Search Results (2,863)

Background: Exposure-based cognitive behavioral therapy (Ex-CBT) is widely seen as the gold-standard treatment for anxiety and obsessive-compulsive disorder (OCD). Yet, minoritized youth are underrepresented in efficacy studies, raising questions about the applicability of Ex-CBT to minoritized youth. Effectiveness data suggest systematic adaptation of Ex-CBT to address youth culture and context is likely needed, and many clinicians make adaptations and augmentations in practice. However, research on the specific strategies clinicians use to address their youth clients’ culture and context within anxiety and OCD treatment is lacking. In the current study, we assess practice-based adaptations, augmentations, and process-based approaches utilized when delivering treatment to youth for OCD and anxiety in public mental health clinics. Methods: We conducted qualitative interviews with 16 clinicians from both specialty anxiety and general mental health clinics serving youth with anxiety or OCD in the public mental health system. Participating clinicians had a mean age of 32.19 (SD = 5.87) and 69% of therapists identified as female; 69% identified as White, 25% identified as Asian, and 6% as Black or African American. In qualitative interviews, clinicians shared how they addressed clients’ culture and context (e.g., social identities, stressors and strengths related to social identities and lived environment). Thematic analysis identified the strategies clinicians employed to address culture and context. Results: Clinicians reported incorporating culture and context through process-based approaches (e.g., building trust gradually, considering clients’ social identity stressors, engaging in self-awareness to facilitate cultural responsiveness) and through culturally adapting and augmenting treatment to promote person-centered care. Core strategies included proactive and ongoing assessment of clients’ cultural and contextual factors, adapting exposures and augmenting Ex-CBT with strategies such as case management and discussion of cultural context, and taking a systems-informed approach to care. Conclusions: Examining practice-based adaptations, augmentations, and process-based approaches to treatment for minoritized youth with OCD or anxiety can inform efforts to understand what comprises person-centered culturally responsive Ex-CBT. Empirical testing of identified strategies is a needed area of future research. Full article

Gender-neutral terms such as “sex work” and “sex worker” have gained prominence in academic, activist, and policy discourses. Unlike terms such as ‘prostitutes’ and ‘prostitution,’ these terms serve to reduce stigma and emphasize the labor involved in sex work. However, numerous studies suggest that these terms carry different meanings across cultural contexts, and their impact is experienced differently by various sub-groups of sex workers. Although originally coined by American activist Carol Leigh to unify sex workers across genders and sectors, these terms are, in some settings—including Kolkata, India—met with silence, coded language, or secrecy, particularly among transient sex workers, including cisgender and transgender women. As researchers with two decades of ethnographic research with 46 cisgender and 37 transgender women engaged in sex work in Kolkata and Eastern India, the authors argue that such silence and non-verbal forms of communication should not be interpreted merely as ignorance or disengagement but rather as strategic/willful acts of agency or resistance. These practices enable sex workers situated in different contexts to navigate unequal power dynamics within NGOs, manage respectability, mitigate structural violence, and foster communal identity. By examining how diverse groups of sex workers employ silence and secrecy, this study contributes to a more nuanced and empathetic understanding of the complexities surrounding the former’s lives and their agency. The study results indicate that it is essential for scholars, advocates and activists to employ strengths-based, context-specific language and research practices to be able to hear the stories of subaltern groups like commercial sex workers. It is also suggested that training of service providers and helping professionals focus on accepting and honoring the language people use to identify themselves in varied spaces and contexts. Full article

Refugees experience disproportionately high rates of sleep disturbances due to trauma, displacement, and resettlement stressors. Sleep health is critically linked to both physical and mental well-being, yet remains an underexplored area of intervention for refugee populations. This systematic review aimed to (1) identify interventions implemented to improve sleep health among refugees, (2) assess their effectiveness, and (3) evaluate the extent of cultural adaptation in their design and implementation. A comprehensive search of peer-reviewed literature from 2004 to 2024 identified nine studies focused on adult refugees in high-income countries. Interventions included psychoeducation, music-assisted relaxation, guided imagery, and nightmare-focused therapies. Several demonstrated improvements in sleep quality, insomnia severity, and nightmare frequency. Music-based interventions and sleep health education stood out as accessible, non-stigmatizing strategies that may be particularly well suited to refugee contexts. However, cultural adaptation emerged as the most significant gap. Using the 4-Domain Cultural Adaptation Model (CAM4)—which assesses adaptation across context, content, delivery, and engagement—most studies showed only surface-level modifications. Few incorporated community voices, and none validated sleep assessment tools for cultural relevance. Future research should prioritize co-creation with refugee communities to ensure interventions are not only evidence-based, but also culturally grounded, trusted, and sustainable across diverse refugee populations. Full article

As part of contemporary urban culture, murals support place making and city identity. While much attention has been paid to their role in activating public space during daylight hours, their presence after dark remains largely unexamined. This paper analyzes how mural content interacts with night-time illumination. The research draws on case studies, photographs, luminance measurements, and lighting simulations. It evaluates how existing lighting systems support or undermine the legibility and impact of commercial murals in urban environments. It explores whether standardized architectural lighting guidelines suit murals, how color and surface affect visibility, and which practices improve night-time legibility. The study identifies a gap in existing lighting strategies, noting that uneven lighting distorts intent and reduces public engagement. In response, a new design tool—the Floodlighting Content Readability Map—is proposed to support artists and planners in creating night-visible murals. This paper situates mural illumination within broader debates on creative urbanism and argues that lighting is not just infrastructure, but a cultural and aesthetic tool that extends the reach and resonance of public art in the 24 h city. It further emphasizes the need for interdisciplinary collaboration and a multi-contextual perspective—encompassing visual, social, environmental, and regulatory dimensions—when designing murals in cities. Full article

This article explores the concept of textuality as embedded within contemporary architecture, understood as the capacity of buildings to generate meanings, narratives, and interpretations that transcend their physical and functional dimensions. An interdisciplinary approach is adopted, integrating architectural theory, semiotics, hermeneutics, and cultural studies, positioning architecture as a form of symbolic production deeply intertwined with current social and technological contexts. The primary aim is to demonstrate how certain paradigmatic buildings operate as open texts that engage in dialogue with their users, urban surroundings, and cultural frameworks. The methodology combines theoretical analysis with an in-depth study of three emblematic cases: the Guggenheim Museum in Bilbao, the Centre Pompidou in Paris, and the Seattle Public Library. The findings reveal that these buildings articulate multiple layers of meaning, fostering rich and participatory interpretive experiences that influence both the perception and construction of public space. The study concludes that contemporary architecture functions as a narrative and symbolic device that actively contributes to the shaping of collective imaginaries. The article also identifies the study’s limitations and proposes future research directions concerning architectural textuality within the context of emerging digital technologies. Full article

Almost one in three firefighters develop mental health disorders at some point during their careers, a rate double that in the general population. Frequent exposures to potentially traumatic situations can contribute to symptoms of these disorders, two of the most common being depression and post-traumatic stress disorder (PTSD). While various psychological interventions have been implemented among this group, reports of their effectiveness include mixed results. To this end, the current study endeavored to test the effectiveness of a 12-week intervention combining occupationally-tailored high-intensity functional training (HIFT) and psychological resilience training (RES) in reducing depressive and post-traumatic stress symptoms (PTSSs), as well as increasing psychological resilience and mental wellbeing, in career firefighters. Thirty career firefighters completed four mental health measurements over 17 weeks while anthropometrics and physical performance (i.e., number of stations completed in 20 min during an eight-station simulated job-task circuit workout [T-CAC]) were measured pre- and post-intervention. Pre to post comparisons were made via repeated-measures t-tests. Significant mean differences were observed for T-CAC stations completed, PTSSs, and psychological resilience between pre- and post-intervention. In future interventions, researchers should actively engage firefighters, maximize integration with daily operations, and employ culturally-relevant practices to explore the links between physical and mental health. Full article

This research advances the integration of terrestrial laser scanning (TLS) in heritage documentation, targeting the development of holistic and practical guidance for practitioners to adopt the technology effectively. Acknowledging the pivotal role of TLS in capturing detailed and accurate representations of cultural heritage, the study emerges against a backdrop of technological progression and the evolving needs of heritage conservation. Through a comprehensive literature review, critical case studies of heritage sites in the U.S., expert interviews, and the development of a TLS for Heritage Documentation Best Practice Guide (the guide), the paper addresses the existing gaps in streamlined practices in the domain of TLS’s applications in heritage documentation. While recognizing and building upon foundational efforts such as international guidelines developed over the past decades, this study contributes a practice-oriented perspective grounded in field experience and case-based analysis. The developed guide seeks to equip practitioners with structured methods and practical tools to optimize the use of TLS, ultimately enhancing the quality and accessibility of heritage documentation. It also sets a foundation for integrating TLS datasets with other technologies, such as Building Information Modeling (BIM), virtual reality (VR), and augmented reality (AR) for heritage preservation, tourism, education, and interpretation, ultimately enhancing access to and engagement with cultural heritage sites. The paper also critically situates this guidance within the evolving theoretical discourse on digital heritage practices, highlighting its alignment with and divergence from existing methodologies. Full article

This study intends to provide insights and challenges for the shape of the B movement, an emerging paradigm that fosters cross-sectoral partnerships and encourages ethical business practices through so-called purpose-driven businesses. Focusing on Italy, the first European country to adopt this managerial model, the research investigates Italian Benefit Corporations, known as Società Benefit (SB), and their most appealing sustainability claims from a consumer perspective. The analysis intends to inform theory development by assuming the cultural and creative industry (CCI) as a field of interest, utilizing a within-subjects experimental design to analyze data from a diverse consumer sample across various contexts. The results indicate that messaging centered on economic sustainability emerged as the most effective in generating positive consumer responses, highlighting a prevailing inclination toward pragmatic factors such as affordability, economic accessibility, and tangible benefits rather than social issues. While sustainable behaviors are not yet widespread, latent ethical sensitivity for authentic, value-driven businesses suggests that economic and ethical dimensions can be strategically synthesized to enhance consumer engagement. This insight highlights the role of BCs in catalyzing a shift in consumption patterns within ethical-based and creative-driven sectors. Full article

This study explores the migration intentions of university students—representing the potential creative class—in Erzurum, a medium-sized city in eastern Turkey experiencing shrinkage. Within the theoretical framework of shrinking cities, it investigates how economic, social, physical, and personal factors influence students’ post-graduation stay or leave decisions. Survey data from 742 Architecture and Fine Arts students at Atatürk University were analyzed using factor analysis, logistic regression, and correlation to identify key migration drivers. Findings reveal that, in addition to economic concerns such as limited job opportunities and low income, personal development opportunities and social engagement also play a decisive role. In particular, the perception of limited chances for skill enhancement and the belief that Erzurum is not a good place to meet people emerged as the strongest predictors of migration intentions. These results suggest that members of the creative class are influenced not only by economic incentives but also by broader urban experiences related to self-growth and social connectivity. This study highlights spatial inequalities in access to cultural, educational, and social infrastructure, raising important questions about spatial justice in shrinking urban contexts. This paper contributes to the literature on shrinking cities by highlighting creative youth in mid-sized Global South cities. It suggests smart shrinkage strategies focused on creative sector development, improved quality of life, and inclusive planning to retain young talent and support sustainable urban revitalization. Full article

Purpose: Following George Floyd’s death, the push for law enforcement accountability policies has intensified. Despite robust legislative action, challenges in enacting and implementing meaningful reforms persist. This study analyzes police accountability policies (PAP) in the U.S. from 2020 to 2022, identifying barriers and facilitators through expert perspectives in enforcement oversight, policy advocacy, and community engagement. Methods: The study used a dual approach: analyzing 226 police accountability bills from all 50 U.S. states, D.C., and Puerto Rico via the National Conference of State Legislatures database, and categorizing them into six key areas such as training, technology use, and certification. Additionally, a survey was conducted among experts to identify the challenges and drivers in passing police accountability legislation. Findings: A legislative analysis showed that although 48 states passed police accountability laws, California, New Jersey, Oklahoma, and Colorado have made significant strides by passing multiple pieces of legislation aimed at enhancing law enforcement accountability and ensuring better policing practices. The most common policies focused on training and technology, enacted by 16 and 12 states, respectively. However, crucial certification and decertification policies were adopted in just 13 states, highlighting the inconsistent implementation of measures critical for police accountability and transparency. The survey identified several barriers to passing PAP, including inadequate support from local governments (72.7%). Structural exclusion of poor and minority communities from policing resources was also a significant barrier (54.5%). Facilitators included community support (81.8%) and a cultural shift in policing towards viewing officers as “guardians” rather than “warriors” (63.6%). Conclusions: While some progress has been made in passing PAP, considerable gaps remain, particularly in enforcement and comprehensive reform. Resistance from law enforcement institutions, lack of community support, and structural inequalities continue to impede the adoption of effective PAP. Full article

Background/Objectives: Strengthening antimicrobial stewardship (AMS) programs is an invaluable intervention in the ongoing efforts to contain the threat of antimicrobial resistance (AMR), particularly in low-resource settings. This study evaluates the impact of the Telementoring, Education, and Advocacy Collaboration initiative for Health through Antimicrobial Stewardship (TEACH AMS), which uses the virtual Extension for Community Healthcare Outcomes (ECHO) learning model to enhance AMS capacity in Kenya, Ghana, and Malawi. Methods: A mixed-methods approach was used, which included attendance data collection, facility-level assessments, post-session and follow-up surveys, as well as focus group discussions. Results: Between September 2023 and February 2025, 77 virtual learning sessions were conducted, engaging 2445 unique participants from hospital-based AMS committees and health professionals across the three countries. Participants reported significant knowledge gain, and data showed facility improvements in two core AMS areas, including the implementation of multidisciplinary ward-based interventions/communications and enhanced monitoring of antibiotic resistance patterns. Along those lines, participants reported that the program assisted them in improving prescribing and culture-based treatments, and also evidence-informed antibiotic selection. The evidence of implementing ward-based interventions was further stressed in focus group discussions, as well as other strengthened practices like point-prevalence surveys, and development or revision of stewardship policies. Substantial improvements in microbiology services were also shared by participants, particularly in Malawi. Other practices mentioned were strengthened multidisciplinary communication, infection prevention efforts, and education of patients and the community. Conclusions: Our findings suggest that a virtual case-based learning educational intervention, providing structured and tailored AMS capacity building, can drive behavior change and strengthen healthcare systems in low resource settings. Future efforts should aim to scale up the engagements and sustain improvements to further strengthen AMS capacity. Full article

Climate change poses an escalating threat to cultural heritage (CH), driven by intensifying climate-related hazards and systemic vulnerabilities. In response, risk assessment frameworks and methodologies (RAFMs) have emerged to evaluate and guide adaptation strategies for safeguarding heritage assets. This study conducts a state-of-the-art (SotA) review of 86 unique RAFMs using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided systematic approach to assess their scope, methodological rigor, alignment with global climate and disaster risk reduction (DRR) frameworks, and consistency in conceptual definitions of hazard, exposure, and vulnerability. Results reveal a growing integration of Intergovernmental Panel on Climate Change (IPCC)-based climate projections and alignment with international policy instruments such as the Sendai Framework and United Nations Sustainable Development Goals (UN SDGs). However, notable gaps persist, including definitional inconsistencies, particularly in the misapplication of vulnerability concepts; fragmented and case-specific methodologies that challenge comparability; and limited integration of intangible heritage. Best practices include participatory stakeholder engagement, scenario-based modeling, and incorporation of multi-scale risk typologies. This review advocates for more standardized, interdisciplinary, and policy-aligned frameworks that enable scalable, culturally sensitive, and action-oriented risk assessments, ultimately strengthening the resilience of cultural heritage in a changing climate. Full article

In the era of digital intelligence, digital media landscapes increasingly influence cultural tourism consumption. Consumerism capitalizes on tourists’ superficial aesthetic commonalities, constructing a homogenized media imagination that leads to collective convergence in travel decisions, which obscures aspects of local culture, poses safety risks, and results in fleeting local tourism booms. In this study, semistructured interviews were conducted with 36 tourists, and NVivo12.0 was used for three-level node coding in a qualitative analysis to explore the digital media attributions of conformist travel behavior. The findings indicate that digital media landscapes exert a “digital persuasion” effect by reconstructing self-experience models, directing the individual gaze, and projecting idealized self-images. These mechanisms drive tourists to follow digital traffic trends and engage in imitative behaviors, ultimately shaping the phenomenon of “group roaming”, grounded in the psychological effect of herd behavior. Full article

This article investigates the role of space in the fiction of Jeffrey Eugenides, focusing on The Virgin Suicides (1993) and Middlesex (2002) through the lens of spatial theory. Drawing on key thinkers such as Henri Lefebvre, Michel Foucault, Edward Soja, Yi-Fu Tuan, and Doreen Massey, the study explores how Eugenides constructs spatial environments that not only frame but actively shape the identities, desires, and traumas of his characters. In The Virgin Suicides, suburban domestic spaces are shown to function as heterotopias—sites of surveillance, repression, and mythologized femininity—while Middlesex engages with transnational and urban spaces to narrate diasporic and intersex identity as dynamic, embodied, and liminal. The analysis reveals that Eugenides uses space as both a narrative device and a thematic concern to interrogate gender, memory, and power. Rather than passive backdrops, the novelistic spaces become charged arenas of conflict and transformation, reflecting and resisting dominant socio-cultural discourses. This study argues that space in Eugenides’ fiction operates as a critical register for understanding the politics of belonging and the production of subjectivity. By situating Eugenides within the broader field of literary spatiality, this article contributes to contemporary debates in literary geography, gender studies, and American fiction. Full article

The purpose of this research is to examine employee perceptions regarding the implementation of ESG (environmental, social, and governance) practices in financial institutions, with a comparative focus on urban and rural banks in the Republic of Serbia. The study investigates how employees assess environmental, social, and governance aspects of ESG, as well as their own role in applying these principles in everyday work. The results reveal statistically significant differences between the two groups; employees in urban banks report greater engagement, more access to training, and stronger involvement in ESG decision-making. These findings suggest the existence of more developed institutional support, infrastructure, and organisational culture in urban banks. In contrast, employees in rural banks highlight the need for enhanced training, clearer ESG guidance, and improved oversight mechanisms. The study underlines the importance of investing in employee development and internal communication, particularly in rural contexts, to improve ESG outcomes. By focusing on employee-level perceptions, this research contributes to the understanding of how organisational and geographic factors influence the implementation of ESG-related practices in financial institutions. Full article