Search Results (5,775)

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

Armed conflict poses a significant threat to the mental health of youth worldwide. This study focused on the role of teachers as protective agents fostering resilience among their students. The study examined the moderating effects of teachers’ personal well-being and their efficacy in the school on relations between their students’ armed conflict exposure and student psychiatric symptoms. Participants included 1260 students and their homeroom teachers from 62 8–11th grade classes. Using self-report standardized measures, teachers reported their life satisfaction and sense of efficacy while students reported their armed conflict exposure and psychiatric symptoms. Data were analyzed using a multilevel modeling (MLM) approach. Findings revealed positive correlations between student armed conflict exposure and psychiatric symptoms. In the between-class level of analysis, teacher personal life satisfaction and efficacy in participation in the school system emerged as protective factors for the students, significantly moderating relations between student exposure and their psychiatric symptoms. However, teacher efficacy in class management showed no significant moderating effect on student mental-health difficulties. Results highlight the importance of supporting teachers in conflict-affected environments and emphasize the need for preventive and therapeutic initiatives that prioritize teacher well-being and organizational resources to enhance teachers’ capacity to foster student resilience. Full article

Objective: Irritability and reactive aggression are transdiagnostic features that are predictive of adverse long-term outcomes. This investigation examined whether intranasal oxytocin administration impacts the interaction between irritability and reactive aggression, and whether these effects can be detected at a neural level via a facial expression processing task during functional MRI (fMRI). Methods: In this study, 40 children and adolescents with severe irritability and psychiatric diagnoses of disruptive mood and behavioral disorders were assigned to either intranasal oxytocin or placebo administration over a 3-week period in a randomized, double-blind trial (ClinicalTrials, NCT02824627). Clinical measures and fMRI during a facial expression processing task were collected pre- and post-intervention. Brain regions sensitive to oxytocin administration were determined using whole-brain statistical analyses, with post hoc analyses to determine whether changes in the neural activity mediated the relationship between changes in irritability and reactive aggression across the intervention period. Results: Youth who received intranasal oxytocin administration exhibited significant decreases in irritability and reactive aggression compared to their counterparts in the placebo group. Further, oxytocin administration was associated with significant increases in neural activity in the right superior prefrontal cortex, which fully mediated the relationship between improvements in irritability and improvements in reactive aggression. Conclusions: Intranasal oxytocin significantly reduced irritability and reactive aggression in youth, as well as neural activity in the prefrontal cortex, such that increases in the cortical activity fully mediated the relationship between changes in irritability and reactive aggression. Taken together, these findings may reflect oxytocin-related enhancements in emotional regulation in youth with severe irritability, a potential therapeutic mechanism for mitigating reactive aggression. Full article

Background/Introduction: Psychological inflexibility, which includes experiential avoidance, is a transdiagnostic process associated with multiple mental health issues in adolescence. Physical fitness (PF) has shown benefits for mental well-being, yet its specific relationship with psychological inflexibility remains understudied, particularly among youth. Objectives: To examine the association between components of PF and psychological inflexibility, measured by the Acceptance and Action Questionnaire-II (AAQ-II), in a representative sample of Spanish adolescents. Methods: A cross-sectional analysis was conducted using data from 631 adolescents (aged 12–17) participating in the Eating Healthy and Daily Life Activities (EHDLA) study. PF was assessed by the Assessing the Levels of PHysical Activity and Fitness (ALPHA-Fit) Test Battery (cardiorespiratory fitness, muscular strength, agility, and flexibility). Psychological inflexibility was measured using the AAQ-II. Generalized linear models (GLMs) were used to evaluate associations, adjusting for age, sex, body mass index, socioeconomic status, physical activity, sedentary behavior, sleep duration, and energy intake. Results: Unadjusted analyses showed weak but significant associations between psychological inflexibility and performance in the 20 m shuttle run test (p = 0.002), the 4 × 10 shuttle run test (p = 0.005), and the sit-and-reach test (p < 0.001). However, after adjusting for covariates, none of the PF components maintained a statistically significant association with the AAQ-II scores. Conclusions: In this adolescent sample, PF components were not independently associated with psychological inflexibility after adjustment for key confounders. These findings suggest that, while PF may contribute to general well-being, it is not a primary determinant of psychological inflexibility. Further longitudinal and intervention studies are needed to clarify the mechanisms linking physical and psychological health in youth. 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

Background: School-based tobacco control policies are critical for preventing youth tobacco use. While many districts adopt formal policies to create smoke- and vape-free environments, the degree to which these policies are enforced at the school level may vary, influencing their effectiveness. Little is known about how consistently such policies are implemented across schools within urban school districts. Objectives: This study aimed to examine the existence and enforcement of school-level tobacco control policies in an urban public school system, using Baltimore City schools as a case example. Methods: We conducted a survey of school personnel from 20 high schools in Baltimore City in 2024. The survey instrument assessed the presence and enforcement of policies related to tobacco use prevention, communication, signage, disciplinary actions, and institutional support. Descriptive statistics (frequencies and percentages) were used to summarize responses. Spearman correlations were also used for bivariate correlations. Additional school-level and neighborhood-level contextual data were collected from the internet (neighborhood socioeconomic status and school performance). Results: While many policies existed across the 20 participating schools, their enforcement was widely inconsistent. Most schools reported the existence of policies prohibiting tobacco use in school buildings (60%) and vehicles (55%). However, few schools had visible tobacco-free signage (35%) or offered cessation programs (15%). Communication of policies to students (70%) and staff (65%) was the most commonly enforced aspect of tobacco control policies. Conclusions: Findings suggest that while tobacco control policies may be adopted across urban school systems, their enforcement at the school level remains uneven. Greater attention may be needed to support policy implementation and to reduce variability in school-level practices. Baltimore City serves as a useful case study to understand these challenges and identify opportunities for strengthening school-based tobacco prevention efforts. Full article

Physical performance data is essential for planning youth training effectively; however, there is a lack of scientific information regarding performance in youth competitions. To address this gap, an innovative study was conducted with Portuguese U14 regional selections. Each player was equipped with a WimuPro™ inertial device. Six variables were considered: accelerations, decelerations, speed, player load, impacts, and high impacts. The objective of this study, based on data from official competitions, was to statistically analyze the distribution and intensity thresholds of six physical performance variables across five defined zones. A cluster k-means analysis was performed for a significance value of p < 0.05. Five zones were identified for all variables: acceleration [<0.37; 0.37 to 0.81; 0.81 to 1.54; 1.54 to 3.49; >3.49 m/s²], deceleration [<−0.26; −0.27 to −0.63; −0.63 to −1.22; −1.22 to −2.545; >−2.54 m/s²], speed [<5.42; 5.42 to 10.19; 10.20 to 14.63; 14.64 to 18.59; >18.59 km/h²], player load [<1.07; 1.07 to 1.36; 1.37 to 1.63; 1.64 to 1.95; >1.95 u.a./min], impacts [<133.45; 133.45 to 158.75; 158.76 to 181.45; 181.46 to 206.59; >206.59 cont/min], and high impacts [<1.13; 1.14 to 2.11; 2.12 to 3.13; 3.14 to 4.42; >4.42 cont/min]. These intensity zones should be taken into account to optimize training and enhance the understanding of competition in U14 basketball. Full article

This study is a qualitative study conducted in order to examine the religious lives of students studying in different faculties of (x) University in the academic year 2024–2025 and to understand their perspectives on religious beliefs and practices. The research data were obtained through semi-structured interviews with 20 students on a voluntary basis. In the study, students’ worship habits, such as prayer, fasting, reading the Qur’an, and praying, which can be considered as the basic worship practices of Islam, and the reflection of these habits on their lives were discussed. The data obtained show that the majority of the students attach importance to religious practices but have various difficulties in fulfilling these practices. In the study, it was determined that most of the participants evaluated prayer as a means of connecting with God, finding inner peace, and gaining a sense of responsibility, and fasting in the context of patience, self-training, empathy, and spiritual maturity. The majority of the participants embraced the Qur’an as the main source and sacred text of Islam, and they practiced reading the Qur’an in Arabic more than they practiced reading the translation. Praying was determined as the most common and continuous practice among the participants. As a result, it has been determined that although university youth do not have different results in terms of beliefs regarding worship, they do not show the same sensitivity in terms of practice. Full article

Urban forests, as a form of green infrastructure, play a vital role in enhancing urban resilience, environmental health, and quality of life. However, users perceive and utilize these spaces in diverse ways. This study aims to identify latent perception types among urban forest visitors and analyze their behavioral, demographic, and policy-related characteristics in Incheon Metropolitan City (Republic of Korea). Using latent class analysis, four distinct visitor types were identified: multipurpose recreationists, balanced relaxation seekers, casual forest users, and passive forest visitors. Multipurpose recreationists preferred active physical use and sports facilities, while balanced relaxation seekers emphasized emotional well-being and cultural experiences. Casual users engaged lightly with forest settings, and passive forest visitors exhibited minimal recreational interest. Satisfaction with forest elements such as vegetation, facilities, and management conditions varied across visitor types and age groups, especially among older adults. These findings highlight the need for perception-based green infrastructure planning. Policy recommendations include expanding accessible neighborhood green spaces for aging populations, promoting community-oriented events, and offering participatory forest programs for youth engagement. By integrating user segmentation into urban forest planning and governance, this study contributes to more inclusive, adaptive, and sustainable management of urban green infrastructure. Full article

Thailand’s southern border provinces need youth-focused multicultural leadership programs integrating local religious–cultural elements, community involvement, and long-term evaluation to enhance social cohesion and sustainable development. This study aimed to develop and evaluate a program to foster multicultural leadership among youth in Thailand’s three southern border provinces. The research was conducted in two phases. The first phase involved synthesizing key multicultural leadership characteristics, designing a structured program and assessing its relevance and coherence through expert evaluation. The second phase focused on empirical validation by implementing the program with 22 selected youth participants, employing repeated-measures analysis of variance to assess its effectiveness. Additionally, experts evaluated the program’s validity, appropriateness, cost-effectiveness, utility, and feasibility. The resulting program, “EARCA”, comprises five core components: Experiential Exposure, Active Exploration & Engagement, Reflective Thinking & Analysis, Concept Integration & Synthesis, and Application & Extension. Expert assessments confirmed its appropriateness at the highest level, with a consistency index ranging from 0.8 to 1.0. Statistical analyses demonstrated significant improvements in all dimensions of multicultural leadership among participants. Furthermore, the program was rated highly accurate, appropriate, cost-effective, practical, and feasible for real-world implementation. These findings offer valuable insights for policymakers and practitioners seeking to enhance multicultural leadership development through structured, evidence-based interventions. Full article

In an era where digitalization shapes economic and social landscapes, the intersection of digital skills, ethics, and integrity plays a crucial role in understanding the vulnerability of youth classified as NEET (Not in Education, Employment, or Training). This study explores how risky internet use and digital skill gaps contribute to socio-economic exclusion, integrating a multivariate and spatial approach to assess regional disparities in Europe. This study adopts a systems thinking perspective to explore digital exclusion as an emergent outcome of multiple interrelated subsystems. The research employs logistic regression, Principal Component Analysis (PCA) with Promax rotation, and Geographic Information Systems (GIS) to examine the impact of digital behaviors on NEET status. Using Eurostat data aggregated at the country level for the period (2000–2023) across 28 European countries, this study evaluates 24 digital indicators covering social media usage, instant messaging, daily internet access, data protection awareness, and digital literacy levels. The findings reveal that low digital skills significantly increase the likelihood of being NEET, while excessive social media and internet use show mixed effects depending on socio-economic context. A strong negative correlation between digital security practices and NEET status suggests that youths with a higher awareness of online risks are less prone to socio-economic exclusion. The GIS analysis highlights regional disparities, where countries with limited digital access and lower literacy levels exhibit higher NEET rates. Digital exclusion is not merely a technological issue but a multidimensional socio-economic challenge. To reduce the NEET rate, policies must focus on enhancing digital skills, fostering online security awareness, and addressing regional disparities. Integrating GIS methods allows for the identification of territorial clusters with heightened digital vulnerabilities, guiding targeted interventions for improving youth employability in the digital economy. Full article

Participation in organized sport is widely encouraged for youth development, yet positive outcomes are not guaranteed. Parents play a pivotal role in shaping young athletes’ experiences, requiring emotional support, interpersonal skills, and self-regulation. This study examines the meanings parents attribute to their children’s sports participation and how young athletes construct their experiences under parental and coaching influences. An interpretive phenomenological methodology involved semi-structured interviews with coaches, focus groups with parents, and open-ended questionnaires to young athletes. Seventeen players (M = 11.2 years, SD = 0.59), nineteen parents (M = 47.6 years, SD = 3.61), and two coaches from the same football club volunteered to participate in the study. Participants were selected through purposive sampling to ensure a homogeneous experience. The findings reveal that parental involvement balances support and pressure, while trust-building between parents and coaches significantly impacts the athletes’ experiences. The evolving role of technology and the importance of social dynamics within teams also emerged as critical factors. Intrinsic motivation, fostering emotional bonding through the sport, and adopting a developmental rather than purely competitive framework were emphasized factors identified as supporting positive youth sport experiences. These findings offer insights into how interconnected relationships among parents, coaches, and athletes influence children’s sports engagement and development. Full article

Background: Thailand is rapidly transitioning into an aging society, creating an intergenerational caregiving gap that strains existing support systems. Objective: This study evaluated the effectiveness of “Young Care,” a community-based intervention designed to enhance youth knowledge, attitudes, and caregiving practices (KAP) toward older adults. Methods: A two-day structured training was conducted in Maha Sarakham Province in 2023 using a pre-post mixed-methods design. Middle and high school students participated in lectures, multimedia sessions, and experiential learning activities related to caregiving. Quantitative data were collected using validated KAP questionnaires, while qualitative insights were obtained from focus group discussions involving students, older persons, caregivers, and local leaders. Results: Post-intervention analysis revealed significant improvements in knowledge and attitudes (p < 0.001), accompanied by increased empathy, caregiving initiative, and a sense of moral responsibility among participants. Conclusions: The initiative fostered formal partnerships among schools, local governments, healthcare providers, and universities through memoranda of understanding. These collaborations enabled budgetary support and outreach to out-of-school youth, positioning “Young Care” as a scalable, youth-centered strategy to address Thailand’s long-term care challenges. Full article

Diagnosing hypermobility disorders and Ehlers-Danlos syndrome (EDS) in children is challenging due to overlapping features with generalized joint hypermobility (GJH) and the lack of biomarkers. Background/Objectives: This study aims to describe the clinical and genetic features of pediatric EDS patients and identify key comorbidities and correlations. Methods: This is a single-center observational study of patients under 18 diagnosed with suspicion of EDS (2018–2024) at a tertiary pediatric hospital. Diagnoses were made using 2017 criteria. Results: Forty-one patients (46% female; mean age 11.1 ± 2.8 years) were included. Based on 2017 criteria, 61% had hypermobile EDS (hEDS)/hypermobility spectrum disorder (HSD), 22% classical EDS, 7.3% vascular, and 9.7% other subtypes. Musculoskeletal (90.2%), cutaneous (68.3%), and psychiatric (56.1%) symptoms were most frequent. Significant associations included older age with psychiatric symptoms (p = 0.029), Beighton score with dislocations (p = 0.026), and less atrophic scarring in hEDS (p < 0.008). Genetic testing (73% performed) confirmed pathogenic variants (11 novel) in EDS with a known molecular cause. Conclusions: This study proposes a clinically guided approach and diagnostic algorithm for youth hypermobility, emphasizing precision medicine principles, while highlighting the urgent need for further research to identify hEDS biomarkers. Full article

Laboratory-based assessment of cardiorespiratory function is a widely applied method in sports science. Most performance evaluations focus on oxygen uptake parameters. Despite the well-established concept of oxygen deficit introduced by Hill in the 1920s, relatively few studies have examined its behavior during submaximal exercise, with limited exploration of deficit dynamics. The present study aimed to analyze the behavior of oxygen deficit in young female handball players (N = 42, age: 15.4 ± 1.3 years) during graded exercise. Oxygen deficit was estimated using the American College of Sports Medicine (ACSM) algorithm, restricted to subanaerobic threshold segments of a quasi-ramp exercise protocol. Cardiorespiratory parameters were measured with the spiroergometry test on treadmills, and body composition was assessed via Dual Energy X-ray Absorptiometry (DEXA). Cluster and principal component analyzes revealed two distinct athlete profiles with statistically significant differences in both morphological and physiological traits. Cluster 2 showed significantly higher relative VO₂ peak (51.43 ± 3.70 vs. 45.70 ± 2.87 mL·kg⁻¹·min⁻¹; p < 0.001; Cohen’s d = 1.76), yet also exhibited a greater oxygen deficit per kilogram (39.03 ± 16.71 vs. 32.56 ± 14.33 mL·kg⁻¹; p = 0.018; d = 0.80). Cluster 1 had higher absolute body mass (69.67 ± 8.13 vs. 59.66 ± 6.81 kg; p < 0.001), skeletal muscle mass (p < 0.001), and fat mass (p < 0.001), indicating that body composition strongly influenced oxygen deficit values. The observed differences in oxygen deficit profiles suggest a strong influence of genetic predispositions, particularly in cardiovascular and muscular oxygen utilization capacity. Age also emerged as a critical factor in determining the potential for adaptation. Oxygen deficit during submaximal exercise appears to be a multifactorial phenomenon shaped by structural and physiological traits. While certain influencing factors can be modified through training, others especially those of genetic origin pose inherent limitations. Early development of cardiorespiratory capacity may offer the most effective strategy for long-term optimization. Full article