Background The COVID-19 pandemic has potentially had a negative impact on the mental health and well-being of individuals and families. Anxiety levels and risk factors within particular populations are poorly described. Objective This study aims to evaluate confidence, understanding, trust, concerns, and levels of anxiety during the COVID-19 pandemic in the general population and assess risk factors for increased anxiety. Methods We launched a cross-sectional online survey of a large Russian population between April 6 and 15, 2020, using multiple social media platforms. A set of questions targeted confidence, understanding, trust, and concerns in respondents. The State-Trait Anxiety Inventory was used to measure anxiety. Multiple linear regressions were used to model predictors of COVID-19–related anxiety. Results The survey was completed by 23,756 out of 53,966 (44.0% response rate) unique visitors; of which, 21,364 were residing in 62 areas of Russia. State Anxiety Scale (S-Anxiety) scores were higher than Trait Anxiety Scale scores across all regions of Russia (median S-Anxiety score 52, IQR 44-60), exceeding published norms. Time spent following news on COVID-19 was strongly associated with an increased S-Anxiety adjusted for baseline anxiety level. One to two hours spent reading COVID-19 news was associated with a 5.46 (95% CI 5.03-5.90) point difference, 2-3 hours with a 7.06 (95% CI 6.37-7.74) point difference, and more than three hours with an 8.65 (95% CI 7.82-9.47) point difference, all compared to less than 30 minutes per day. Job loss during the pandemic was another important factor associated with higher S-Anxiety scores (3.95, 95% CI 3.31-4.58). Despite survey respondents reporting high confidence in information regarding COVID-19 as well as an understanding of health care guidance, they reported low overall trust in state and local authorities, and perception of country readiness. Conclusions Among Russian respondents from multiple social media platforms, there was evidence of higher levels of state anxiety associated with recent job loss and increased news consumption, as well as lower than expected trust in government agencies. These findings can help inform the development of key public health messages to help reduce anxiety and raise perceived trust in governmental response to this current national emergency. Using a similar methodology, comparative surveys are ongoing in other national populations.

ObjectivesTo review available health and nutrition claims for infant formula products in multiple countries and to evaluate the validity of the evidence used for substantiation of claims.DesignInternational cross sectional survey.SettingPublic facing and healthcare professional facing company owned or company managed formula industry websites providing information about products marketed for healthy infants delivered at full term in 15 countries: Australia, Canada, Germany, India, Italy, Japan, Nigeria, Norway, Pakistan, Russia, Saudi Arabia, South Africa, Spain, the United Kingdom, and the United States in 2020-22.Main outcome measuresNumber and type of claims made for each product and ingredient. References cited were reviewed and risk of bias was assessed for registered clinical trials using the Cochrane risk of bias tool, and for systematic reviews using the Risk Of Bias in Systematic reviews tool.Results757 infant formula products were identified, each with a median of two claims (range from 1 (Australia) to 4 (US)), and 31 types of claims across all products. Of 608 products with ≥1 claims, the most common claim types were “helps/supports development of brain and/or eyes and/or nervous system” (323 (53%) products, 13 ingredients), “strengthens/supports a healthy immune system” (239 (39%) products, 12 ingredients), and “helps/supports growth and development” (224 (37%) products, 20 ingredients). 41 groups of ingredients were associated with ≥1claims, but many claims were made without reference to a specific ingredient (307 (50%) products). The most common groups of ingredients cited in claims were long chain polyunsaturated fatty acids (278 (46%) products, 9 different claims); prebiotics, probiotics, or synbiotics (225 (37%) products, 19 claims); and hydrolysed protein (120 (20%) products, 9 claims). 161/608 (26%) products with ≥1 claims provided a scientific reference to support the claim—266 unique references were cited for 24 different claim types for 161 products. The reference types most frequently cited were clinical trials (50%, 134/266) and reviews (20%, 52/266). 28% (38/134) of referenced clinical trials were registered, 14% (19/134) prospectively. 58 claims referred to 32 registered clinical trials, of which 51 claims (27 trials) related to a randomised comparison. 46 of 51 claims (90%) referenced registered clinical trial outcomes at high risk of bias, and all cited systematic reviews and pooled analyses, carried a high risk of bias.ConclusionsMost infant formula products had at least one health and nutrition claim. Multiple ingredients were claimed to achieve similar health or nutrition effects, multiple claims were made for the same ingredient type, most products did not provide scientific references to support claims, and referenced claims were not supported by robust clinical trial evidence.

A growing number of studies are focusing on the associations between human milk (HM) immunological composition and allergic diseases. This scoping review aims to identify statistical methods applied in the field and highlight pitfalls and unmet needs. A comprehensive literature search in MEDLINE and Embase retrieved 13,607 unique records. Following title/abstract screening, 29 studies met the selection criteria and were included in this review. We found that definitions of colostrum and mature milk varied across the studies. A total of 17 out of 29 (59%) studies collected samples longitudinally, but only 12% of these used serial (longitudinal) analyses. Multivariable analysis was used in 45% of the studies, but statistical approaches to modelling varied largely across the studies. Types of variables included as potential confounding factors differed considerably between models. Discrimination analysis was absent from all studies and only a single study reported classification measures. Outcomes of this scoping review highlight lack of standardization, both in data collection and handling, which remains one of the main challenges in the field. Improved standardization could be obtained by a consensus group of researchers and clinicians that could recommend appropriate methods to be applied in future prospective studies, as well as already existing datasets.

Background: Pediatrics is a specialty reserved until later stages of the medical curriculum, with many students receiving early exposure via volunteering opportunities. Self-perceived confidence across the pediatric curriculum is crucial, due to limited clinical exposure before qualification. We aimed to assess the impact of a 7-week pediatric placement on medical students' self-perceived confidence and factors that influenced self-perceived confidence. Methods: We conducted a prospective pilot survey on three cohorts of fifth-year students undertaking pediatric placements in 2018. A two-part questionnaire was distributed before and after the placement, evaluating the level of self-confidence in clinical skills using a 10-point scale. Results: Of 103 students, 62 (60%) students completed both questionnaires. Of these, 34 (55%) students reported previous professional experiences with children. There was a significant increase in self-reported confidence scores across ten questions before (mean 5.4 [IQR 4.1-6.1]) and after the placement (7.6 [6.6-8.5], p<0.0001). Subgroup analyses between students with prior professional experience with children and those without revealed a significant difference in preplacement confidence in four pediatric practices: verbal communication, physical engagement, asking sensitive or probing questions, and explaining medical management (p<0.05). There was no significant difference in postplacement confidence between these two groups. Conclusion: Medical students with prior professional experience with children reported higher self-confidence in interacting with pediatric patients prior to placement. However, a large and consistent increase in confidence across the cohort was such that there were no measurable differences at exit. This study supports the value of undergraduate pediatric training in promoting student self-confidence in managing pediatric clinical issues.

The present study investigated the significance of auditory discrimination and the use of phonological and orthographic codes during the course of reading development in Chinese students who are deaf or hard of hearing (D/HH). In this study, the reading behaviors of D/HH students in 2 tasks-a task on auditory perception of onset rime and a synonym decision task-were compared with those of their chronological age-matched and reading level (RL)-matched controls. Cross-group comparison of the performances of participants in the task on auditory perception suggests that poor auditory discrimination ability may be a possible cause of reading problems for D/HH students. In addition, results of the synonym decision task reveal that D/HH students with poor reading ability demonstrate a significantly greater preference for orthographic rather than phonological information, when compared with the D/HH students with good reading ability and their RL-matched controls. Implications for future studies and educational planning are discussed.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has potentially had a negative impact on the mental health and well being of individuals and families. Anxiety levels and risk factors within particular populations are poorly described. OBJECTIVE To evaluate confidence, understanding, trust and concerns and levels of anxiety during COVID-19 pandemic in general population and assess risk factors for increased anxiety. METHODS We launched a cross-sectional online survey to a large online Russian population between 6th and 15th April 2020 using multiple social media platforms. A set of questions targeted confidence, understanding, trust and concerns in respondents. State-Trait Anxiety Inventory (STAI) was used to measure anxiety. Multiple linear regressions were used to model predictors of COVID-19 related anxiety. RESULTS The survey was completed by of 21,634 participants (41% response rate) from 62 areas of Russia. State anxiety scores were higher than Trait anxiety across all regions of Russia (median S-Anxiety score 52 [IQR 44 – 60]), exceeding published norms. Time spent following news on COVID-19 was strongly associated with an increased S-Anxiety adjusted for baseline anxiety level. One to two hours spent reading COVID news was associated with 5.46 (95%CI 5.03 – 5.90) point difference, 2-3 hours 7.06 (6.37 – 7.74) and more than three hours 8.65 (7.82 – 9.47), respectively; all compared to less than 30 minutes per day. Job loss during pandemic was another important factor associated with higher S-Anxiety scores (3.95 (3.31 – 4.58)). Despite survey respondents reporting high confidence in information regarding COVID-19 as well as understanding of healthcare guidance, they reported low overall trust in state and local authorities and perception of country readiness. CONCLUSIONS Among Russian respondents from multiple social media platforms, there is evidence of higher levels of state-anxiety associated with recent job loss and increased news consumption, as well as lower than expected trust in government agencies. These findings can help inform development of key public-health messages to help reduce anxiety and raise perceived trust in governmental response to this current national emergency. Using similar methodology, comparative surveys are ongoing in other national populations.

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