United States Experience Research Articles

Respectful Maternity Care in the United States-Characterizing Inequities Experienced by Birthing People.

The purpose of this study is to understand experiences of respectful maternity care (RMC) from the perspective of birthing people in the United States from 2013 to 2018. We conducted an online cross-sectional survey of United States birthing people ages 18-50 in April 2018 using SurveyMonkey Audience. Quantitative survey data consisted of demographics and responses to RMC indicators. Qualitative data consisted of comments from individuals regarding their birth experiences. 1036 birthing people participated in the survey. Most births (95%) occurred in hospitals. 16.3% of Black or African American participants reported discrimination compared to 5.5% of participants who did not identify as Black or African American (p < 0.001). Participants who speak a language other than English were also more likely to report discrimination. 19.5% of all respondents felt neglected during their birth experience. Most prevalent experiences of disrespect and mistreatment were related to neglect (most commonly in postpartum phase of care), poor interpersonal communication, lack of respect for patient wishes, negative experience with breastfeeding services, peripartum complications, and discrimination. Birthing people in the United States experience many forms of mistreatment, particularly those who identify as Black or African American or speak a language other than English. Patients described experiencing neglect most commonly after birth-an opportunity to improve the provision of RMC postpartum. Strategies to improve quality of maternal health care in the United States should include the provision of RMC as part of a larger effort to reduce inequities in maternal health experiences and outcomes.

Medical financial hardship between young adult cancer survivors and matched individuals without cancer in the United States.

Young adult cancer survivors face medical financial hardships that may lead to delaying or forgoing medical care. This study describes the medical financial difficulties young adult cancer survivors in the United States experience in the post-Patient Protection and Affordable Care Act period. We identified 1009 cancer survivors aged 18 to 39 years from the National Health Interview Survey (2015-2022) and matched 963 (95%) cancer survivors to 2733 control individuals using nearest-neighbor matching. We used conditional logistic regression to examine the association between cancer history and medical financial hardship and to assess whether this association varied by age, sex, race and ethnicity, and region of residence. Compared with those who did not have a history of cancer, young adult cancer survivors were more likely to report material financial hardship (22.8% vs 15.2%; odds ratio = 1.65, 95% confidence interval = 1.50 to 1.81) and behavior-related financial hardship (34.3% vs 24.4%; odds ratio = 1.62, 95% confidence interval = 1.49 to 1.76) but not psychological financial hardship (52.6% vs 50.9%; odds ratio = 1.07, 95% confidence interval = 0.99 to 1.16). Young adult cancer survivors who were Hispanic or lived in the Midwest and South were more likely to report psychological financial hardship than their counterparts. We found that young adult cancer survivors were more likely to experience material and behavior-related financial hardship than young adults without a history of cancer. We also identified specific subgroups of young adult cancer survivors that may benefit from targeted policies and interventions to alleviate medical financial hardship.

THE ROLE OF GOVERNMENT POLICY IN FOSTERING ENTREPRENEURSHIP: A USA AND AFRICA REVIEW

This Review explores the crucial role of government policies in fostering entrepreneurship by examining the experiences of the United States (USA) and various African nations. Entrepreneurship is a driving force for economic growth, job creation, and innovation, and government policies play a pivotal role in shaping the entrepreneurial landscape. In the USA, a robust history of entrepreneurial success is attributed in part to supportive government policies. The Review delves into specific policies that have contributed to fostering entrepreneurship, including tax incentives, access to funding through Small Business Administration (SBA) programs, and initiatives promoting innovation and research. The analysis extends to the regulatory environment, emphasizing the importance of flexible regulations that encourage innovation while ensuring consumer protection. Turning attention to Africa, the Review explores the diversity of government approaches across the continent. It considers initiatives implemented by African nations to promote entrepreneurship, such as the establishment of entrepreneurial ecosystems, funding mechanisms for startups, and efforts to streamline regulatory frameworks. The review acknowledges the unique challenges faced by African entrepreneurs, including limited access to capital and infrastructure constraints, and evaluates how government policies aim to address these issues. The comparative analysis highlights lessons that African nations can draw from the USA's successful policies, such as the importance of fostering a culture of innovation, providing targeted financial support, and creating an enabling regulatory environment. Moreover, it emphasizes the need for context-specific policies that consider the unique socio-economic conditions of each African nation. In conclusion, the Review underscores the critical role of government policy in nurturing entrepreneurship, drawing insights from the USA's experience and the varied approaches across African nations. It calls for a nuanced understanding of the diverse African entrepreneurial landscape and encourages policymakers to tailor initiatives that catalyze entrepreneurship, driving economic development across the continent.&#x0D; Keywords: Role, Government, Policy, Fostering, Entrepreneurship.

Muhammad Abdullah, Lahore-Ahmadi Americans and the Black Muslims of America

Abstract Imam Muhammad Abdullah (1905–1992) has played a pivotal role shaping the Islamic experience in Fiji and America, two vastly different countries that spanned over six decades. Yet even today, his real historic identity is still shrouded in murky obscurity while his legacy lay mired by layers of confusing myths. This makes him at once fascinating and frustrating. Because Abdullah remains a figure of devotion and a contested site of memory across Islamic movements, it heightens the necessity amongst scholars to disentangle the mythical Abdullah from the historical Abdullah. This essay investigates Abdullah and the Lahore-Ahmadi’s complex entanglements with Wallace Muhammad’s black Muslim community. Their paths were curiously erratic and messy; at times intersecting on a personal, co-conspiratorial level in early 1960s Philadelphia and at other periods they chartered their own separate ways in the mid 1960s after the murderous bloodbaths of Nation of Islam’s religious feuds. From 1970, the pair rekindled their collaboration as their respective organizations became symbiotically intertwined with mixed ramifications.

Is Europe prepared for Risk Assessment Technologies in criminal justice? Lessons from the US experience

Risk Assessment Technologies (‘RAT’) are currently used by criminal courts to evaluate defendants: their risk to reoffend. Despite critique on opacity, complexity, non-contestability or discriminative impact, some courts have favoured RAT-considerations, in light of alleged accuracy, effectiveness and efficiency. This contribution assesses whether and the degree to which RAT can comply with evidence-related rules and fundamental human rights. After detecting key legal challenges in the United States (US), it makes recommendations for the proper regulation and consideration of RAT. It then moves on to the European regime with a view to assessing whether and how it can better tackle RAT-implementations in the criminal justice system.

Emotional dysregulation among English-speaking Hispanic persons who smoke living in the United states

Hispanic/Latinx (hereafter Hispanic) individuals in the United States (US) experience serious tobacco-related disparities and factors contributing to such disparities need to be adequately identified and clinically addressed. Emotion dysregulation is a key transdiagnostic relevant to smoking. The present cross-sectional investigation sought to test if emotion dysregulation was related to more severe problems during smoking quit attempts (e.g., irritability, weight gain), perceptions of difficulty about quitting, as well as negative and positive beliefs about smoking abstinence in a sample of English-speaking Hispanic adults residing in the US who smoke. Participants included 332 Hispanic adults who engaged in daily cigarette smoking (35.46 years old, 37 % identified as female). Emotion dysregulation was significantly related to more severe problems when quitting and perceived barriers for quitting, as well as negative beliefs about smoking abstinence. Additionally, emotion dysregulation was significantly and negatively related to positive outcomes about smoking abstinence. The amount of change in the various smoking criterion variables accounted for by emotion dysregulation was small (sr2 range: 0.028-0.085), but evident in adjusted models that accounted for a wide range of factors (e.g., depression, drug use severity). Overall, this investigation found consistent empirical evidence that individual differences in emotion dysregulation in Hispanic individuals were associated with several clinically significant smoking processes, suggesting this construct may represent an important factor involved in the maintenance and relapse of smoking among this ethnic population.

The prevalence and risk factors of Helicobacter pylori infection and cagA virulence gene carriage in adults in the Navajo Nation.

American Indian and Alaska Native people in the United States experience high rates of stomach cancer. Helicobacter pylori infection is a significant risk factor for stomach cancer, and H. pylori strains that carry the cagA gene are linked to greater gastrointestinal disease severity. Yet, little is known about H. pylori and cagA infections in American Indian and Alaska Native people, particularly at the tribal level. We assessed the prevalence and risk factors of H. pylori infection and cagA gene carriage in tribal members from the Navajo Nation. We conducted a cross-sectional study with adults from the Navajo Nation. Stool samples collected from participants were analyzed with droplet digital PCR for H. pylori 16S ribosomal and cagA virulence genes. Self-administered health and food questionnaires were mailed to participants to collect information on sociodemographic, health, lifestyle, and environmental risk factors for H. pylori infection. Logistic regression assessed the association between risk factors and H. pylori infection and cagA gene carriage. Among 99 adults, the median age was 45 (age range: 18 to 79 years), and 73.7% were female. About 56.6% (95% CI: 46.2-66.5) of participants were infected with H. pylori. Of H. pylori-infected participants, 78.6% (95% CI: 65.6-88.4) were cagA-gene positive. No significant associations of relevant risk factors with H. pylori and cagA-gene positive infections were noted. In a community-based study population, a substantial proportion of adult tribal members had H. pylori and cagA-gene positive infections. Given these high proportions, culturally appropriate prevention strategies and interventions addressing H. pylori infections present an avenue for additional research and stomach cancer prevention in the Navajo Nation.

Perinatal Mood and Anxiety Disorder in Times of COVID

Between 15-20% of pregnant and birthing people in the United States experience symptoms of Perinatal Mood and Anxiety Disorders (PMAD). This percentage is higher for individuals who are low income, racially minoritized, and/or marginalized. Social systems of care and support have been shown to reduce symptoms of PMAD and help optimize the health of pregnant and postpartum people. For many people, COVID-19 further exacerbated the negative impacts of PMAD, largely because of disruptions of social support networks and health care resources. This article uses testimonio and autoethnography to discuss the stress, abandonment, and feeling of loss associated with the disruption of access to postpartum mental health care and support. While such feelings of loss and abandonment may feel personal, this article argues that it is critical to recognize the structural dimensions of perinatal mental health and postpartum care. The author concludes that misrecognition of the structural dimensions of PMAD contributes to structural violence.

Intra-urban variability of long-term exposure to PM2.5 and NO2 in five cities in Colombia

Rapidly urbanizing cities in Latin America experience high levels of air pollution which are known risk factors for population health. However, the estimates of long-term exposure to air pollution are scarce in the region. We developed intraurban land use regression (LUR) models to map long-term exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) in the five largest cities in Colombia. We conducted air pollution measurement campaigns using gravimetric PM2.5 and passive NO2 sensors for 2 weeks during both the dry and rainy seasons in 2021 in the cities of Barranquilla, Bucaramanga, Bogotá, Cali, and Medellín, and combined these data with geospatial and meteorological variables. Annual models were developed using multivariable spatial regression models. The city annual PM2.5 mean concentrations measured ranged between 12.32 and 15.99 µg/m3 while NO2 concentrations ranged between 24.92 and 49.15 µg/m3. The PM2.5 annual models explained 82% of the variance (R2) in Medellín, 77% in Bucaramanga, 73% in Barranquilla, 70% in Cali, and 44% in Bogotá. The NO2 models explained 65% of the variance in Bucaramanga, 57% in Medellín, 44% in Cali, 40% in Bogotá, and 30% in Barranquilla. Most of the predictor variables included in the models were a combination of specific land use characteristics and roadway variables. Cross-validation suggests that PM2.5 outperformed NO2 models. The developed models can be used as exposure estimate in epidemiological studies, as input in hybrid models to improve personal exposure assessment, and for policy evaluation.

Editorial acerca de: “Resecciones hepáticas videolaparoscópicas: estudio descriptivo de nuestra experiencia en 16 años”

Laparoscopic liver resections (LLRs) are steadily evolving. Any liver resection can be performed laparoscopically, depending on the experience of the surgical team and the hospital environment in which the practice is performed. There is scientific evidence that LLRs has better surgical outcomes than conventional hepatectomies, and the oncological results are noninferior1-3. The study presented by Alesandrini A et al. shows the experience of a pioneering team in our country in minimally invasive liver surgery4. One of the most significant findings is the 75% applicability rate of the method. This percentage is really very high and is one of the highest in our region. We must keep in mind that these results cover the initial stage of their experience. According to a publication by J. Pekolj some years ago, reviewing the experience in South America, the average applicability rate of LLRs in the region ranges from 4 to 85%5.

PrEP initiation and discontinuation among transgender women in the United States: a longitudinal, mixed methods cohort study.

Transgender women in the United States experience high HIV incidence and suboptimal Pre-exposure prophylaxis (PrEP) engagement. We sought to estimate PrEP initiation and discontinuation rates and characterize PrEP discontinuation experiences among a prospective cohort of transgender women. Using a sequential, explanatory, mixed-methods design, 1312 transgender women at risk for HIV acquisition were enrolled from March 2018 to August 2020 and followed through July 2022 (median follow-up 24 months; interquartile range 15-36). Cox regression models assessed predictors of initiation and discontinuation. In-depth interviews were conducted among 18 participants, including life history calendars to explore key events and experiences surrounding discontinuations. Qualitative and quantitative data were integrated to generate typologies of discontinuation, inform meta-inferences and facilitate the interpretation of findings. 21.8% (n = 286) of participants reported taking PrEP at one or more study visits while under observation. We observed 139 PrEP initiations over 2127 person-years (6.5 initiations/100 person-years, 95% CI: 5.5-7.7). Predictors of initiation included identifying as Black and PrEP indication. The rate of initiation among those who were PrEP-indicated was 9.6 initiations/100 person-years (132/1372 person-years; 95% CI: 8.1-11.4). We observed 138 PrEP discontinuations over 368 person-years (37.5 discontinuations/100 person-years, 95% CI: 31.7-44.3). Predictors of discontinuation included high school education or less and initiating PrEP for the first time while under observation. Four discontinuation typologies emerged: (1) seroconversion following discontinuation; (2) ongoing HIV acquisition risk following discontinuation; (3) reassessment of HIV/STI prevention strategy following discontinuation; and (4) dynamic PrEP use coinciding with changes in HIV acquisition risk. PrEP initiation rates were low and discontinuation rates were high. Complex motivations to stop using PrEP did not consistently correspond with HIV acquisition risk reduction. Evidence-based interventions to increase PrEP persistence among transgender women with ongoing acquisition risk and provide HIV prevention support for those who discontinue PrEP are necessary to reduce HIV incidence in this population.

Mind, body, and spirit: a constructivist grounded theory study of wellness among middle-class Black women

ABSTRACT Previous studies show that Black women in the United States experience disproportionately poorer health outcomes compared to women of other racial/ethnic groups. Recently the focus is on improving the health of Black women in the United States. However, there is little empirical evidence on what Black women need to improve their health to be well. The goal of this constructivist grounded theory was to increase the understanding of wellness among middle-class Black women (N = 30) in a large Midwestern city in the United States through an intersectional lens. The findings show that the connection and balance between mind, body, and spirit was the core experience of wellness among middle-class Black women. Mind, body, and spirit was described in three ways—(a) mentally managing, (b) physically caring for my body, and (c) connecting spiritually—with the women also noting the barriers and facilitators they endured to be well. Each of these categories highlight the tension middle-class Black women experience with trying to be well. Implications for future practice and research with middle-class Black women are discussed.

Diaper Need: It’s Time for a Change in Practice and Policy

Over one-third of families in the United States experience diaper need, negatively affecting the health and developmental outcomes of young children. Research has shown that when providers recognize the importance of addressing the social determinants of health (SDOH), including diaper need, critical support is provided to children and families. Early intervention (EI) providers work collaboratively with families to address goals for their children, including SDOH. Through longitudinal partnerships with families, EI providers are ideally positioned to address disparities like diaper need and provide essential supports to families. When diaper need affects children with developmental delays and disabilities, the disparities are often exacerbated due to the extended length of time that may be required for the child to wear diapers. EI providers can address this need by increasing awareness of this issue, connecting families to resources, and advocating for policy changes to effectively address diaper need and optimize outcomes for children.

Environment predicts the maintenance of reproductive isolation in a mosaic hybrid zone of rubber rabbitbrush.

Widely distributed plants of western North America experience divergent selection across environmental gradients, have complex histories shaped by biogeographic barriers and distributional shifts and often illustrate continuums of reproductive isolation. Rubber rabbitbrush (Ericameria nauseosa) is a foundational shrub species that occurs across diverse environments of western North America. Its remarkable phenotypic diversity is currently ascribed to two subspecies-Ericameria nauseosa nauseosa and Ericameria nauseosa consimilis-and 22 named varieties. To understand how genetic variation is partitioned across subspecies, varieties, and environments, we used high throughput sequencing of reduced representation libraries. We found clear evidence for divergence between the two subspecies, despite largely sympatric distributions. Numerous locations exhibiting admixed ancestry were not geographically localized but were widely distributed across a mosaic hybrid zone. The occurrence of hybrid and subspecific ancestries was strongly predicted by environmental variables as well as the proximity to major ecotones between ecoregions. Although this repeatability illustrates the importance of environmental factors in shaping reproductive isolation, variability in the prevalence of hybridization also indicates these factors likely differ across ecological contexts. There was mixed evidence for the evolutionary cohesiveness of varieties, but several genetically distinct and narrow endemic varieties exhibited admixed subspecific ancestries, hinting at the possibility for transgressive hybridization to contribute to phenotypic novelty and the colonization of new environments in E. nauseosa.

Diagnostic performance of the 0/2 hours ESC algorithm with high-sensitivity cardiac troponin T in an unselected community United States cohort

Abstract Background There are no robust data addressing the United States (US) experience with the 0/2 hours (h) European Society of Cardiology (ESC) algorithm using high-sensitivity cardiac troponin T (hs-cTnT). Purpose To evaluate the diagnostic performance of the 0/2h ESC-recommended absolute deltas in a US population. Methods Observational US cohort study of ED patients undergoing 0 and 2 h hs-cTnT measurements. The 99th percentiles upper reference limits (URL) used were 10 ng/L for women and 15 ng/L for men. Diagnostic outcomes were the adjudicated diagnoses of acute myocardial infarction (MI, type 1 or 2). Results A total of 1084 patients met inclusion criteria, amongst which 49% were women. Chest discomfort was reported in 521 (48%) patients. Among patients with a baseline hs-cTnT≤99th URL (n=434), 4 MIs occurred. To rule-out MI, an absolute 0-2h delta change &amp;lt;4 ng/L resulted in a sensitivity of 100% (95% CI: 39.8, 100) and a negative predictive value (NPV) of 100% (95% CI: 99.1, 100). To rule-in MI, an absolute 0-2h delta ≥10 ng/L had a specificity of 99.8 % (95% CI: 98.7, 99.9) and positive predictive value (PPV) of 75% (95% CI: 19.4, 99.4). Among patients with a baseline hs-cTnT &amp;gt;99th URL (n=650), 110 MIs occurred. In these patients, both rule-out (sensitivity 65%, NPV 91%) and rule-in (specificity 7.2%, PPV 11%) were poor using the ESC-recommended absolute deltas. Among patients with modest hs-cTnT increases (99th URL to 100 ng/L) neither the ESC-recommended absolute nor the Fourth Universal Definition of MI (UDMI)-recommended relative deltas provided acceptable performance. Among patients with marked hs-cTnT increases at presentation (&amp;gt;100 ng/L), a relative delta change &amp;gt;20% as recommended by the UDMI resulted in a superior rule-in performance, with a specificity of 92.0% (95% CI 74.0, 99.0) and PPV of 84.6% (57.4, 95.7). Conclusions In our unselected US-cohort of patients undergoing hs-cTnT, the 0/2h ESC algorithm had a good diagnostic performance in patients without myocardial injury at presentation. Conversely, in patients with myocardial injury at baseline, the ESC-recommended absolute deltas performed poorly to determine who had MI. In patients with marked hs-cTnT increases &amp;gt;100 ng/L at presentation, the UDMI recommended 20% relative change showed good rule-in performance.

Does a high baseline high sensitivity cardiac troponin T allow for the early diagnosis of acute myocardial infarction?

Abstract Background Guidelines suggest that the diagnosis of acute myocardial infarction (MI) is likely when high concentrations of high-sensitivity cardiac troponin (hs-cTn) are present in the initial sample. These concentration thresholds are much higher than the 99th percentile and are said to provide a high positive predictive value (PPV) for acute MI1. Purpose Evaluate the PPV of recommended baseline hs-cTnT thresholds (&amp;gt;52 and &amp;gt;100 ng/L) for the diagnosis of acute MI from our multi-center United States (US) experience. Methods Retrospective, multicenter (n=22), observational biomarker study involving consecutive, adult patients presenting to the emergency department (ED) in whom at least 1 hs-cTnT measurement was obtained within 12 hours of presentation (CV DataMart Biomarker cohort). The primary endpoint was also evaluated in an adjudicated cohort of consecutive patients presenting to the ED with at least 1 hs-cTnT &amp;gt;99th percentile (ACTION cohort). These cases were adjudicated based on the Fourth Universal Definition of MI by trained physicians. The primary efficacy endpoint was the PPV of acute MI (type 1 or 2), type 1 MI and type 2 MI during index hospitalization using baseline hs-cTnT thresholds of &amp;gt;52 ng/L and &amp;gt;100 ng/L. Results The CV DataMart Biomarker cohort consisted of 143,709 patients, amongst whom 3,003 (2.1%) were diagnosed with acute MI using ICD codes. In the CV DataMart Biomarker cohort, baseline hs-cTnT concentrations of &amp;gt;52 ng/L and &amp;gt;100 ng/L resulted in PPVs of 12% (95% CI: 11, 12) and 17% (95% CI: 17, 19) for acute MI, respectively. In patients with chest pain and baseline hs-cTnT concentrations &amp;gt;52 ng/L, PPV for acute MI was 17% (95% CI: 15, 18), and in those with hs-cTnT concentrations &amp;gt;100 ng/L, PPV was 22% (95% CI: 19, 25). The adjudicated ACTION cohort consisted of 2,107 patients, amongst whom 155 (7.4%) were diagnosed with acute MI including 64 (41%) with type 1 MI and 91 (59%) with type 2 MI. In the ACTION cohort, baseline hs-cTnT concentrations of &amp;gt;52 ng/L and &amp;gt;100 ng/L resulted in PPVs of 46% (95% CI: 40, 53) and 62% (95% CI: 53, 70) for acute MI, respectively. In patients with chest pain and baseline hs-cTnT concentrations &amp;gt;52 ng/L, PPV was 67% (95% CI: 57, 76) for acute MI, 52% (95% CI: 41, 62) for type 1 MI and 15% (95% CI: 8.4, 24) for type 2 MI. In those with chest pain and baseline hs-cTnT concentrations &amp;gt;100 ng/L, PPV was 77% (95% CI: 65, 87) for acute MI, 64% (95% CI: 51, 75) for type 1 MI and 14% (95% CI 6.4, 24) for type 2 MI (Figure). Conclusion Using previously recommended high-risk hs-cTnT thresholds of 52 and 100 ng/L in US patients provides reasonable performance to rule-in acute MI when used in patients with chest pain. When used more broadly across all-comers, the diagnostic performance is poor.

Enhancing Indigenous Food Sovereignty and Community Health Through the Karuk Agroecosystem Resilience Initiative: We Are Caring for It: xúus nu'éethti.

Indigenous communities in the United States experience some of the highest rates of food insecurity and diet-related diseases despite an abundance of food assistance programs and other public health interventions. New approaches that center Indigenous perspectives and solutions are emerging and urgently needed to better understand and address these challenges. This Practice Note shares lessons learned from ongoing collaboration between the Karuk Tribe and University of California, Berkeley researchers and other partners to assess and enhance food sovereignty among Tribes and Tribal communities in the Klamath River Basin. Through two participatory research and extension projects, we demonstrate the importance of centering Indigenous knowledge to strengthen research findings and identify more culturally appropriate solutions to community identified food access, health, and ecosystem challenges. Key findings suggest that approaches to food sovereignty and community health must emanate from the community, be approached holistically, reflect community values and priorities, and center Indigenous land stewardship.

Perfecting the Mechanism of Successful Mediation Agreement Under the Laws of Vietnam and the Experience of Germany, USA, Australia, and Singapore

Objective: Improve the legal provisions on the mechanism for implementing successful mediation agreements according to Vietnam Commercial Mediation law.&#x0D; &#x0D; Method: Methods used in this article include: writing law analysis, comparative method, and data collected from documentation... to compare and analyze The successful mediation enforcement mechanism under Vietnamese law and some countries such as Germany, the United States, Australia, and Singapore.&#x0D; &#x0D; Result: Resolved inadequacies in recognizing a “Successful mediation agreement”; Proposed to develop regulations on the mechanism of implementing a successful mediation agreement within the scope of the law on commercial mediation, the law on handling administrative violations, and the law on enforcement of civil judgments.&#x0D; &#x0D; Conclusion: This study contributes to orienting, perfecting, and resolving shortcomings related to the key role of the commercial mediator, improving security principles, and simplifying processes to recognize a “Successful settlement agreement”. This important legal foundation helps the Commercial Mediation method operate effectively.

Asian American social workers’ experiences and perspectives on anti-Asian hate

Summary The rise in anti-Asian hate since the COVID-19 pandemic highlighted the challenges that Asian Americans in the United States (U.S.) experience with xenophobia, racism, and the “model-minority stereotype.” The model-minority stereotype is a misleading myth that has been pervasively attached to the Asian American identity and experiences. Thus, it can serve as a useful framework to understand experiences in the current anti-Asian hate climate. In this exploratory qualitative study, the investigators interviewed Asian American social workers ( N = 17), highlighting their perspectives and experiences during the anti-Asian hate climate, with attention paid to how the model minority stereotype was contextualized among participants. Findings The resounding tone underlying participants’ model-minority stereotype-related discussions was the need to counter the model minority stereotype. Notably, the model-minority stereotype was contextualized differently for participants and three themes were identified: (1) limbo between model minority and perpetual foreigner status; (2) impacts on the social worker role and in the organizational setting; and (3) impacts on advocacy work. Applications Study findings suggest a need for continued support and opportunities to unlearn and relearn the purpose of the model-minority stereotype and its broad sweep and attacks on various health dimensions (physically, psychologically, socially, and spiritually) across Asian Americans ethnic groups. Countering the model-minority stereotype can play a pivotal role in transforming the narratives surrounding Asian American's identity and experiences in the U.S., in addition to organizational culture and dynamics to support Asian Americans social workers practice and advocacy work across practice levels.

Discrimination Against Muslims in the USA and Couple Interactions: An Actor-Partner Interdependence Model.

Muslims in the USA experience unfair treatment and direct exposure to discriminatory acts because of their religion. Trauma stemming from discrimination can strengthen couples' relationships as they find solace in each other, or strain relationships if couples struggle to cope with the stress. This study examined the relationship between experiencing anti-Muslim hate and couples' interactional quality. Further, the role of open communication between partners in moderating the impact of anti-Muslim hate on couple interactions was examined. The study included a sample of 129 Muslim couples. The results indicated gender disparity whereby anti-Muslim hate was linked to negative interactions in relationships for Muslim women, but this was not true for their male partners. In addition, open communication had contracting gender effects on the relationship between anti-Muslim hate and couple interactions. Increased self-disclosure buffered the adverse effects of anti-Muslim hate by reducing the likelihood of negative interactions. Among women, increased self-disclosure exacerbated the detrimental effects of anti-Muslim hate on the couples' relationship such that couples engaged in more negative interactions. Clinical implications are discussed.