Search Results (233)

The current refugee crisis has revealed flaws in existing systems. Factors such as socioeconomic background, access to housing, and urban policies influence refugees’ abilities to fully participate in city life. The research objective is to analyze the interplay between housing access for adult refugees residing in Curitiba, Brazil, and the city’s targeted public policies and strategies for refugees. The research methodology adopts a case study approach centered on Curitiba, Brazil, with the city shown as a key destination for refugees in Brazil. This study combines qualitative and quantitative techniques, following a structured research protocol that guides the processes of data collection and analysis. The innovation and originality lie in offering a new perspective on how urban strategies intersect with the rights and inclusion of refugees, exploring the relationship between refugees’ housing access and its interconnection with the strategic digital city framework. The results highlight the importance of a multifaceted approach to addressing housing access challenges for refugees, which includes safeguarding their rights, promoting stability, integration, and ensuring their participation in shaping public policies. The conclusion outlines the urgent need to promote integration by reassessing housing affordability, ensuring access to services, engaging refugees in decision-making processes, and improving their social welfare. Full article

(1) Background: Mental health disparities persist across culturally diverse populations despite robust cognitive–behavioral therapy (CBT) efficacy evidence. Cultural neuroscience suggests that neurobiological processes underlying therapeutic mechanisms may exhibit culturally variable patterns, yet integration of neuroscientific frameworks into culturally adapted interventions remains limited. (2) Methods: Following PRISMA 2020 guidelines, we systematically searched PubMed/MEDLINE, PsycINFO, Scopus, and Web of Science (January 2014–December 2024) for peer-reviewed studies examining CBT interventions targeting depression, anxiety, PTSD, or psychological distress in culturally diverse populations. Ninety-four studies were synthesized using narrative methods; methodological heterogeneity precluded meta-analytic pooling. (3) Results: Culturally adapted CBT interventions consistently demonstrated superior outcomes compared to standard protocols across diverse populations. Group formats showed exceptional retention in collectivistic cultures, while hybrid technology-enhanced models achieved strong completion rates across contexts. Cultural adaptation enhanced engagement (e.g., 84% vs. 52% retention in refugee populations) and maintenance of treatment gains. Individual studies reported effect sizes ranging from d = 0.29 to d = 2.4; substantial within-group variability was observed, and identified patterns likely reflect learned cultural adaptations rather than inherent biological differences. Direct neuroimaging evidence within included studies remained limited (13.8%). (4) Conclusions: The evidence supports culturally adapted interventions as essential for equitable mental health outcomes. Cultural experiences may influence therapeutic processes, suggesting potential benefit from considering culturally variable processing patterns alongside universal mechanisms. However, conclusions regarding specific neural pathways remain preliminary, and individual assessment remains paramount, with cultural background representing one factor among many in treatment planning. Full article

Refugees often face significant barriers to healthcare access and integration, contributing to poor health outcomes. Although perceptions of health are known predictors of self-reported health status, little is known about how refugees themselves conceptualize health. This study employed a community-engaged, transformative mixed-methods design to explore refugee health perceptions in the Denver-metro area. Data collection included 149 surveys and 27 interviews with refugees and asylum seekers conducted between November 2018 and March 2019. Hierarchical linear regression was used to assess associations between social determinants of health (SDoH) and self-reported health, while qualitative data were analyzed using a constant comparative approach. The final regression model explained 75.8% of the variance in self-reported health (R² = 0.758, p < 0.001). Significant predictors included country of origin (Burma: −3.419, p = 0.030; Somalia: −9.155, p < 0.001), age (1.901, p < 0.001), sex (male: −3.252, p < 0.001), and education level (−0.999, p < 0.001). Qualitative findings revealed themes such as health as the ability to live life and health as happiness, each shaped by cultural context, community connectedness, and perceptions of safety. Integrating these findings highlights how structural conditions and culturally rooted understandings of well-being intersect to shape refugee health after resettlement. This study underscores the need for public health and clinical interventions that center refugee-defined priorities and suggests future research should incorporate constructs, such as happiness and culturally grounded notions of safety, that emerged as central to health in this study. Full article

Tuberculosis (TB) remains a public health threat in low- and middle-income countries (LMICs) of the World Health Organization (WHO) Eastern Mediterranean Region (EMR), driven by a combination of social determinants including undernutrition, fragile health systems, conflict-related disruptions, human mobility and displacement, sub-optimal programmatic implementation, and insufficient domestic investment. These programmatic and governance constraints operate within a broader geopolitical context marked by conflict, sanctions, protracted crises, and large-scale displacement, which further limit countries’ ability to deliver uninterrupted TB services. In 2023, the region’s TB incidence was estimated at 116 per 100,000 population, with Pakistan alone accounting for about 73% of the regional burden. Despite a multitude of efforts, progress in reducing the TB burden in the EMR remains slow, with high case detection and treatment coverage gaps, low uptake of TB preventive treatment (TPT), underutilization of WHO-recommended rapid diagnostics, and only 25% of drug-resistant TB (DR-TB) cases initiated on treatment. Vulnerable populations, including internally displaced persons, migrants, refugees, prisoners, and returnees, continue to face major access barriers, and cross-border TB collaboration remains limited. This commentary reasons that the slow pace of TB burden reduction in the region is not only a biomedical or resource issue but also a reflection of structural and governance shortcomings. It proposes a ten-point strategic vision focused on building a sustainable ecosystem, enhancing primary healthcare systems, adopting people-centered and rights-based approaches, leveraging artificial intelligence, and gradually reducing dependency on external donors where feasible. However, in highly fragile settings such as Yemen or Somalia, domestic financing remains limited, and sustained external support will continue to be indispensable. The commentary calls for stronger national leadership, inclusive stakeholder engagement, and increased domestic financing to deliver integrated and resilient TB services. Ending TB in the EMR is within reach, but it requires boldly committed, coordinated, and country-led action. Full article

Learning the host language is a crucial factor in the settlement of migrants and refugees in a new country. It offers opportunities, but can also generate exclusion, marginalization, and isolation, hindering the possibilities of participation and the creation of social networks. Host language classes, therefore, play a crucial role, fostering critical awareness that enables learners to act within their social and cultural context. This promotes agency, autonomy, and empowerment, transforming differences into productivity and fostering social justice. This article focuses on classes of Portuguese as a host language (HL) in northern Portugal, examining how these contexts shape learners’ relationship with the language beyond depoliticized or subaltern approaches. It discusses the main obstacles and difficulties in these educational settings, as well as mechanisms that could contribute to more democratic and effective practices. Drawing on interviews with teachers (n = 10), trainers (n = 4), volunteers (n = 8), and students (n = 20) involved in the HL learning process, the content analysis highlights how policies and pedagogical practices impact students and how they are interpreted by these actors, revealing their impact on processes of participation, belonging, and citizenship. The results indicate an emergent form of collective autonomy in the relationship among students, the host society, and teachers, which means that teaching practices encompass not only the development of communication skills but also the civic and political awareness of learners. Lastly, while the language teachers identified more practical barriers in these teaching and learning contexts, the students described emotional and sociocultural obstacles. Full article

In this paper we discuss a journey through different collective singing experiences held between 2019 and 2023 in Lebanon, Mozambique, Benin, and Greece. It is an autoethnographic work that includes the short-term participant observation of a choir in a context of conflicting neighbourhoods (Lebanon); the long-term experience of teaching choirs in a musical project aiming at social integration (Mozambique); the short-term experience of leading musical activities in a project for orphaned children rescued from voodoo convents (Benin); and the medium-term experience of facilitating music sessions in an organization working with people living in refugee camps (Greece). Ethics of care emerged as an inspiration for reformulating previous European choir tradition practices, adapting it to the reality of each context and supporting the overall experience. Starting from an idea of choir rooted in our European background, this journey transformed our perception of collective singing communities and how we can nurture well-being and build a sense of care within groups. Assuming different types of leadership, adapting the communication to specific circumstances, and being aware of opposite needs for continuity were the main strategies involved in making each experience a unique act of care. Full article

Financial literacy, defined as the set of knowledge, skills, and attitudes that enable individuals to make informed economic decisions and manage resources efficiently, is fundamental for social inclusion and the reduction of inequalities. This study, through a systematic review of the scientific literature using the PRISMA methodology, selected 120 primary studies that met the inclusion and exclusion criteria and presented a low risk of bias. These studies examined aspects related to financial literacy programs, the populations benefited, their effects, the challenges encountered, and the lessons that can guide the replication of these initiatives. The results show that the most frequent programs include training in basic financial concepts—savings, budgeting, access to banking services and microfinance—as well as workshops, seminars, and group training sessions. The populations most benefited were rural communities and women, although informal workers, migrants, and refugees could also significantly improve their financial inclusion and economic resilience. Among the positive effects, improvements were observed in income and expense management, increased savings, investment planning, preparation for emergencies and retirement, and the strengthening of economic empowerment and the sustainability of microenterprises and small enterprises. These findings highlight the importance of implementing financial literacy programs adapted to specific contexts to promote inclusion and economic well-being. Full article

Background: Brucella canis is a zoonotic pathogen associated with reproductive disorders in dogs and represents an emerging public health concern. Dogs are the only known source of infection for humans, and transmission is often associated with close contact, particularly in occupational settings. Reports of canine and human infections in Europe are increasing, underscoring the need for integrated surveillance to assess the risk of introduction and spread. Objectives: This study aimed to investigate the possible circulation of B. canis in different subgroups of dogs from Central Italy, representing diverse risk contexts (stray, breeding, blood donor, refugee-associated, and previously outbreak-linked dogs), and to generate sentinel data to inform further risk-based surveillance and zoonotic risk assessment. Methods: A comprehensive serological, molecular, and bacteriological survey was conducted on 128 dogs sampled in the Umbria region, covering animals from different backgrounds and risk contexts. Blood samples were tested using bacterial culture, real-time PCR, serum agglutination test, complement fixation test, and/or indirect immunofluorescence antibody test. Results: All tested dogs were negative for B. canis. The upper 95% confidence limit for prevalence was 3.5%, suggesting that widespread circulation is unlikely, although a low/moderate prevalence in specific groups cannot be excluded. Conclusions: Although no cases of B. canis were detected, the results provide sentinel information and highlight the need for continued risk-based surveillance, particularly in low-prevalence areas to prevent introduction of the infection and to enable early detection in case of occurrence. As dogs are the only known source of human infection, veterinary monitoring plays a pivotal role in mitigating zoonotic risks and supporting One Health strategies for evidence-based control. Full article

Background: Refugees often face major health challenges owing to displacement, poor living conditions, limited access to healthcare, and the psychological toll of forced migration. Access to healthcare has been a major concern because of disrupted medical services, pre-existing health conditions, and integration challenges in host countries. This study aimed to evaluate the effect of infectious diseases on refugees in the context of the war in Ukraine by analyzing data from patients who accessed health services from a county hospital. Methods: We analyzed the data of Ukrainian refugees who presented for an infectious disease between February 2022 and March 2025 in the largest hospital unit in Romania located immediately near the border with Ukraine. Results: A total of 2052 refugee patients of Ukrainian nationality presented to the Emergency Reception Unit of “St. Ioan cel Nou Suceava” for consultations; 672 patients required an evaluation by an infectious disease specialist and 48 were hospitalized in the Department of Infectious Diseases. The most common disease encountered in children was influenza, whereas the most common disease in adults was SARS-CoV-2 infection. The most frequently encountered comorbidities in pediatric patients were anemia (26.9%) and dehydration syndrome (46.2%). In adults, comorbidities included chronic obstructive pulmonary disease (18.2%), hypertension (13.6%), chronic coronary disease (4.5%), diabetes (9.1%), and chronic hepatitis (4.5%). Patients were treated with antivirals, rehydration solutions or only symptomatic treatment. Conclusions: Romania is implementing public health measures to address these challenges, focusing on vaccination and disease screening, and ensuring access to essential healthcare services. These services include access to primary care physicians, specialist consultations, hospitalization, and essential medications. Full article

The global population of older adults is growing rapidly, and refugees are now a significant proportion of the older adult population in Canada. Transnational healthcare practices (THPs)—seeking health information or services from the country of origin—may be an essential strategy used by refugee older adults in Canada, but few studies have explored this phenomenon. This is a protocol for a study, which is aimed at developing a comprehensive understanding of the role THPs play in the lives of older adults from three refugee groups (Afghan, Syrian and Ukrainian) (re)settled in the Greater Toronto Area (GTA), Canada. It will be informed by Constructivist Grounded Theory and will consist of three phases. Phase 1 will involve semi-structured individual interviews with Afghan, Syrian, and Ukrainian refugee older adults living in the GTA (n = 75–90) to explore their perspectives and experiences with various types of THP. Phase 2 will also involve semi-structured interviews with 75–90 refugee older adults from the three communities to examine the role of THP in stress, coping, and resilience in the context of health promotion, illness diagnosis, and disease management as well as the individual and contextual factors driving the use of THPs. Phase 3 will involve six focus groups (n = 36–48) with refugee older adults from these communities to explore what information, care, supports, technology, and services are needed to manage their health and illnesses locally. This project will advance knowledge in the areas of (re)settlement and integration, aging, local healthcare access, and THPs among refugee older adults in Canada. The findings will inform more effective integration policies and the delivery of efficient and equitable health information, care, support, technology, and services that address the healthcare needs of refugee older adults, enabling them to age well and age in place. Full article

In the context of an increasingly hostile national political environment and federal cuts to refugee resettlement programs in the United States, advocates often highlight the economic contributions of immigrants and refugees to garner local support, especially in regions with histories of economic and population decline. While these narratives continue to be a centerpiece of pro-immigrant and -refugee advocacy, in practice advocates and refugees themselves use a diverse set of frames to promote belonging. In this paper, we examine pro-refugee advocacy frames in a small, nontraditional destination in the Midwest. We draw on survey and focus group research with young adult refugees and nonprofit advocates and content analysis of online stories about refugees. We found that pro-refugee values frames (humanitarian and faith-based) and contributions frames (economic, cultural and civic) coexisted across the local landscape and were used by not only nonprofit advocates and local officials, but also by refugees themselves. While advocacy groups emphasized the dominant frame highlighting refugees’ economic contributions, they were also strategic in using overlapping frames to highlight a less public frame, refugees’ contributions to civic engagement through community service and volunteering. Advocates tended to reproduce the economic contributions frame to appeal to key stakeholders, which consequently obscures refugees’ diverse contributions, but we argue that refugee self-advocates’ use of the civic engagement frame pushes back against economic and other frames that limit their contributions and helps them to create spaces of belonging. Full article

This article examines how Ukrainian migrants and war refugees in Finland perceive and use Suržyk, a cluster of intermediate varieties between Ukrainian and Russian, as a transitional stage facilitating the shift from Russian-dominant to Ukrainian-dominant speech. Drawing on 1615 survey responses collected between November 2022 and January 2023, the study reveals that 42 respondents view Suržyk as a bridge that supports the gradual acquisition of standard Ukrainian. Qualitative content analysis of open-ended responses shows repeated references to Suržyk as a “stepping stone”, “temporary means” or “bridge”, highlighting its role in maintaining intelligibility and fluency for speakers who are not confident in standard Ukrainian. Although some respondents acknowledge the stigma associated with mixed speech, they also stress Suržyk’s practical advantages in contexts shaped by the 2022 full-scale war and heightened purist discourses. Speakers report pressure to adhere to purist language norms in formal settings, whereas in informal spaces, they consider Suržyk a natural outcome of bilingual backgrounds. These findings illuminate the interplay between language ideologies, sociopolitical dynamics, and individual agency, suggesting that for many Ukrainians in Finland, Suržyk serves as a temporary yet functional means to align with Ukrainian identity under rapidly changing circumstances. Full article

This study examines refugee integration in South Korea’s emerging asylum context by analyzing how education policies and practices shape inclusion, drawing on interviews with 23 key informants from government and civil society. Despite legal frameworks guaranteeing access, findings reveal how institutional, sociocultural, and political factors create significant policy–practice gaps, hindering both structural integration (enrollment, curriculum, language of instruction, certification) and relational integration (sense of belonging) in schools. Barriers include bureaucratic obstacles, language barriers, discrimination, and limited post-secondary pathways. While civil society actors create opportunities, broader systemic changes are needed to promote the meaningful inclusion of students with refugee backgrounds in South Korean society. Full article

Following the 2022 Russian invasion of Ukraine and the resulting refugee crisis, this study investigates innovative and flexible forms of trans-local care among communities of Ukrainian refugees living with HIV in host countries, particularly Germany and Poland. The study adopts a community-based participatory research approach to understand how trans-local community-based organizations (CBOs) support access to HIV care for Ukrainian refugees in Germany and Poland, and what roles activists and peer networks play in overcoming barriers to healthcare in the context of forced displacement. It is based on semi-structured interviews with refugee activists, community members, healthcare professionals, social workers, and subject-matter experts—52 interviews in total conducted in 2023–2024. The research identifies emerging configurations of community networks that facilitate access to healthcare, including community-based, mixed-type, and bridge-type organizations. Activists play a central role in navigating unfamiliar healthcare systems, advocating for migrant-sensitive services, and developing grassroots solutions to both individual and structural barriers to HIV care in contexts of forced displacement. Migrant organizations are instrumental in facilitating community-based linkage to HIV care for refugees. In the case of Ukrainian transnational communities, these organizations draw on previously acquired experiences, knowledge, and skills to support their peers. The involvement of community-led initiatives is essential to reducing disparities in healthcare access and promoting the well-being of forced migrants. Full article

Providing culturally responsive, trauma-informed afterschool programming is a promising intervention to promote the adjustment, educational achievement, and well-being of newly arrived refugee and immigrant children. Connecting Communities and Multilingual Learners (CCML) is a local nonprofit organization in the Southeastern part of the United States that provides this type of programming to newly arrived families. To better understand their impact on children, CCML aimed to examine its model of programming via a mixed methods, strengths-focused evaluation. Evaluation efforts focused on describing the effects of the program on children at CCML’s flagship site in a robust urban center. Data were collected from students and facilitators at two times (beginning and end of the year) over one academic school year. Results revealed that CCML supported students’ socio-emotional well-being, English language acquisition, and cultural pride in positive and sustaining ways. Evidence from this study suggests that culturally responsive and trauma-informed programs offer promising, adaptable models for addressing the evolving needs of newly arrived refugee and immigrant youth in diverse community contexts. Full article