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The prevalence of pediatric anxiety disorders is on the rise but youth have challenges in accessing specialty evidence-based mental health care. As a result, families turn to their pediatric primary care provider (PCP) for assessment and management of anxiety. To increase PCPs’ abilities to manage anxiety, the Extension for Community Healthcare Outcomes (“Project ECHO”) was used. The purpose of this study is to explore the impact of Project ECHO on participating PCPs’ knowledge, self-efficacy and interventions surrounding the assessment and management of anxiety.

Data were collected pre- and post-course across five cohorts. Participants completed a clinical knowledge test, ratings of self-efficacy and self-reported frequencies of in-office interventions. Satisfaction was also measured.

Attendance remained strong, and participants rated high satisfaction. From pre- to post-course, participants demonstrated increased knowledge on almost all objective questions. Participants reported increased self-efficacy across all domains. Finally, participants endorsed increased use of several in-office interventions.

This study highlights the importance of Project ECHO as a continuing education model to enhance PCPs’ abilities and confidence in the assessment and management of anxiety. Future continuing education endeavors should consider Project ECHO as a means of increasing PCPs’ capacity to manage mental health conditions.

To the best of the authors’ knowledge, this is the first study that applied the Project ECHO model to pediatric anxiety as a mechanism of increasing knowledge, self-efficacy and in-office interventions with PCPs.

This study aims to explore the link between prevalent risk factors for early childhood diarrhea, including hygiene, feeding, weaning practices and maternal education and the occurrence and severity of early childhood diarrhea in Saudi Arabia.

A case-control study was conducted, involving 98 mothers from the Eastern Region of Saudi Arabia (51 cases and 47 controls). Data were collected from both hospital and community sources. The collected data were statistically analyzed and depicted using descriptive statistics and frequency tables.

Demographic data revealed that 60% of mothers were housewives, 75% had normal deliveries and all babies were full term. In the study cohort, 44% of children aged one to two years. Four domains were compared: diarrheal management, hygiene, weaning and feeding practices. Diarrheal management was suboptimal in some cases: 29% increased fluid intake, 10% maintained adequate food intake, 50% sought medical advice, 58% were familiar with oral rehydration solutions and only 37% used them. Hygiene practices were deficient, with 35% using wipes or sanitizers, 64% handwashing before feeding and 52% adhering to the recommended 10-s duration. Controls exhibited better hygiene practices. Weaning practices were generally similar, with no significant differences between the two groups.

To the best of the authors’ knowledge, this is the first study to collectively report on the risk factors linked to early childhood diarrhea in Saudi Arabia. This study yields significant insights, highlighting the crucial role of managing diarrhea, educating mothers and implementing proper household practices in impacting the occurrence and severity of this perilous ailment.

This chapter offers a theoretical framework to explore the relationship between resilience, wellbeing, and authentic leadership through the students’ transition from high school to university. It highlights how student leaders can thrive despite the challenges they face throughout this transition. First, the author presents an overview of resilience research, specifically by defining key characteristics of resilient students, followed by the outline of the four waves of resilience research. Next, the author describes the construct of wellbeing and the common characteristics among the wellbeing models in relation to the general university student population, as well as student leaders. Next, the author reviews the authentic leadership theory, including its key components of authentic leadership, the psychological capabilities for authentic leadership, and how resilience manifests in authentic leaders. The author concludes with an overview of transitional periods, critical life events, and their manifestations in the transition from high school to university.

The study explored how information institutions can support the resilience of parents of adolescents affected by the Russia–Ukraine war. Ukrainian parents are facing major challenges of supporting their teenagers through a difficult developmental phase while also “buffering” their war-related hardships. By supporting parents, information institutions can also support children.

Fifteen parents were interviewed about mental health challenges and resources that are helpful and/or missing from their support systems. Recordings of participant narratives were analyzed using the qualitative thematic analysis technique.

The findings indicate that both teens and parents rely on internal resilience skills, family, friends and community resources to support themselves. However, a number of additional resources could be offered by information institutions, including content for (1) teens on developing skills in communication, interpersonal relationships, problem solving and academic pursuits; (2) parents on child development and opportunities in their host countries; both groups on (3) both groups on mental health first aid and safe spaces to meet peers. The study recommendations will be of interest to information professionals working with families, especially families affected by disasters.

The study relied on a small convenience sample of participants.

Study recommendations would be of interest to information professionals who develop and provide services to families affected by natural and manmade disasters.

Study recommendations improve understanding of the (potential) role of information institutions and libraries in strengthening family and community resilience.

The study offers a rare insight into experiences of war-affect families and provides evidence-driven recommendations for information institutions to support family and community resilience.

Food security reflects the amount of access and availability of healthy, nutritious, and culturally appropriate food and represents a significant problem both nationally and globally. Individuals and families that are considered food insecure experience disparities and inequities in food access and availability and insufficiency in the amount and kind of food required for a healthy lifestyle. We see high food insecurity as a violation of one's rights to a healthy and secure life and a denial of the opportunity for individuals, families, and communities to realize their full potential in society. Thus, we examine food insecurity from three distinct but related perspectives: social responsibility, social justice, and social sustainability. We then explore the link between food insecurity and the “built environment” as needed to shape research, practice, and sustainable solutions in the future.

This chapter reviews the evidence on the role of physicians in shaping inequalities in access to and utilisation of healthcare. The authors examine three types of physician decisions that can influence inequalities in access and utilisation: location decisions, decisions to work in the public and/or private sector, and decisions or behaviours in the doctor–patient encounter. For each, the authors summarise the issues and empirical evidence on possible policies to help reduce inequalities in access. Future research to reduce inequalities should focus on changes to health systems that influence physician decisions, such as health insurance expansions, the public–private mix and financial incentives, as well as physician training and policies for a more diverse physician workforce.

The outbreak of COVID-19 endemic forced people not only to think but also to pause and objectively reflect how to deal with the situation that has arisen and how to develop well-being and resilience strategies for the welfare of humanity. The endemic brought a global economic shock of enormous magnitude in most of the countries. Policymakers across the globe today have been facing alarming situations and unpredictable challenges as they try to find solutions to problems in the areas of tourism, at macro-economic levels and in socio-cultural arena. People in developing countries are concerned with earning livelihood and supporting their families and find some opportunities to survive by increase in tourist arrivals. Conversely, industralized countries struggle to improve the general psychological and physical health of their citizens. Travelling for well-being appears to be a sensible and uplifting resilience tactic in such a situation. This piece discusses how, in such a situation, cultivating resilience and well-being techniques may enable us to overcome a variety of obstacles in the travel and tourist industry. According to the author, policies aimed at enhancing well-being through travel should give priority to factors like affordability, accessibility, sustainability, safety and education. By promoting an environment where travel is affordable, accessible and sustainable, policymakers can guarantee that more people can take advantage of the positive experiences and enrichment that travel can provide to their lives, while also benefiting the greater community and environment.

This study aims to examine the dietary compliance of children and adolescents with celiac disease (CD) and their diet quality (DQ) and dietary acid load (DAL) and to determine the relationship of these dietary parameters with health-related quality of life (HRQoL).

Ninety-one children and adolescents with CD and 144 healthy peers were included in this cross-sectional study. Anthropometric measurements were conducted by researchers. DQ and DAL were calculated from participants’ 24-h dietary recall records. HRQoL was assessed using the Pediatric Quality of Life Inventory, and compliance with a gluten-free diet (GFD) was obtained using the GFD score. Data was collected through a face-to-face questionnaire.

Of celiac patients, 53.1% were strictly compatible with the GFD, and 35.8% were non-compliant with the diet. The DQ scores of participants with CD were higher than their healthy peers, and the DAL scores were lower (p < 0.01). Finally, no relationship was found between the DQ and DAL with HRQoL scores in celiac patients (p > 0.05). However, better dietary compliance with the GFD was associated with improved HRQoL (p < 0.05).

While DQ and DAL had no association with HRQoL, better dietary compliance improved the HRQoL of celiac patients. This may help develop solutions to the problems experienced by celiac patients, thereby improving the management of CD.

To the best of the authors’ knowledge, this study is the first to investigate the association of DQ and DAL with HRQoL in children with CD.

This study aims to examine how an educational intervention, using the lens of the LEADS framework, can influence the development of primary care doctors’ leadership skills in Aceh, Indonesia. In order to persevere in the face of inadequate resources and infrastructure, particularly in rural and remote settings of low- and middle‐income countries, physicians require strong leadership skills. However, there is a lack of information on leadership development in these settings.

This study applied an educational intervention consisting of a two-day workshop. The authors evaluated the impact of the workshop on participants’ knowledge and skill by combining quantitative pre- and post-intervention questionnaires (based on Levels 1 and 2 of Kirkpatrick’s model) with qualitative post-intervention in-depth interviews, using a phenomenological approach and thematic analysis.

The workshop yielded positive results, as evidenced by participants’ increased confidence to apply and use the information and skills acquired during the workshop. Critical success factors were as follows: participants were curiosity-driven; the use of multiple learning methodologies that attracted participants; and the use of authentic scenarios as a critical feature of the program.

The intervention may offer a preliminary model for improving physician leadership skills in rural and remote settings by incorporating multiple teaching approaches and considering local cultural norms.