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Combating Trauma And The Immigrant Paradox In Schools, Emma Bergman Apr 2024

Combating Trauma And The Immigrant Paradox In Schools, Emma Bergman

Honors Projects

Over time, research on immigrant populations has revealed a trend known as the immigrant paradox in which, the further generations get from the generation of immigration, the poorer their outcomes are in areas such as mental health, delinquency, substance abuse, and education. Though a definitive explanation for this trend has yet to be identified, prevailing theories include several social, familial, and community-based factors such as the impacts of bilingualism, parental expectations, biculturalism, co-ethnic peers, quality of schools, and community support. Little attention has been paid to individual factors such as mental health and trauma. The present study proposes the transgenerational …


Trauma And Juvenile Offending, Cynthia Vasquez, April Terry Apr 2024

Trauma And Juvenile Offending, Cynthia Vasquez, April Terry

SACAD: Scholarly Activities

Over the past few decades, studies have shown a relationship between childhood abuse and neglect and juvenile justice system involvement. Additionally, the United States supervises and incarcerates more youth than other established country. This process—from abuse to incarceration—has become known as the abuse-to-prison pipeline or victimization-to-imprisonment. Many traumatized youth find themselves responding to their trauma with behaviors deemed delinquent (e.g., skipping school and running away) which then begins their path into the juvenile justice system. For a sub-set of youth, they are dual-involved, meaning, they are supervised in both the child welfare and juvenile justice systems. For some youth, their …


Trauma-Informed Educational Practices: Perceptions Of Undergraduate Communication Sciences And Disorders Students, Lindsey J. Knussmann Mar 2024

Trauma-Informed Educational Practices: Perceptions Of Undergraduate Communication Sciences And Disorders Students, Lindsey J. Knussmann

Honors College Theses

Trauma is a prevalent issue among college students, with lasting negative effects on mental health, physical well-being, and academic performance. Despite this, literature exploring the application of trauma-informed education practices (TIEPs), specifically within the field of communication sciences and disorders (CSD), is limited. The purpose of this study was to address this literature gap by exploring which TIEPs CSD students find most beneficial.

Undergraduate students majoring in CSD participated in this research, rating the helpfulness of 12 TIEPs. Most participants reported perceiving all TIEPs as at least “very helpful”. These data represent a step toward improved understanding of the effects …


Infusing Trauma-Informed Care In Career Counseling: Promising Practices And A Proposed Framework, Lisa M. Cardello, Galaxina G. Wright Mar 2024

Infusing Trauma-Informed Care In Career Counseling: Promising Practices And A Proposed Framework, Lisa M. Cardello, Galaxina G. Wright

Trauma Counseling and Resilience

The impact of trauma on career development is well-documented and includes effects on career decision, stability, and unemployment. However, literature on trauma-informed interventions in the career counseling setting is scarce and a universal model for providing career counseling with a trauma-informed lens does not currently exist. Therefore, the authors discuss existing literature on trauma-informed care and application for career counseling. An integrated framework for trauma-informed career counseling, the HEART model, is proposed and includes five components: (a) instilling hope, (b) establishing safety, (c) recognizing and responding to chronic stress, (d) building resilience, and (e) the importance of engaging in ongoing …


Trauma Curriculum Integration In Counselor Education: A Delphi Study, Jaimee York, Adrienne Baggs, Laura Schmuldt, Nancy Sherman Mar 2024

Trauma Curriculum Integration In Counselor Education: A Delphi Study, Jaimee York, Adrienne Baggs, Laura Schmuldt, Nancy Sherman

Trauma Counseling and Resilience

Research has established the need for trauma education and training for safe and effective entry-level practice. However, studies have shown insufficient and inconsistent training in graduate counseling programs. Those studies reflected the opinions and experiences of practitioners and graduate students. To add to the extant literature, we used the Delphi method to gather information from counselor educators who have experience in trauma counseling and education. The Delphi technique is a group communication strategy designed to obtain expert consensus through a series of survey questionnaires, modified and adapted to reflect group opinion. We asked participants for their insight into the most …


For Black Women - When The Rainbow Was Not Enough (Shange, 1976, New York City): An Autoethnographic Collection About Spirit Assassination, Teresa Quarles, Tamika Galvin, Sherrie Mcclellan Mar 2024

For Black Women - When The Rainbow Was Not Enough (Shange, 1976, New York City): An Autoethnographic Collection About Spirit Assassination, Teresa Quarles, Tamika Galvin, Sherrie Mcclellan

Dissertations

ABSTRACT

We live in an America where the higher you elevate in your career as a Black woman, the greater your chances of being subjected to racism, discrimination, isolation, and bullying. We are underrepresented in various elevated roles, but we will not let that stop us. As Black women, we can attest to the experiences that we are subjected to with no question about our mental health. The Black community in America has been subjected to a considerable presence of systemic racism, oppression, and violence - with the objectives of exercising authority and oppressing the Black community, as well as …


Animal Assisted Play Therapy® For Childhood Animal Abuse Following Exposure To Family Violence: A Case Example, Katharine Wenocur, Rise Vanfleet Feb 2024

Animal Assisted Play Therapy® For Childhood Animal Abuse Following Exposure To Family Violence: A Case Example, Katharine Wenocur, Rise Vanfleet

People and Animals: The International Journal of Research and Practice

Intentional harm to nonhuman animals in childhood often correlates with histories of witnessing, experiencing, or perpetrating violence. Without appropriate intervention, children and adolescents who abuse animals following exposure to family violence risk long-term behavioral health challenges. While some treatment models have been specifically designed to reduce the risk of future violence among children displaying this behavior, interventions involving nonhuman animals represent a novel approach and show promise in addressing behavioral challenges associated with this behavior. Framed through the lens of a clinical case study, this article presents the potential benefits of implementing Animal Assisted Play Therapy® to treat symptoms of …


The Role Of Family Accommodation In Child Posttraumatic Stress Symptoms And Functional Impairment In The Context Of Cognitive Behavioral Therapy, Ogechi Cynthia Onyeka, Samuel D Spencer, Alison Salloum, Katie Jiannetto, Eric A Storch Feb 2024

The Role Of Family Accommodation In Child Posttraumatic Stress Symptoms And Functional Impairment In The Context Of Cognitive Behavioral Therapy, Ogechi Cynthia Onyeka, Samuel D Spencer, Alison Salloum, Katie Jiannetto, Eric A Storch

Faculty, Staff and Students Publications

BACKGROUND: Caregiver behaviors such as family accommodation (FA) are negatively reinforced by reduced distress in the short term, but ultimately maintain symptoms. It is important to explore the role of FA on symptoms and impairment. The current study examined the relationship among FA, posttraumatic stress symptoms (PTSS), and functional impairment in a sample of children and their caregivers who completed trauma treatment.

METHOD: Participants included 183 children and their caregivers (M age = 7.89; 55.19 % female; 73.22 % non-Hispanic; 51.37 % White). Data consisted of parent-reported measures collected at baseline, post-treatment, and 12-month follow-up from a randomized control trial …


Caring, 1979, V3 N1, Spring, Advocate Aurora Health Jan 2024

Caring, 1979, V3 N1, Spring, Advocate Aurora Health

Historical Documents - Combined

Illinois Masonic Medical Center, Chicago, IL: Issue of "Caring", a quarterly patient education publication. This issue has an article on the rise and prominence of ambulatory care as well as news about staffing, publications, events, and other updates.


Identifying Barriers To Mental Health Services Utilization For Black Youth In The United States: A Qualitative Study, Emily Stein, Matthew Hutnyan, Neely Myers Jan 2024

Identifying Barriers To Mental Health Services Utilization For Black Youth In The United States: A Qualitative Study, Emily Stein, Matthew Hutnyan, Neely Myers

SMU Journal of Undergraduate Research

Mental health in Black communities and racial/ethnic disparities in mental health service utilization remain growing concerns. Evidence suggests that psychotic disorders may be more prevalent among Black individuals than white individuals and the Black community faces barriers to care that can negatively influence outcomes. To better understand these barriers, we interviewed mental healthcare providers (n = 11) and Black young adults with first-person experience of psychosis (n = 13) about the experiences of minority young adults with mental health treatment. We analyzed interview transcripts and, consistent with constructivist grounded theory methods, identified iterative patterns across individuals about barriers to care. …


The Benefits Of Trauma Informed Teaching Strategies And Interventions For Students, Ryan J. Abrahamson Jan 2024

The Benefits Of Trauma Informed Teaching Strategies And Interventions For Students, Ryan J. Abrahamson

All Electronic Theses and Dissertations

Over the years, schools have faced an uphill battle when discussing trauma in students. As the research continues to improve and the more it is studied, more schools are able to talk about it and learn about it. This can become a big weight on the shoulders of the teachers because students do spend the majority of their day at school during the school year. Not only are the general education students experiencing trauma but also students with disabilities are also experiencing it.. This can lead to a higher risk for the students with disabilities to experience mental health issues …


Trauma Exposure’S Influence On How Black Superwomen Cope And Perceive Stress, Latisha Thomas Jan 2024

Trauma Exposure’S Influence On How Black Superwomen Cope And Perceive Stress, Latisha Thomas

Social Work Dissertations - Archive

Black women in the United States experience high levels of lifetime trauma exposure, which significantly affects their perceived stress and coping mechanisms. The lifetime trauma experienced by Black women in the United States is a large and intricate issue shaped by numerous historical, cultural, and structural elements that affect their perceived stress and coping mechanisms. Lifetime trauma encompasses a wide range of painful events or experiences that transpire throughout an individual's life, significantly and persistently affecting their mental, emotional, and physical health (National Institute of Mental Health, 2020). These traumatic occurrences can encompass a broad range of experiences, including physical …


Yoga And Wellness-Based Interventions With Marginalized Populations, Marisa Moore Jan 2024

Yoga And Wellness-Based Interventions With Marginalized Populations, Marisa Moore

Entry-Level Occupational Therapy Doctorate - Doctoral Capstone Symposium

In the realm of mental health, the intersection of addiction, trauma, and various behaviors represents a complex and multifaceted landscape that requires specialized understanding and treatment approaches. Upward Inertia is a nonprofit organization whose mission is to improve the mental, physical, and social-emotional health and wellbeing of marginalized populations through the use of therapeutic yoga and mind-body based interventions. Ongoing programming is currently offered at five Idaho prisons, both men's and women's facilities, ranging from minimum to maximum security. This capstone project explores the possibility of expansion to other marginalized populations including pediatrics. After investigation, there are stakeholders that are …


Trauma And Parenting: Are There Unintentional Effects?, A'Tora Hill Jan 2024

Trauma And Parenting: Are There Unintentional Effects?, A'Tora Hill

Theses and Dissertations--Early Childhood, Special Education, and Counselor Education

The goal in conducting this study was to explore the effects of trauma across generations, if any were to be confirmed. This study, specifically, aimed to investigate whether parents reported having dealt with trauma and if their trauma had any impact on the way they parent their children. Research has shown that parents who have endured trauma take on different parenting styles and techniques than those who have not endured trauma. This study highlights the effects of trauma on those who encounter it as well as how it may transcend through generations through a survey. A key outcome of this …


The Effectiveness Of Group Treatments For Veterans: A Meta-Analysis, Janine S. Hazel Jan 2024

The Effectiveness Of Group Treatments For Veterans: A Meta-Analysis, Janine S. Hazel

Doctor of Psychology (PsyD)

Transitioning into civilian life after serving in the military can be a huge adjustment for many military members. The military lifestyle and culture are unique structures that become a large part of military members’ identity and belief systems. For decades, veterans have struggled with several mental health issues and other poor outcomes at higher rates than non-military individuals (i.e., depression, PTSD, suicidal ideation, homelessness, financial distress). Often, these poor outcomes can leave veterans feeling alone and misunderstood by their non-military community—impacting their ability to reintegrate into civilian life successfully. Social isolation and a lack of felt interconnectedness negatively affect veterans’ …


Religious Trauma And Identity, Kylie N. Angiel Jan 2024

Religious Trauma And Identity, Kylie N. Angiel

Honors Undergraduate Theses

Religious trauma is most often the result of prolonged emotional and mental trauma, rather than a one-time occurring physical experience, which can thereby lead to complex post-traumatic stress disorder (C-PTSD). This prolonged form of trauma can have negative impacts on one’s psychological well-being and possibly one’s sense of identity. The purpose of this study was to gain a deeper understanding of how religious trauma may be related to identity development. College students (N = 223) completed an anonymous online survey battery for course credit. Scores on a measure of religious and spiritual struggles was positively correlated with identity distress and …


An Exploration Of The Lived Experiences And Psychological States Of Migrants And Refugees, Zainab Akef, Senel Poyrazli, Isabel Quintero Jan 2024

An Exploration Of The Lived Experiences And Psychological States Of Migrants And Refugees, Zainab Akef, Senel Poyrazli, Isabel Quintero

The Qualitative Report

UNHCR reports that about 82.4 million individuals were forcibly displaced as they attempted to avoid persecution, conflict, or human rights violations in their home countries. In addition to traumatic experiences, refugees encounter stressors such as low income, reduced social support, and language barriers. This qualitative study aimed to explore the impact of pre-migration trauma and political detainment on mental health outcomes and living conditions. A total of eight interviewees participated in video conferencing interviews. A non-probability convenience sampling using the snowballing technique was utilized to identify participants. Data were analyzed using an inductive approach for thematic analysis. The software Dedoose …


Veterans, Providers, Moral Injury, And The Integration Of Spirituality In Clinical Care, Claire Muldrew Jan 2024

Veterans, Providers, Moral Injury, And The Integration Of Spirituality In Clinical Care, Claire Muldrew

Theses and Dissertations

Moral Injury (MI) is known to be prevalent among military populations, however, the integration of spirituality into the treatment of veterans with trauma/posttraumatic stress disorder (PTSD) is an understudied topic. This systematic review sought to explore how mental health clinicians and chaplains view the integration of spirituality in the course of clinical care with traumatized veterans who experience MI. Utilizing qualitative methodology, the existing knowledge base was studied to shed light on this topic and to also identify the similarities and differences between these types of providers. The meta-aggregation approach was applied to analysis of the available data and a …


The Experience Of Growing Up Deaf In A Hearing-Abled Family: A Phenomenological Study, Alison B. Wetmur Jan 2024

The Experience Of Growing Up Deaf In A Hearing-Abled Family: A Phenomenological Study, Alison B. Wetmur

The Journal of Sociology & Social Welfare

d/Deaf Americans constitute a cultural and linguistic minority in America. Most d/Deaf people, 90–95%, are born to hearing-abled parents. By a wide margin, hearing-abled families prefer that their d/Deaf children learn spoken English and enroll their children in oral-education programs. Existing literature must highlight the unique struggles d/Deaf people face when growing up in hearing-abled families. By interviewing 14 d/Deaf adults born into hearing-abled families, this study explored the lived realities of growing up different in ability than other family members. These d/Deaf adults spoke about their childhood feelings of shame and isolation and ongoing frustrations. Respondents also often spoke …


Fostering Entry Level Practitioner Knowledge, Confidence, And Competence In Trauma-Informed Care Application, Mollie Keyser, Mary A. Barnes Jan 2024

Fostering Entry Level Practitioner Knowledge, Confidence, And Competence In Trauma-Informed Care Application, Mollie Keyser, Mary A. Barnes

Journal of Occupational Therapy Education

Trauma is pervasive worldwide and is associated with poor health outcomes if left unaddressed, however, a gap in practice continues to exist in the implementation of trauma-informed care (TIC). Occupational therapy practitioners will encounter individuals, communities, and populations influenced by trauma, which warrants the need for TIC to improve overall service delivery across the lifespan. However, TIC is currently not systematically integrated into any Accreditation Council for Occupational Therapy Education (ACOTE) occupational therapy educational standards. The purpose of this study was to design, implement, and evaluate a TIC application-based workshop for a sample of entry-level occupational therapy doctorate (OTD) students. …


Mental Health Practitioners’ Trauma Knowledge And Self-Efficacy Post-Emdr Training, Christy R. Collins, Shelby L. Dean, Jose Carbajal Jan 2024

Mental Health Practitioners’ Trauma Knowledge And Self-Efficacy Post-Emdr Training, Christy R. Collins, Shelby L. Dean, Jose Carbajal

Journal of Human Services: Training, Research, and Practice

This research study examines mental health practitioners’ level of trauma knowledge and trauma treatment self-efficacy pre- and post-EMDR therapy training in Texas. The purpose is to determine if practitioners' self-perception of efficacy in treating trauma and trauma knowledge will improve after completing EMDR training. The practitioner sample (N = 113) is from an EMDR trainer who conducted six EMDR trainings in Texas. Descriptive, correlational, and paired t-test statistical procedures were implemented to analyze the data for the study. The results show that practitioners’ self-perception of competence and knowledge could be attributed to their years of clinical experience treating clients with …


Ain’T I A Survivor Too: Contextualizing Black Women’S Experience Of Sexual Trauma And Healing, Danielle Alyssa Samuel Jan 2024

Ain’T I A Survivor Too: Contextualizing Black Women’S Experience Of Sexual Trauma And Healing, Danielle Alyssa Samuel

Antioch University Dissertations & Theses

The double bind of Black womanhood has been long documented in Black feminist literature. This dissertation seeks to greatly contextualize how Black women experience make sense of, and heal from, sexual trauma given the nature of gendered racism in the United States (U.S). Utilizing a convergent parallel design grounded in Black Feminist Theory and hermeneutic phenomenology, the lived experiences of 98 Black women from across the U.S. were investigated. Regression analyses revealed that the frequency of gendered racial microaggressions and the associated appraisal were not significant predictors of participants’ PTSD symptoms. Additionally, PTSD symptoms were inversely predictive of current perceptions …


Cuing Safety In The Law School Classroom: Using A Polyvagal Theory Framework In Support Of Trauma-Informed Teaching Practices, Gigi Walker, Brian Flaherty Jan 2024

Cuing Safety In The Law School Classroom: Using A Polyvagal Theory Framework In Support Of Trauma-Informed Teaching Practices, Gigi Walker, Brian Flaherty

Faculty Scholarship

The past few decades have seen a welcomed focus on “Trauma-informed education.” This focus is often traced back to the 1997 Adverse Childhood Experiences study, which identified many significant negative outcomes that resulted from childhood trauma.1 While the original study focused on outcomes such as chronic health problems, incarceration, and employment challenges, later researchers focused on the negative impacts on education and learning as a result of trauma.2 Educators continue to work with this research trying to figure out how to be more “trauma-informed,” and to better reach those students whose lives and learning capacity have been affected …


Intimate Partner Violence And Spirituality: A Healing Process, Sheila Diane Lundquist Dec 2023

Intimate Partner Violence And Spirituality: A Healing Process, Sheila Diane Lundquist

Doctoral Dissertations and Projects

The purpose of this qualitative phenomenological study is to understand how intimate partner violence (IPV) survivors, from the Atlanta area, use spirituality to heal from the abuse. The theory guiding this study is Maslow’s (1954) Hierarchy of Needs as it shows how spirituality helped these women meet the needs on the hierarchy after having many of the needs ripped from them by the perpetrator(s). Intimate partner violence is a fundamental problem in the United States, especially during these times of COVID-19 and the stay-at home orders. Intimate partner violence takes a toll on the family unit, the community, and the …


The Cost Of Creating Therapeutic Relationships: A Phenomenological Study, Robert D. January Dec 2023

The Cost Of Creating Therapeutic Relationships: A Phenomenological Study, Robert D. January

Doctoral Dissertations and Projects

The purpose of this phenomenological study was to describe how licensed counselors address vicarious trauma and burnout when working with individuals exposed to trauma. This study involved ten licensed professionals from diverse settings including clinics, private practices, and non-profit organizations. Constructive Self-Development Theory guided this study, which defines how traumatic experiences influence a person’s sense of identity. This theory is particularly relevant to this qualitative study because it explains the challenges faced by professional counselors who interact with trauma survivors and acts as a guide toward solutions for preventing counselors from experiencing vicarious trauma and burnout. Snowball sampling was used …


Beyond The Physical Wounds: A Proactive Approach To Mental Health Recovery After A Traumatic Injury, Christine Mcgahey Dec 2023

Beyond The Physical Wounds: A Proactive Approach To Mental Health Recovery After A Traumatic Injury, Christine Mcgahey

Doctor of Nursing Practice (DNP) Projects

Beyond the Physical Wounds: A Proactive Approach to Mental Health Recovery After a Traumatic Injury

Background: Every year, millions of Americans incur a life-threatening traumatic event and are admitted to trauma centers to treat their acute physical injuries. While traumatic injury is closely associated with developing post-traumatic stress disorder (PTSD), patients are rarely evaluated for PTSD risk or educated about long-term psychological sequelae.

Local Problem: The predictive value of early screening to quantify PTSD risk in trauma patients is well documented in the literature. However, in a 241-bed Level II Trauma acute care hospital, there was no protocol to evaluate …


Cultivating Well-Being In English As A Second Language: Teaching Stress Reduction Techniques In The Adult Esl Classroom, Sara C. Coronado Dec 2023

Cultivating Well-Being In English As A Second Language: Teaching Stress Reduction Techniques In The Adult Esl Classroom, Sara C. Coronado

Master's Projects and Capstones

Adult immigrant and refugee speakers of English as a Second Language (ESL) including California community college students may suffer trauma and stressors that can lead to negative mental health outcomes during the stages of migration, yet underutilize mental health services owing to cultural stigma, structural barriers, and a lack of English language proficiency. In addition, ESL speakers may also suffer from language anxiety evoked by speaking the less-developed language in the classroom as well as outside of the classroom during interactions with the majority language community. Both forms of anxiety share symptoms including tense muscles, rapid breathing, shortness of breath, …


Educators’ Perceptions Of Trauma-Informed Instructional Practices In One Northeast Tennessee School District, Alecia Burleson Dec 2023

Educators’ Perceptions Of Trauma-Informed Instructional Practices In One Northeast Tennessee School District, Alecia Burleson

Electronic Theses and Dissertations

The purpose of this qualitative phenomenological study was to investigate the perceptions of classroom-level educators regarding the application of trauma-informed instructional practices. This was achieved by evaluating educators' understanding of the influence of trauma on students, their level of familiarity with trauma-informed instructional practices, and their assessments of the effectiveness of these practices. Trauma refers to an individual's response to a single traumatic incident, a succession of traumatic events, or extended exposure to a traumatic event (SAMHSA, 2014). As awareness of the prevalence of childhood trauma has increased, it is acknowledged as a serious public health issue (Lang et al., …


Crisis Migration Adverse Childhood Events: A New Category Of Youth Adversity For Crisis Migrant Children And Adolescents, Beyhan Ertanir, Cory L. Cobb, Jennifer B. Unger, Teresa Celada-Dalton, Amy E. West, Ingrid Zeledon, Patrizia A. Perazzo, Miguel Ángel Cano, Sabrina E. Des Rosiers, Luis H. Zayas Dec 2023

Crisis Migration Adverse Childhood Events: A New Category Of Youth Adversity For Crisis Migrant Children And Adolescents, Beyhan Ertanir, Cory L. Cobb, Jennifer B. Unger, Teresa Celada-Dalton, Amy E. West, Ingrid Zeledon, Patrizia A. Perazzo, Miguel Ángel Cano, Sabrina E. Des Rosiers, Luis H. Zayas

School of Social Work Faculty Publications

The present article proposes an extension of the concept of adverse childhood experiences (ACEs) to apply to crisis migration - where youth and families are fleeing armed conflicts, natural disasters, community violence, government repression, and other large-scale emergencies. We propose that adverse events occurring prior to, during, and following migration can be classified as crisis-migration-related ACEs, and that the developmental logic underlying ACEs can be extended to the new class of crisis-migration-related ACEs. Specifically, greater numbers, severity, and chronicity of crisis-migration-related ACEs would be expected to predict greater impairments in mental and physical health, poorer interpersonal relationships, and less job …


A Formative Evaluation Of ‘Mind Matters: Overcoming Adversity And Building Resiliency’ With Hispanic Adolescents Prior To And During Covid‑19, Heidi Adams Rueda, Abigail Vera, Arminda Marcial, Amanda Mariano Nov 2023

A Formative Evaluation Of ‘Mind Matters: Overcoming Adversity And Building Resiliency’ With Hispanic Adolescents Prior To And During Covid‑19, Heidi Adams Rueda, Abigail Vera, Arminda Marcial, Amanda Mariano

Social Work Faculty Publications

Youth living in poverty are more likely to experience cumulative stressors including multiple adverse childhood events. Further, the Covid-19 pandemic has disproportionality affected Hispanic youth and communities, leading to unprecedented levels of trauma. This research responded to a need for a youth resiliency-building program in an urban and impoverished area with a majority Hispanic population. We conducted a formative evaluation of a youth intervention entitled Mind Mat- ters: Overcoming Adversity and Building Resilience, which aims to help youth overcome adversity and to build resilience via psychoeducation and skill development. Just prior to the pandemic in the United States (August-December, …