, women experience the VIP party less as leisure and more as work, and they are less likely to participate. My findings embed the labor process in a relational infrastructure and hold insights for explaining why people work for free in culture and technology sectors of the post-Fordist economy. [ABSTRACT FROM AUTHOR]

Findings are from an investigation of 24 criminal domestic violence courts (DVCs) across New York, testing their effect on recidivism, case processing, and case resolutions. Overall, we found a small positive impact on recidivism among convicted offenders. We further found that the sex of defendants moderated the court impact on case resolutions; that is, among male defendants only, DVCs increased conviction rates and sentences involving jail or prison. In addition, multi-level, multivariate analyses found that court policies specifically designed to increase victim safety, hold offenders accountable, and reduce offender recidivism (through deterrence or rehabilitation) were instrumental in reducing recidivism. [ABSTRACT FROM AUTHOR]

This article reports and illustrates challenges encountered by those who were born and raised in an insular Ultra-Orthodox Jewish community and opted to transition to the modern world. Based on content analysis of the narratives shared by means of in-depth interviews with 19 men and women from the NY metropolitan area, social, intellectual, legal, logistic, and financial challenges were identified. Reported strategies for coping with these challenges included reaching compromises and reasoning, relocating to a different geographical area, often to states with a small Jewish population, pretending, developing a “thick skin,” catching up and reinventing. These findings are discussed using a stress and copying conceptual framework. Implications for practice and directions for future research are suggested. [ABSTRACT FROM AUTHOR]

Background. In 1998, the Centers for Disease Control and Prevention (CDC) published Recommendations for Prevention and Control of Hepatitis C Virus (HCV) Infection and HCV-Related Chronic Disease, recommending HCV testing for populations most likely to be infected with HCV. However, the implementation of risk-based screening has not been widely adopted in health care settings, and 45% to 85% of infected U.S. adults remain unidentified. Objectives. To develop a better understanding of why CDC’s 1998 recommendations have had limited success in identifying persons with HCV infection and provide information about how CDC’s 2012 Recommendations for the Identification of Chronic Hepatitis C Virus Infection Among Persons Born During 1945-1965 may be implemented more effectively. Design. Qualitative data were collected and analyzed from a multidisciplinary team as part of the Birth Cohort Evaluation to Advance Screening and Testing for Hepatitis C project. Respondents. Nineteen providers were asked open-ended questions to identify current perspectives, practices, facilitators, and barriers to HCV screening and testing. Providers were affiliated with Henry Ford Hospital, Mount Sinai Hospital, the University of Alabama, and the University of Texas Health Science Center. Results. Respondents reported the complexity of the 1998 recommendations, and numerous indicated risk factors were major barriers to effective implementation. Other hindrances to hepatitis C testing included physician discomfort in asking questions about socially undesirable behaviors and physician uncertainty about patient insurance coverage. Conclusion. Implementation of the CDC’s 2012 recommendations could be more successful than the 1998 recommendations due to their relative simplicity; however, effective strategies need to be used for dissemination and implementation for full success. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the living experience of difficulty telling the truth. Parse’s research method was used to answer the question: What is the structure of the living experience of difficulty telling the truth? The participants were 9 nurses and 1 physician. The central finding of the study is the structure: difficulty telling the truth is uncomfortable dialogues with knowing silences arise with anguishing deliberations anticipating potential adversity, while contemplating intentional withholding gives rise to calm acquiescence. The findings are discussed in relation to the humanbecoming school of thought and extant literature. [ABSTRACT FROM AUTHOR]

HIV testing behavior is important in understanding the high rates of undiagnosed infection among Hispanic/Latino men who have sex with men (MSM). Correlates of repeat/recent testing (within the past year and ≥5 tests during lifetime) and test avoidance (never or >5 years earlier) were examined among 608 sexually active Hispanic/Latino MSM (Miami-Dade County and New York City). Those who reported repeat/recent testing were more likely to have incomes over $30,000, speak English predominately, and have visited and disclosed same-sex behavior to a health care provider (HCP) in the past year. Those who were classified as test avoiders were less likely to have incomes over $10,000 and to have seen an HCP in the past year. The main reason for not testing (in both groups) was fear of HIV positivity; however, twice as many test avoiders considered this their main reason, and more test avoiders had confidentiality concerns. Results suggest that messages to encourage testing among Hispanic/Latino MSM may be most effective if past testing patterns and reasons for not testing are considered. HCPs can play an important role by consistently offering HIV tests to MSM and tailoring messages based on prior testing histories. [ABSTRACT FROM PUBLISHER]

Research suggests that moral disgust, shame, and guilt are present in posttraumatic psychopathology. However, it is unclear that these emotional states are responsive to empirically supported interventions for posttraumatic stress symptoms (PTSS). This study explored the relations among moral disgust, shame, guilt, and PTSS, and examined comprehensive distancing (CD) as a novel intervention for these emotional states in undergraduates with elevated PTSS. Participants were randomly assigned to use a CD or a cognitive challenge task in response to personalized scripts of a traumatic event. Both interventions were associated with decreases in disgust, moral disgust, shame, and guilt. Contrary to predictions, there were no significant differences between the exercises in the reduction of negative emotions. In addition, PTSS severity was correlated with trauma-related guilt as well as state guilt and shame, but not trait or state measures of disgust or moral disgust. This proof of concept project sets the stage for further research examining CD as an alternative or adjunctive intervention for posttraumatic stress reactions with strong features of moral disgust, shame, and guilt. [ABSTRACT FROM PUBLISHER]

The study was grounded in the lived experiences of 13 female and 20 male children of Bangladeshi descent in New York City. It explored how the intersection of ethnicity, gender, generation, and migration shaped the distinctive experiences of the girls as they came of age, straddling the native culture and the host culture. By walking a tightrope between intergenerational continuity of normative gender practice, and change, prompted by egalitarian socialization, they foregrounded educational/career trajectories. Unlike the boys, who acquiesced with the status quo despite its equal opportunity disadvantages, they started rewriting the rules of engagement with patriarchy from this new threshold. [ABSTRACT FROM AUTHOR]