Effect of Gaza War on Mental Health of Different Egyptian Generations

Effect of Gaza War on Mental Health of Different Egyptian Generations | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Effect of Gaza War on Mental Health of Different Egyptian Generations Nadira Mansour Hassan, Rabab Ahmed Hammad, Amira Ahmed Abd El karem This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-5852378/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 03 Jul, 2025 Read the published version in BMC Psychology → Version 1 posted 13 You are reading this latest preprint version Abstract Background : Exposure to unfavorable environmental circumstances including conflicts and wars increases people’s risk of experiencing mental health disturbances. Prevalence rates of anxiety, depression and stress disorders were two- to three-fold higher between people exposed to war or those interested in war news. Objectives : to explore prevalence of depression, anxiety and stress among Tanta university students and their parent representing different Egyptian generations, identify associated factors and their effect on study/or work performance Methods: A cross-sectional study was conducted to collect data from undergraduate medical students at Tanta University and their parent by using random cluster sampling technique. The study included 100 medical students and 200 parent. A self-administrated questionnaire was used which included sociodemographic data, DASS-21 (Depression, Anxiety Stress Scale) to measure levels of depression, anxiety and stress and the impact of war on studying /or work performance. Results : Females were constituting 79.0% of students. All students and vast majority of fathers and mothers reported that they follow war news. Social media networks were the most frequently used source of information especially among students. Depression symptoms were expressed by 97.0% of students, 77.0% of mothers and 65.0% of fathers. Anxiety and stress were reported by about two thirds of students and 51% of mothers and 45.0% of fathers. Multivariant logistic regression analysis showed that the shared predictor that pointed to severe and extremely severe level of depression (p .004), Anxiety and stress (p<0.001) was frequently checkup of war news. On the other hand, young age (p<0.001) and female sex (p=0.023) were significant predictors for depression and urban residence was a significant predictor for severe and extremely severe level of anxiety. Students’ desire to study and study hours were affected to some degree but among most parent, work performance was not affected. Conclusion : Mental health problems were more prevalent among students followed by mothers and finally fathers. The students representing the younger generation were following war news frequently and were the worst affected generation. This study pointed that in countries outside wars, screening for different mental health problems, their determinants and predictors among different generations is crucial for identification of people whose condition requires specialized interventions War Mental health Depression Anxiety Stress DASS-21 Students Adults associated factors Figures Figure 1 Figure 2 Figure 3 Introduction Global rates of armed conflicts have shown an alarming increase since 2008. Wars have devastating and long- term cumulative impacts on health. They directly kill, injure, maim and destroy life and cause extensive morbidity and mortality among military personnel and noncombatant civilians. [ 1 ] Morbidity includes a wide range of disorders, from disabling injuries to adverse effects on mental health. The World Health Organization (WHO) estimates that 22.1% of people in conflict-affected populations have developed a wide range of mental health symptoms mainly of depression, anxiety and posttraumatic disorders. [ 2 , 3 ] Mental health is considered as a vital part of well-being, whereas poor mental health is associated with decreased productivity, a lesser quality of life, and disability. Nowadays millions of people have been watching wars in the media and this exposed them to psychological trauma which extends its participants and refugees to include wider groups influenced by the media coverage of the war [ 4 , 5 ]. Prior studies documented that those citizens of Germany, Poland, the United Kingdom and the United States experienced feelings of psychological disturbances including anxiety, stress and depression related to Russian Ukrainian War (RUW-22).[ 6 ] The long-standing Israeli Palestinian conflict has escalated since the beginning of the 20th century, resulting in a humanitarian crisis in Palestine especially at Gaza strip which has been exposed to recurrent violence and escalation for many years resulting in a state of constant complex humanitarian emergency (WHO, 2022). [ 7 , 8 ]. Since the beginning of Israel-Gaza war on the 7th of October 2023, current media attention has mainly focused on the horrendous consequences of this war on the people of Gaza Strip, its rates of serious injury, death, struggle for physical survival and on the destruction of infrastructure. [ 9 ]. While only 18% of Israeli students experienced severe degree of stress during this war, more than three quarters (76.66%) of medical students at Gaza suffering from severe and extremely severe stress. [ 9 , 10 ] The effect of this war on mental health extends out of Israeli and Gaza people to all populations in the world due to circulating images of suffering and destruction on media. Egypt has direct border with Gaza strip and Egyptians were highly concerned with war news at initial months so, it was important to study the mental health burden of Gaza war-23 on different Egyptian generations. Medical students and their parents constituting two important different generations with different cultures and interests and studying the effect of the Gaza war-23 on mental health of them, could be considered as an indicator for mental health of this influencing sector of Egyptian population. The overarching goal of this study was to explore the mental health burden of the Gaza war among different generations of Egyptian population (youth and adults). Objectives The current study aims to; Assess the level of depression, anxiety and stress among medical students in Tanta university and their parent during the first months of Gaza − 23 war Assess the relationship between frequency of following war news and mental health disorders. Identify the associated and predicting factors of severity of DASS among studied groups Identify the impact of war on academic and/or work performance. Methods Study design, duration, setting: the current study was a descriptive cross-sectional study. It was carried out during a period of four months from November 2023 throughout February 2024 at faculty of medicine, Tanta university which is the main university at middle delta in Egypt. Tanta City is the capital of Gharbia Governorate in the Middle Delta region of Egypt. It is 92 Km north of Cairo. Study population, sample size and sampling techniques: The study participants were both sexes from fifth year students at faculty of medicine and their parent. The study included 300 participants. Hundred students and 200 parent (100 mothers and 100 fathers). The sample size was dependent on the expected prevalence of 66.6% of mental problems according to Kasierska , et al (2023), significance level 95%, precision 5% and using Epi Info program [11] The sampling type was probability sampling in the form of cluster random sampling. The number of students at 5 th year medical student was 1070, the number of clinical rounds was 20 rounds, each round contained around 50 students, 3 rounds were chosen randomly to compensate the non-responsiveness and excluded participants and each student was given three questionnaires, one for himself and two for his parents (one for his mother and another one for his father). • Inclusion and exclusion criteria : - Fifth year students of both sexes at faculty of medicine, Tanta university and their parent after taking their consent to participate in the study. -Those students who didn’t live with their parents and those who are non-Egyptian were excluded from the study also students who were incompletely filling out the questionnaires (either of them or their parent) were excluded and replaced by others of the same round. Study tool: The pre-designed questionnaire included four parts; sociodemographic, frequency of following war news, DASS-21 scale Arabic version [12], and the fourth part was about academic /or work performance ● The questionnaire includes 4 parts as following: • Part I: Socio-demographic data including age, sex, residence, and qualification of parents. • Part II: Frequency of following the news. That part included 5 questions to estimate frequently used news outlets and news following frequency at the beginning of the war and after one month to identify the change at the rate of following the news. • Part III : the short version of the Depression, Anxiety, and Stress Scale (DASS 21, Arabic version) • Part IV: Academic /or work performance. That part included three questions. Each question had a three-point Likert scale as the following; not at all (1), to some extent (2), and to a large extent (3) to estimate the effect of following war news on the students' academic study and work performance of parents. Each question was coded from 1 to 3. Total score was calculated ranging from 3 to 9, where higher scores reflect more affection. DASS-21 scale : This scale is the short version of DASS-42, the original manual. According to the DASS manual, emotional syndromes like depression and anxiety are intrinsically dimensional—they vary along a continuum of severity. Hence the selection of a single cutoff score to represent “clinical” severity is necessarily arbitrary. This is one of the main differences between DASS and categorical measures based on psychiatric diagnosis. Further, DASS authors developed a set of cut‐off scores for defining mild/moderate/severe/extremely severe scores for each DASS scale; as guided by the DASS manual. Psychometrically, DASS is quite different from diagnostic instruments in that it reflects the underlying continuity of severity of symptoms in the population; DASS scale scores are dimensional rather than categorical [13,14] On filling the questionnaire, the participants were asked to indicate to what extent they had experienced each symptom during the past week (on the original manual but we asked about the past first two months of the war). DASS-21 included three subscales seven questions for each domain. The 21 items on the DASS were rated on a 4‐four‐point scale, where 0 corresponded to “did not apply to me at all” and 3 to “applies to me very much.”. in total DASS-21 consists of 21 questions which was designated for participants to specify their emotional level for each statement. Item scores were added together for each dimension and multiplied by two (as per DASS manual) to equal 42, in order to match the original scale . The minimum score is zero and the maximum score is 42. The final score of DASS can be categorized as in Table 1. Table 1: Severity of depression, anxiety and stress (13) Rating Depression Anxiety Stress Normal 0-9 0-7 0-14 Mild 10-13 8-9 15-18 Moderate 14-20 10-14 19-25 Severe 21-27 15-19 26-33 Extremely severe 28+ 20+ 34+ DASS is a reliable tool to assess psychological distress in clinical and non-clinical populations [13, 15,16]. Together, the subscales provide a broad-spectrum measure of psychological distress, indicating the severity and frequency of symptoms. DASS-21 requires less time to administer, and it is superior to the full-scale version [17]. Validity of the study questionnaire : The questionnaire used in this study showed good validity, which was confirmed by three experts from the community and public health department and modifying the questionnaire according to their recommendations. Also, before data collection, reliability of modified questionnaire was tested on 15 participants (5 students and 10 parent) not included in the study. Cronbach’s alpha was found to be 0.875. The average time for fulfilling the questionnaire was 5-10 minutes. Data collection: The students were met during their study time at each round and data was collected at the beginning of the rounds to avoid examination times and stress inquired during these “hectic” and stressful periods of students’ academic lives. The objectives of the study were explained to the students who were informed that their participation was voluntary, and anonymity was assured. The participants were also told that the results of this research will be published. Each student was responsible for three questionnaires (one for him/herself which was fulfilled in the class and two for his parent). Questionnaires of students were obtained in class, and arrangements were made to bring back the complete questionnaires of parent. Statistics analysis of data: After collecting data, it was entered by excel sheet and SPSS version 21. After summation of the subscale scores for depression, anxiety and stress and their multiplication by 2 the investigators were recategorized the level of each domain as in table 2. Table (2): Severity of depression, anxiety and stress Rating Depression Anxiety Stress Normal 0-9 0-7 0-14 Mild to moderate 10-20 8-14 15-25 Severe to Extremely severe 21-28+ 15-20+ 26-34+ Distribution of participants in these categories was reported as frequencies and percentages. The scores were reported as mean ± standard deviation and median. When variables met the normality condition (assessed by the Shapiro–Wilk test), parametric tests were used for analysis like ANOVA test which was used to compare more than one group and when not met the normality condition, non-parametric test (Kruskal–Wallis test) was used for the analyses. Categorical data were presented as number and percentage and compared by chi square test for bivariate analysis, and it was replaced by Montecarlo exact when it was found appropriate. Multiple logistic regression was used to detect predictors of severe levels DAS. The value of p ≤ 0.05 was considered statistically significant. The data were analyzed using SPSS version 21.0 Ethical Consideration: Before starting the study approval of ethical committee of faculty of medicine, Tanta University was obtained. After explaining research objectives and procedures, formal consent was obtained from all participants before filling in the questionnaires. The participants were free to choose whether they want to participate or not, they could withdraw at any time without any negative effects and they had a right to privacy and confidentiality. All authors have no potential conflict of interest. Results The current study included 3 00 participants: one hundred medical students and their parent representing youth and young adult generations to assess depression, anxiety and stress levels. Table (1): Sociodemographic characters of studied participants Variable Students Fathers Mothers Age/years Mean ±SD Range 22.31 ± 0.66 21-24 55.8± 4.9 48-65 48.7± 4.3 42-58 n= 100 % n=100 % n=100 % Sex Males Females 21 79 21.0 79.0 100 -- 100.0 -- -- 100 -- 100.0 Residence Urban Rural 45 55 45.0 55.0 Education level: -Basic education (primary and preparatory) -Technical education - University education 100 100 13 8 79 13.0 8.0 79.0 20 14 66 20.0 14.0 66..0 Table (1) describes the sociodemographic characteristics of the study participants. The mean age of students was 22.31 ± 0.66 years old, corresponding to a mean age of 56.5± 5.0 among fathers and 49.5± 5.0 among mothers. The female students represented higher percentage (79.0%) than males (21.0%). More than half of the students were from rural areas (55.0%). Regarding the educational level of parents, university education represented the highest percentage (79.0%, 66.0% of fathers and mothers respectively). Table (2): Follow up of Gaza war news among the study participants and their parent. Follow up of Gaza news status Students (n=100) Fathers (n=100) Mothers (n=100) Total (n=300) χ 2 P n % n % n % n % Do you follow news of Gaza war Yes 100 100 99 99 97 97 296 98.7 M.C 0.170 No 0 0 1 1 3 3 4 1.3 Has your follow up rate changed since the beginning of the war? Decreased 57 57 41 41 51 51 149 49.7 M.C 0.145 Increased 30 30 34 34 29 29 93 31.0 Did not change 13 13 25 25 20 20 58 19.3 Follow up during the first month of war ≤ every 2 hours 43 43 27 27 22 22 92 30.7 3 times a day 30 30 15 15 19 19 64 21.3 Twice a day 10 10 16 16 22 22 48 16.0 30.801 0.001* Once a day 10 10 28 28 24 24 62 20.7 Few times a week 7 7 14 14 13 13 29 9.7 Follow up during the second month of war ≤ every 2 hours 19 19 16 16 15 15 50 16.7 3 times a day 18 18 15 15 14 14 47 15.7 Twice a day 22 22 14 14 13 13 49 16.3 Once a day 17 17 22 22 34 34 73 24.3 21.714 0.041* Few times a week 20 20 21 21 10 10 51 17.0 Once a week 4 4 12 12 14 14 29 9.7 Frequently used media Social media networks Television 89 9 89 9 46 51 46 51 51 46 51 46 186 106 62.0 35.3 MC 0.001* Digital news portals 2 2 3 3 3 3 8 2.7 Regarding the news, all students reported that they follow the news, vast majority of fathers and mothers (99.0%, 97.0% respectively). More than half of the students (57.0%) revealed that the rate of their following up to the news decreased, compared to 41.0% of fathers and 51.0% of mothers. Follow up rate during the first month of the war; 43.0% of students checked the news every couple of hours or less and 30.0% of them checked it three times a day. Lower rates were observed among parents as only 27.0% of fathers checked the news every couple of hours versus 22.0% of mothers. The most frequently used source of information was social media networks. It was reported by 89.0% of students, 46.0% of fathers and 51.0% of mothers. Television is still a main source of news for parents. Table (3): DASS - 21 Scale levels among the studied participants (students and their parent) DASS- 21 levels Students Fathers Mothers Significance test n % n % n % 1-Depression -Normal - Mild to moderate -Severe to extremely Severe 7 39 54 7.0 39.0 54.0 35 39 26 35.0 39.0 26.0 23 41 36 23.0 41.0 36.0 X 2 = 28.696 P= < 0. 001* Mean ±SD Median 22.8 ±9.5 22 15.0± 10 14 17.6± 10.5 16 Kruskal-Wallis test P= < 0. 001* 2- Anxiety : -Normal - Mild to Moderate -Severe to extremely severe 32 35 33 32.0 35 33 49 27 24 49 27 24 41 31 28 41.0 31.0 28.0 X 2 = 6.025 P= 0.197 Mean ±SD Median 10.8 ± 8.1 10 10.1± 8.1 8 11.4± 8 10 Kruskal–Wallis test P= 0. 476 3-Stress -Normal - Mild to moderate -Severe to Extremely severe 34 37 29 34 37 29 55 25 20 55 25 20 49 29 22 49.0 29.0 22 .0 X 2 = 9.436 P= 0.051* Mean ±SD Median 21.2± 7.9 18 14.2±9.7 14 19.4± 7.1 16 Kruskal–Wallis test P= < 0. 001* Table 3 pointed to depression levels; severe or extremely severe depression symptoms were expressed by more than half of students (54.0%) followed by 36.0% of mothers and lastly 26.0% of fathers. Depression scale had the highest mean among students reflecting the highest affection (22.08±9.5), followed by mothers who had mean of 17.6±10.5 and eventually fathers who were the least affected with a mean of 15.0+10.0. these differences were statistically significant (P= < 0. 001*) (figure 1). As regards anxiety levels, one third of students (33.0%) had severe to extremely severe anxiety followed by 28.0% of mothers and lastly 24.0% of fathers. For anxiety scale means, mothers had the highest score (11.4±8.0), followed by both students and fathers (10.1±8.1 for each of them), however, these differences were not statistically significant ( figure 2). Pointing to stress levels, 29.0% of students had severe to extremely severe stress score followed by 22.0% of mothers and 20.0% of fathers. As regards stress scale means, students had the highest mean reflecting the highest affection (21.2± 7.9), followed by mothers who had mean of 19.4± 7.1 and eventually fathers who were the least affected with a mean of 14.2±9.7 and these differences were statistically significant (P= < 0. 001) (figure 3). Table (4) showed univariant and multivariant analysis for the effect sociodemographic characteristics of all participants groups and frequency of war news checkup on depression, anxiety and stress disorders The univariant analysis showed statistically significant association between age and level of depression (p<0.001) and stress (p=0.013) where young age students (≤ 24 years) reported more severe and extremely severe manifestations of depression and stress (54% and 29% respectively) Vs parents (31%, and 21%) respectively. Also, sex showed significant difference (p=0.004) with severe and extremely severe depression level (45.3%) females Vs. 28.9% for males. There was significant difference between rural and urban participants regarding level of anxiety (p=0.004) where urban participants were more associated with severe and extremely severe levels. Frequent checkup up of war news was significantly associated with high levels of depression(p=0.003), anxiety and stress (p< 0.001). Multivariant logistic regression analysis showed that the only predictor that pointed to severe and extremely severe level of depression (p .004), Anxiety and stress (p<0.001) was frequently checkup of war news. On the other hand, young age (p<0.001) and female sex (p=0.023) were significant predictors for depression and urban residence was a significant predictor for severe and extremely severe level of anxiety. Table (5): Impact of war events on study /or work performance among the studied participants (students and their parent ). Variable Students (n=100) Fathers (n=100) Mothers (n=100) Total (n=300) Sig. test p-value n % n % n % n % Desire to study or work decreases due to the events of the war: -To a great degree -To some degree -Not at all 30 30.0 48 48.0 22 22.0 16 16.0 31 31.0 53 53.0 18 18.0 30 30.0 52 52.0 64 21.3 109 36.3 127 42.3 χ 2 25.669 <0.001 * Number of hours you study /or work affected: -To a great degree -To some degree -Not at all 21 21.0 50 50.0 29 29.0 15 15.0 24 24.0 61 61.0 14 14.0 33 33.0 53 53.0 50 16.7 107 35.7 143 47.7 χ 2 23.132 <0.001 * Performance /or grades decrease due to the events of the war: -To a great degree -To some degree -Not at all 14 14.0 56 56.0 30 30.0 8 8.0 31 31.0 61 61.0 11 11.0 36 36.0 53 53.0 33 11.0 123 41.0 144 48.0 χ 2 20.965 <0.001 * Total score of impact of war on the study participants F 3.250 0.040 * Mean ± SD 7.4 ± 1.7 6.7 ± 2.1 6.9 ± 2.0 7.0 ± 2.0 Range 3.0 - 9.0 3.0 - 9.0 3.0 - 9.0 3.0 - 9.0 Table 5 revealed that war events had significant effect on study /or work performance among the studied participants (students and their parents) [p=0.040]. But a statistically significant difference between students and their parents (fathers and mothers) was observed (p<0.001). The desire for study, hours of study and grades were affected to some degree for most of students (48%,50% and 56% respectively) corresponding to only about one third of fathers and mothers. Also, most fathers (61%) and mothers (53%) their work performance was not affected at all. Discussion The study was conducted at the Faculty of Medicine, Tanta University. The target population enrolled fifth-year medical students and their parents representing two different generations of Egyptian population. It included various age groups and both sexes. The overarching goal of this study was to shed light on the mental health burden of Gaza war − 23 among youth and adult Egyptian population. The primary objectives were to assess depression, anxiety and stress, effect of war news on level of these mental disorders and their effect on academic/or work performance among fifth-year medical students and their parents. To the best of our knowledge, this is the first study that dealing with mental health burden among population of different generations in Egypt (a country that has share borders with the conflict zone). At the time of carrying out of this study, Gaza war-23 was about to end its second month. The key findings of this study could be summarized as follows: Firstly, females constituted higher proportion of the student participants Second, during first months of Gaza war − 23, there was great mental distress among the studied population with significant difference between students (youth) and adults (parents). Third, frequent checkup of following war news through media was significantly associated with high levels of depression, anxiety and stress. Fourth, females whether youth or adults were more susceptible to mental distress when exposed to stressed environment. Fifth, social media networks are the favorite source of news for youth and television still constitutes important for adults. Sixth, war events had a noticeable effect on youth than adults manifested by the significant differences in degree of desire to study/or work, hours of study/or work and total score of impact of war events. Wars are public health emergencies that affect human lives at multiple levels. The immediate effect of wars is military and civilian casualties, suffering, death and maiming but war changes the lives of survivors forever [ 18 , 19 ] Gaza war-23 could be considered as a massive humanitarian crisis that occurred after Russian Ukrainian War-2022 (RUW-22). The destruction of the district is a source of trauma not only for the district population but also for neighboring countries and even all over the world. Occurrence of a wide variety of mental disorders (psychological symptoms and syndromes) in populations of conflict areas is widely documented by available research [ 19 – 21 ] but after RUW-22 some research was concerned with populations far from areas directly affected by armed conflict but exposed to suffering from accounts of war and images circulating in media. [ 18 , 22 , 23 ]. The present study investigated this problem among the Egyptian generations represented by medical students and their parents. Findings of the study showed that female students constituted higher proportion of the student participants this was mostly due to the high female to male ratio among the target population. Similarly, Selmo P et al. (2021), in Syria , reported in their study which included around 387 university students from different areas of Syria that most of them were females [ 20 ]. On assessment of mental burden by using DASS-21 of the studied participants; more than one half of students (54%) expressed manifestations of severe to extremely severe depression corresponding to 36% and 26% of mothers and fathers respectively, Mothers reported mild to moderate level of depression more than students and fathers (41% vs 39% and 39% respectively). One third (33%) of students experienced symptoms of severe anxiety corresponding to 28% and 24% of mothers and fathers respectively. On the other hand, mild to moderate anxiety symptoms reported by 35% of students and 28% and 24% of mothers and fathers respectively. Also, more students (29%) exhibited severe stress than mothers (22%) and fathers (20%) while more than one third (37%) of students and 22% of mothers and 20% of fathers exhibited mild to moderate degree of stress. At the current study, prevalence of severe depression among students was more than of university students (40%) in Czech Republic following RUW-22. [ 18 ] and that of parents were more that was reported among general population in Poland and Taiwan which represented two populations affected with RUW-22 indirectly [ 23 ]. This variation may be emotional nature of Egyptian population besides the close relationship between Egyptians and Palestinians Also, Hendawy et al. (2024) reported that being an Egyptian as one of univariant predictors that elevate general distress. [ 24 ] On studying depression, anxiety and posttraumatic stress during the 2022 RussoUkrainian war, among Poland, Ukraine, and Taiwan populations, multivariate linear regression analyses showed that females were significantly associated with higher DASS-21 [ 23 ]. The findings of the present study ensured that females whether youth or adults when exposed to stressed environment, were more susceptible to mental distress. Many previous studies were in consistence with sex difference in perception of stressed environment. [ 20 , 24 – 27 ] The risk of psychological consequences in those indirectly affected by war was linked to exposure to violence and suffering from accounts of war and images that were circulated on social media [ 5 ] Nearly all participants of our study were following news of Gaza war-23 with variations at the rate of follow up and source of news information. About half of students were checkup news every couple of hours or less corresponding to only around one fifth of parents. Also, vast majority of students (89%) were depending on social media networks on following up war news but parents depending on both social media and television. This may explain the higher level of DASS-21 score among students than their parents and this was in consistence of previous studies which revealed that population z was mostly dependent on social media on following news. [ 28 , 29 ]. Our results also confirmed the observation of Chudzicka-Czupała et.al. (2023) that people living outside a war zone can develop mental health problems through viewing war news and scenes via television and social media. Additionally, the war in Gaza was almost reported continuously in the media, and drastic images and scenes can be seen by virtually anyone with access to the Internet and television. Similar to the findings of the current study, prior studies proved that heightened exposure of individuals to violence and suffering due to reports of armed conflicts and images presented on social media increased level of mental distress (18,21–24,30). Recently, Hendawy et al. 2024 found that it was a predictor for both elevated general distress and for moderate and marked general distress.[ 24 ] Follow up rate of Gaza war news was decreased among participants since beginning of the war especially students (57%), this was noticed by De Bruin et al (2021) who stated that shift in behavior could be attributed largely to the overwhelming amount of information that individuals were exposed to and the negative emotions often associated with consuming news. [ 31 ] Besides, this decrease in the follow up rate was probably a coping strategy followed by participants especially students as in a study carried out by Xu W et al., (2022) in Ukraine which showed that Self-distraction coping decreased the level of anxiety, depression, and insomnia. [ 21 ] The findings of the present study revealed that war events leading to mental distress (depression, stress and anxiety) among participants with different levels between students and parents (mothers and fathers). Zhang et.al (2024) showed a significant association between stress, depression, and anxiety levels with academic performance of the students and pointed out that regression analysis identified mental health as a potential predictor of academic performance. [ 32 ] Moreover, Ntoiti et.al (2024) explained that high mental distress levels, in terms of depression, anxiety, and stress, may result in low academic achievement among undergraduate students. [ 33 ] Aso, Elotla et al. (2021) in Egypt [ 34 ] and de Oliveira et al. (2023) [ 35 ] in their systematic review documented that There was clear evidence that poor mental health was associated with lost productivity (i.e., absenteeism and presenteeism) all these studies were in agreement of results of the present study where desire for study, hours of study and academic / or work performance were affected among students and to a lesser degree among parents (mothers and father) who may be busy with other responsibilities of life. Also, the total score of impact of war on mental distress on academic/or work performance of students was higher than that of fathers and mothers. These findings point to the difference between generations where youth were affected more than adults. Limitations of the study As the study was a cross-sectional one it misses the causality relationships. Also, it included a single academic year from a single medical university with a lack of comparability in addition to the smaller number of students enrolled in the study. There may be recall bias as the participants were asked to describe their condition two months ago. The study's reliance on self-reported data, which could result in errors because of recall bias or forgetfulness, is another drawback. Multicenter research and community-based studies on the topic can offer additional insights into mental burden of war on youth and adult population who represent the core population of Egypt community. Conclusion The mental health of both generations was affected by Gaza-23 war events with significant difference between students and their parent. Students were following up the war events and expressing more depression and stress than their parents. Students and mothers were more affected than fathers. No significant difference between the students and their parent regarding Anxiety. Although Students’ desire to study and study hours were affected to some degree, their grades were not affected to the same degree. However, among most parent, work performance was not affected. Declarations Ethical Standards Disclosure: "This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Ethical Committee of Scientific Research of Faculty of Medicine, Tanta University, Federal Wide Assurance (FWA 00022834), (IRB 0010038) and approval code was 36264PR697. Informed consent was obtained from all subjects. Consent for publication : "None." As the manuscript does not contain any individual person’s data in any form. Informed consent: Formal consent was obtained from all participants. Availability of data and material: The data presented in this study are available on request from the corresponding author Competing interests: "None." Funding: "None." Authors' contributions: NH: Conceptualization, supervision and direction throughout the research, reviewing methodology, data curation, the original draft and final manuscript for submission Rabab Ahmed : data collection, sharing in designing of questionnaire. Amira M Abd El Kareem : Conceptualization, methodology, share collection, data analysis and writing the original draft. All authors read and approved the final manuscript. Acknowledgements: thanks to medical students at Tanta University; Khaled Hesham, Khlood Esmaeel, Khlood Khaled, Khlood Abel-Nasser, Khlood Mahmood, Khlood Mostafa, Khlood Walid, Khaleel Gadalla, Dalia Ibraheem, and Dana Abdelaziz who contributed actively in data collection. References Barry S, Levy, Victor W, Side. Documenting the Effects of Armed Conflict on Population Health. Annu Rev Public Health. 2016;37:205–18. Jayasinghe S. The 12 dimensions of health impacts of war (the 12- D framework): a novel framework to conceptualise impacts of war on social and environmental determinants of health and public health. BMJ Glob Health. 2024;9:e014749. 10.1136/bmjgh-2023-014749 . Charlson F, et al. New WHO prevalence estimates of mental disorders in conflict settings: a systematic review and meta-analysis. Lancet. 2019;394:240–8. Kaur J, Masaun M, Bhatia M. Role of physiotherapy in mental health disorders. Delhi Psychiatry J. 2013;16(2):404–8. Greenglass E, Begic P, Buchwald P, Karkkola P, Hintsa T. Watching the War in Ukraine and Psychological Factors: Comparisons between Europe and North America. In Proceedings of the Conference of Stress, Trauma, Anxiety and Resilience Society, Faro, Portugal, 19–21 July 2023. Moshagen M, Hilbig B. Citizens’ Psychological Reactions following the Russian invasion of the Ukraine: A cross-national study. Ed. PsyArXiv; 2022. Abdallah, Abudayya. Geir Tarje Fugleberg Bruaset, Hedda Bøe Nyhus, Radwan Aburukba, Randi Tofthagen. Consequences of war-related traumatic stress among Palestinian young people in the Strip: A scoping review. Mental Health Prev. 2023;32:200305A. WHO. (2022). Mental health in emergencies. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/mental-health-in-emergencies Kienzler H, Daniel G, Hammoudeh W, et al. Unbearable suffering: mental health consequences of the October 2023 Israeli military assault on the Gaza Strip. BMJ Glob Health. 2024;9:e014835. 10.1136/bmjgh-2023-01483 . Dopelt K, Houminer-Klepar N. War-Related Stress among Israeli College Students Following 7 October 2023 Terror Attack in Israel. Eur J Investig Health Psychol Educ. 2024;14:2175–86. https://doi.org/10.3390/ejihpe14080145 . Kasierska M, Suwalska J, Łojko D, Jakubiak-Głowacka M, Tobis S, Suwalska A. Symptoms of Anxiety and Depression in Polish Population in the Context of the War in Ukraine: Analysis of Risk Factors and Practical Implications. Volume 15. Sustainability; 2023. p. 14230. 19. Taouk M, Lovibond P, Laube R. Psychometric properties of an Arabic version of the depression anxiety stress scales (DASS21). Cumberland Hospital. Sydney: Report for New South Wales Transcultural Mental Health Centre; 2001. Lovibond S, Lovibond P. Manual for the Depression Anxiety Stress Scales. Sydney: Psychology Foundation; 1995. ISBN 7334-1423-0; 1995. Lovibond PF, Lovibond SH. The structure of negative emotional states: comparison of the Depression Anxiety Stress Scales (DASS) with the beck depression and anxiety inventories. Behav Res Ther. 1995;33(3):335–43. Ronk FR, Korman JR, Hooke GR, Page AC. Assessing Clinical Significance of Treatment Outcomes Using the DASS-21. Psychol Assess. 2013;25:1103–10. Henry JD, Crawford JR. The Short-Form Version of the Depression Anxiety Stress Scales (DASS-21): Construct Validity and Normative Data in a Large Non-Clinical Sample. Br J Clin Psychol. 2010;44:227–39. McDowell I. Measuring health: a guide to rating scales and questionnaires. New York: Oxford University Press; 2006. Riad A, Drobov A, Krobot M, Antalová N, Alkasaby MA, Peřina A et al. Mental Health Burden of the Russian–Ukrainian War 2022 (RUW-22): Anxiety and Depression Levels among Young Adults in Central Europe. International Journal of Environmental Research and Public Health [Internet]. 2022;19(14):8418. Available from: https://www.mdpi.com/1660-4601/19/14/8418/htm Murthy RS, Lakshminarayana R. Mental health consequences of war: a brief review of research findings. World Psychiatry. 2006;5(1):25–30. PMID: 16757987; PMCID: PMC1472271. Selmo P, Knaevelsrud C, Mohamad N, Rehm J. Prevalence and predictors of psychopathology in the war-afflicted Syrian population. Transcult Psychiatry. 2020;58(2):226–38. Xu W, Pavlova I, Chen X, Petrytsa P, Graf-Vlachy L, Zhang SX. Mental health symptoms and coping strategies among Ukrainians during the Russia-Ukraine war in March 2022. Int J Soc Psychiatry. 2023;69(4):957–66. 10.1177/00207640221143919 . Kasierska M, Suwalska J, Łojko D, Jakubiak-Głowacka M, Tobis S, Suwalska A. Symptoms of Anxiety and Depression in Polish Population in the Context of the War in Ukraine: Analysis of Risk Factors and Practical Implications. Sustainability. 2023;15:14230. https://doi.org/10.3390/su151914230 . Chudzicka-Czupała A, Hapon N, Chiang SK, ˙ Zywiołek-Szeja M, Karamushka L, Lee CT, Grabowski D, Paliga M, Rosenblat JD, Ho R, et al. Depression, anxiety and post-traumatic stress during the 2022 Russo-Ukrainian war, a comparison between populations in Poland, Ukraine, and Taiwan. Sci Rep. 2023;13:3602. Hendawy M, Abouzid M, Gamal A, Ghanayem A, Amer M, Tanashat M, Eltewacy NK, et al. Psychological distress among students in Egypt and Jordan during the initial months of the Gaza war. BMC Psychol. 2024;12:678. https://doi.org/10.1186/s40359-024-02161-2 . Greenberg MR, Schneider DF. Gender Differences in Risk Perception: Effects Differ in Stressed vs. Non-Stressed Environments. Risk Anal. 1995;15:503–11. Gustafsod PE. Gender Differences in Risk Perception: Theoretical and Methodological erspectives. Risk Anal. 1998;18:805–11. Nellis AM. Gender Differences in Fear of Terrorism. J Contemp Crim Justice. 2009;25:322–40. Roselina E, Asmiyanto T, Andriany M. Health Information-Seeking Behavior on the COVID-19 Pandemic: Social Media Usage by GenZinJakarta, Indonesia. Libr Philos Pract 2021, 1–7. Svrovátková J, Pavliˇ cek A. Social Media News Credibility among Students in the Czech Republic. In Proceedings of the 2021 Eighth International Conference on Social Network Analysis, Management and Security (SNAMS), Gandia, Spain, 6–9 December 2021; pp. 1–7. Hoffmann K, Michalak M, Kopciuch D, Bryl W, Kus K, Nowakowska E, Paczkowska A. The Prevalence and Correlates of Anxiety, Stress, Mood Disorders, and Sleep Disturbances in Poland after the Outbreak of the Russian–Ukrainian War 2022. Healthcare 2024, 12, 1848. https://doi.org/10.3390/healthcare12181848 De Bruin K, de Haan Y, Vliegenthart R, Kruikemeier S, Boukes M. News Avoidance during the Covid-19 Crisis: Understanding Information Overload. Digit Journalism. 2021;9(9):1–17. Zhang J, Peng C, Chen C. Mental health and academic performance of college students: Knowledge in the field of mental health, self-control, and learning in college. Acta Psychol (Amst). 2024;248:104351. 10.1016/j.actpsy.2024.104351 . Epub 2024 Jun 20. PMID: 38905949. Ntoiti AK, Kigen EM, Kinai TK, Mawang LL, Mental, Distress. Coping Strategies, and Academic Achievement among University Students. South Fla J Dev. 2024;5(2):845–52. https://doi.org/10.46932/sfjdv5n2-034 . Elotla SF, Gafaar SEM, Ameen AE, Fouad AM. Association between mental health distress and work productivity: A cross-sectional study. Egypt J Occup Med. 2021;45(2):51–68. de Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. Appl Health Econ Health Policy. 2023;21(2):167–93. 10.1007/s40258-022-00761-w . Epub 2022 Nov 15. PMID: 36376610; PMCID: PMC9663290. Tables Table 4 is available in the Supplementary Files section. Additional Declarations No competing interests reported. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-5852378","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":405609062,"identity":"e78a4a54-bd80-4fac-9513-2b200825ca1a","order_by":0,"name":"Nadira Mansour Hassan","email":"data:image/png;base64,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","orcid":"","institution":"Tanta University","correspondingAuthor":true,"prefix":"","firstName":"Nadira","middleName":"Mansour","lastName":"Hassan","suffix":""},{"id":405609063,"identity":"b6e89ee3-cbfd-48a9-b904-044172fc0f57","order_by":1,"name":"Rabab Ahmed Hammad","email":"","orcid":"","institution":"Tanta University","correspondingAuthor":false,"prefix":"","firstName":"Rabab","middleName":"Ahmed","lastName":"Hammad","suffix":""},{"id":405609064,"identity":"0e707faf-23a2-4479-bd5a-3be31583ead1","order_by":2,"name":"Amira Ahmed Abd El karem","email":"","orcid":"","institution":"Tanta University","correspondingAuthor":false,"prefix":"","firstName":"Amira","middleName":"Ahmed Abd El","lastName":"karem","suffix":""}],"badges":[],"createdAt":"2025-01-18 02:38:04","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-5852378/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-5852378/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1186/s40359-025-03032-0","type":"published","date":"2025-07-03T15:57:29+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":74653701,"identity":"a3bd7551-e636-4824-be2e-16a616a78656","added_by":"auto","created_at":"2025-01-24 11:13:25","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":19486,"visible":true,"origin":"","legend":"\u003cp\u003eDepression levels among students and their parent s and their parent\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-5852378/v1/6185e226b2b3a125af9bed06.png"},{"id":74653702,"identity":"3a4c7899-cfad-443a-857a-13a5474f3490","added_by":"auto","created_at":"2025-01-24 11:13:25","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":20344,"visible":true,"origin":"","legend":"\u003cp\u003eAnxiety levels among students and their parent\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-5852378/v1/346e0a8534a6c97da98dd17e.png"},{"id":74653963,"identity":"ac9d4869-a3bb-4f77-97a9-cb8a9586018d","added_by":"auto","created_at":"2025-01-24 11:21:25","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":19926,"visible":true,"origin":"","legend":"\u003cp\u003eStress levels among \u0026nbsp;students and their parent\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-5852378/v1/7b3aa23f5346781736f7b83d.png"},{"id":86178979,"identity":"19ded81f-9a35-4973-b66e-1b88880c4de4","added_by":"auto","created_at":"2025-07-07 16:13:55","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1507296,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-5852378/v1/429c39d3-1e6e-4e64-b62c-f9a15b3ab4e7.pdf"},{"id":74653707,"identity":"973e5f26-047d-4597-b995-9501582fe63f","added_by":"auto","created_at":"2025-01-24 11:13:25","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":25703,"visible":true,"origin":"","legend":"","description":"","filename":"table4log.regression.docx","url":"https://assets-eu.researchsquare.com/files/rs-5852378/v1/8f2a7615636f783301c6798f.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Effect of Gaza War on Mental Health of Different Egyptian Generations","fulltext":[{"header":"Introduction","content":"\u003cp\u003eGlobal rates of armed conflicts have shown an alarming increase since 2008. Wars have devastating and long- term cumulative impacts on health. They directly kill, injure, maim and destroy life and cause extensive morbidity and mortality among military personnel and noncombatant civilians. [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eMorbidity includes a wide range of disorders, from disabling injuries to adverse effects on mental health. The World Health Organization (WHO) estimates that 22.1% of people in conflict-affected populations have developed a wide range of mental health symptoms mainly of depression, anxiety and posttraumatic disorders. [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eMental health is considered as a vital part of well-being, whereas poor mental health is associated with decreased productivity, a lesser quality of life, and disability. Nowadays millions of people have been watching wars in the media and this exposed them to psychological trauma which extends its participants and refugees to include wider groups influenced by the media coverage of the war [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003ePrior studies documented that those citizens of Germany, Poland, the United Kingdom and the United States experienced feelings of psychological disturbances including anxiety, stress and depression related to Russian Ukrainian War (RUW-22).[\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe long-standing Israeli Palestinian conflict has escalated since the beginning of the 20th century, resulting in a humanitarian crisis in Palestine especially at Gaza strip which has been exposed to recurrent violence and escalation for many years resulting in a state of constant complex humanitarian emergency (WHO, 2022). [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eSince the beginning of Israel-Gaza war on the 7th of October 2023, current media attention has mainly focused on the horrendous consequences of this war on the people of Gaza Strip, its rates of serious injury, death, struggle for physical survival and on the destruction of infrastructure. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. While only 18% of Israeli students experienced severe degree of stress during this war, more than three quarters (76.66%) of medical students at Gaza suffering from severe and extremely severe stress. [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e] The effect of this war on mental health extends out of Israeli and Gaza people to all populations in the world due to circulating images of suffering and destruction on media.\u003c/p\u003e \u003cp\u003eEgypt has direct border with Gaza strip and Egyptians were highly concerned with war news at initial months so, it was important to study the mental health burden of Gaza war-23 on different Egyptian generations. Medical students and their parents constituting two important different generations with different cultures and interests and studying the effect of the Gaza war-23 on mental health of them, could be considered as an indicator for mental health of this influencing sector of Egyptian population.\u003c/p\u003e \u003cp\u003eThe overarching goal of this study was to explore the mental health burden of the Gaza war among different generations of Egyptian population (youth and adults).\u003c/p\u003e\u003ch2\u003eObjectives\u003c/h2\u003e\u003cp\u003eThe current study aims to;\u003c/p\u003e \u003col\u003e \u003cli\u003e \u003cp\u003eAssess the level of depression, anxiety and stress among medical students in Tanta university and their parent during the first months of Gaza \u0026minus;\u0026thinsp;23 war\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eAssess the relationship between frequency of following war news and mental health disorders.\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIdentify the associated and predicting factors of severity of DASS among studied groups\u003c/p\u003e \u003c/li\u003e \u003cli\u003e \u003cp\u003eIdentify the impact of war on academic and/or work performance.\u003c/p\u003e \u003c/li\u003e \u003c/ol\u003e "},{"header":"Methods","content":"\u003cp\u003e\u003cstrong\u003eStudy design, duration, setting:\u003c/strong\u003e the current study was a descriptive cross-sectional study. It was carried out during a period of four months from November 2023 throughout February 2024 at faculty of medicine, Tanta university which is the main university at middle delta in Egypt. Tanta City is the capital of Gharbia Governorate in the Middle Delta region of Egypt. It is 92 Km north of Cairo.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStudy population, sample size and sampling techniques:\u0026nbsp;\u003c/strong\u003eThe study participants were both sexes from fifth year students at faculty of medicine and their parent. The study included 300 participants. Hundred students and 200 parent (100 mothers and 100 fathers). The sample size was dependent on the expected prevalence of 66.6% of mental problems according to\u0026nbsp;Kasierska\u003cstrong\u003e,\u003c/strong\u003e et al (2023), significance level 95%, precision 5% and using Epi Info program [11]\u003c/p\u003e\n\u003cp\u003eThe sampling type was probability sampling in the form of cluster random sampling. The number of students at 5\u003csup\u003eth\u003c/sup\u003e year medical student was 1070, the number of clinical rounds was 20 rounds, each round contained around 50 students, 3 rounds were chosen randomly to compensate the non-responsiveness and excluded participants and each student was given three questionnaires, one for himself and two for his parents (one for his mother and another one for his father).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u003cstrong\u003eInclusion and exclusion criteria\u003c/strong\u003e:\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e- Fifth year students of both sexes at faculty of medicine, Tanta university and their parent after taking their consent to participate in the study.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e-Those students who didn\u0026rsquo;t live with their parents and those who are non-Egyptian were excluded from the study also students who were incompletely filling out the questionnaires (either of them or their parent) were excluded and replaced by others of the same round.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;Study tool:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe pre-designed questionnaire included four parts; sociodemographic, frequency of following war news, DASS-21 scale Arabic version [12], and the fourth part was about academic /or work performance\u003c/p\u003e\n\u003cp\u003e● The questionnaire includes 4 parts as following:\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u003cstrong\u003ePart I:\u003c/strong\u003e Socio-demographic data including age, sex, residence, and qualification of parents.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u003cstrong\u003ePart II:\u003c/strong\u003e Frequency of following the news. That part included 5 questions to estimate frequently used news outlets and news following frequency at the beginning of the war and after one month to identify the change at the rate of following the news.\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u003cstrong\u003ePart III\u003c/strong\u003e: the short version of the Depression, Anxiety, and Stress Scale (DASS 21, Arabic version)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u0026bull; \u003cstrong\u003ePart IV:\u0026nbsp;\u003c/strong\u003eAcademic /or work performance. That part included three questions. Each question had a three-point Likert scale as the following; not at all (1), to some extent (2), and to a large extent (3) to estimate the effect of following war news on the students\u0026apos; academic study and work performance of parents. Each question was coded from 1 to 3. Total score was calculated ranging from 3 to 9, where higher scores reflect more affection.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDASS-21 scale\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThis scale is the short version of DASS-42, the original manual. \u0026nbsp;According to the DASS manual, emotional syndromes like depression and anxiety are intrinsically dimensional\u0026mdash;they vary along a continuum of severity. Hence the selection of a single cutoff score to represent \u0026ldquo;clinical\u0026rdquo; severity is necessarily arbitrary. This is one of the main differences between DASS and categorical measures based on psychiatric diagnosis. Further, DASS authors developed a set of cut‐off scores for defining mild/moderate/severe/extremely severe scores for each DASS scale; as guided by the DASS manual. Psychometrically, DASS is quite different from diagnostic instruments in that it reflects the underlying continuity of severity of symptoms in the population; DASS scale scores are dimensional rather than categorical [13,14]\u003c/p\u003e\n\u003cp\u003eOn filling the questionnaire, the participants were asked to indicate to what extent they had experienced each symptom during the past week (on the original manual but we asked about the past first two months of the war). DASS-21 included three subscales seven questions for each domain. The 21 items on the DASS were rated on a 4‐four‐point scale, where 0 corresponded to \u0026ldquo;did not apply to me at all\u0026rdquo; and 3 to \u0026ldquo;applies to me very much.\u0026rdquo;. in total DASS-21 consists of 21 questions which was designated for participants to specify their emotional level for each statement. Item scores were added together for each dimension and multiplied by two (as per DASS manual) to equal 42, in order to match the original scale\u003cstrong\u003e.\u003c/strong\u003e The minimum score is zero and the maximum score is 42. The final score of DASS can be categorized as in Table 1.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 1: Severity of depression, anxiety and stress (13)\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRating\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDepression\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStress\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMild\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10-13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15-18\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eModerate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e14-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e19-25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSevere\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21-27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15-19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26-33\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eExtremely severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e28+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e20+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e34+\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDASS is a reliable tool to assess psychological distress in clinical and non-clinical populations [13, 15,16]. Together, the subscales provide a broad-spectrum measure of psychological distress, indicating the severity and frequency of symptoms. DASS-21 requires less time to administer, and it is superior to the full-scale version [17].\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eValidity of the study questionnaire\u003c/strong\u003e:\u003c/p\u003e\n\u003cp\u003eThe questionnaire used in this study showed good validity, which was confirmed by three experts from the community and public health department and modifying the questionnaire according to their recommendations. Also, before data collection, reliability of modified questionnaire was tested on 15 participants (5 students and 10 parent) not included in the study. Cronbach\u0026rsquo;s alpha was found to be 0.875. The average time for fulfilling the questionnaire was 5-10 minutes.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData collection:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The students were met during their study time at each round and data was collected at the beginning of the rounds to avoid examination times and stress inquired during these \u0026ldquo;hectic\u0026rdquo; and stressful periods of students\u0026rsquo; academic lives. The objectives of the study were explained to the students who were informed that their participation was voluntary, and anonymity was assured. The participants were also told that the results of this research will be published. Each student was responsible for three questionnaires (one for him/herself which was fulfilled in the class and two for his parent). Questionnaires of students were obtained in class, and arrangements were made to bring back the complete questionnaires of parent.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStatistics analysis of data:\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAfter collecting data, it was entered by excel sheet and SPSS version 21. After summation of the subscale scores for depression, anxiety and stress and their multiplication by 2 the investigators were recategorized the level of each domain as in table 2.\u003c/p\u003e\n\u003cp\u003eTable (2): Severity of depression, anxiety and stress\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eRating\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDepression\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAnxiety\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eStress\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNormal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e0-14\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMild to moderate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e10-20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e8-14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15-25\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSevere to Extremely severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e21-28+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e15-20+\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e26-34+\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eDistribution of participants in these categories was reported as frequencies and percentages. The scores were reported as mean \u0026plusmn; standard deviation and median. When variables met the normality condition (assessed by the Shapiro\u0026ndash;Wilk test), parametric tests were used for analysis like ANOVA test which was used to compare more than one group and when not met the normality condition, non-parametric test (Kruskal\u0026ndash;Wallis test) was used for the analyses. Categorical data were presented as number and percentage and compared by chi square test for bivariate analysis, and it was replaced by Montecarlo exact when it was found appropriate. Multiple logistic regression was used to detect predictors of severe levels DAS. The value of p \u0026le; 0.05 was considered statistically significant. The data were analyzed using SPSS version 21.0\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Consideration:\u0026nbsp;\u003c/strong\u003eBefore\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003estarting the study approval of ethical committee of faculty of medicine, Tanta University was obtained. After explaining research objectives and procedures, formal consent was obtained from all participants before filling in the questionnaires. The participants were free to choose whether they want to participate or not, they could withdraw at any time without any negative effects and they had a right to privacy and confidentiality. All authors have no potential conflict of interest.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThe current study included \u003cspan dir=\"RTL\"\u003e3\u003c/span\u003e00 participants: one hundred medical students and their parent representing youth and young adult generations to assess depression, anxiety and stress levels.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (1): Sociodemographic characters of studied participants\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eVariable\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eFathers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eAge/years\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003eMean \u0026plusmn;SD\u003c/p\u003e\n \u003cp\u003eRange\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e22.31 \u0026plusmn; 0.66\u003c/p\u003e\n \u003cp\u003e21-24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55.8\u0026plusmn; 4.9\u003c/p\u003e\n \u003cp\u003e48-65\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e48.7\u0026plusmn; 4.3\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e42-58\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003en= 100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003en=100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003en=100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eSex\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Males\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Females\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21.0\u003c/p\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e--\u003c/p\u003e\n \u003cp\u003e100.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eResidence\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Urban\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; Rural\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e45.0\u003c/p\u003e\n \u003cp\u003e55.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducation level:\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e-Basic education\u003c/p\u003e\n \u003cp\u003e(primary and preparatory)\u003c/p\u003e\n \u003cp\u003e-Technical education\u003c/p\u003e\n \u003cp\u003e- University education\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003cp\u003e79\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e13.0\u003c/p\u003e\n \u003cp\u003e8.0\u003c/p\u003e\n \u003cp\u003e79.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003cp\u003e66\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e20.0\u003c/p\u003e\n \u003cp\u003e14.0\u003c/p\u003e\n \u003cp\u003e66..0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable (1) describes the sociodemographic characteristics of the study participants. The mean age of students was 22.31 \u0026plusmn; 0.66 years old, corresponding to a mean age of 56.5\u0026plusmn; 5.0 among fathers and 49.5\u0026plusmn; 5.0 among mothers. The female students represented higher percentage (79.0%) than males (21.0%). More than half of the students were from rural areas (55.0%). Regarding the educational level of parents, university education represented the highest percentage (79.0%, 66.0% of fathers and mothers respectively).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (2): Follow up of Gaza war news among the study participants and their parent.\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"100%\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow up of Gaza news status\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 13px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudents\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFathers\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 11px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=100)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 12px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTotal\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(n=300)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eP\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eDo you follow news of Gaza war\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eYes\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e100\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e99\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e296\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e98.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM.C\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.170\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eNo\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e1.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eHas your follow up rate changed since the beginning of the war?\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDecreased\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e57\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e149\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e49.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eM.C\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.145\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eIncreased\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e93\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDid not change\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow up during the first month of war\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026le; every 2 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e43\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e92\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e30.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003e3 times a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e64\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e21.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eTwice a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e48\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e16.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e30.801\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eOnce a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e20.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 34px;\"\u003e\n \u003cp\u003eFew times a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 4px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 5px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 7px;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFollow up during the second month of war\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u0026le; every 2 hours\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e19\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e50\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e3 times a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e18\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e47\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e15.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eTwice a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e13\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e16.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eOnce a day\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e24.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e21.714\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.041*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eFew times a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e21\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e17.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eOnce a week\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e12\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e14\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e9.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFrequently used media\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eSocial media networks\u003c/p\u003e\n \u003cp\u003eTelevision\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e51\u003c/p\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e186\u003c/p\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e62.0\u003c/p\u003e\n \u003cp\u003e35.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMC\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e0.001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 34px;\"\u003e\n \u003cp\u003eDigital news portals\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 4px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 5px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 7px;\"\u003e\n \u003cp\u003e2.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 8px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eRegarding the news, all students reported that they follow the news, vast majority of fathers and mothers (99.0%, 97.0% respectively). \u0026nbsp;More than half of the students (57.0%) revealed that the rate of their following up to the news decreased, compared to 41.0% of fathers and 51.0% of mothers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eFollow up rate during the first month of the war; 43.0% of students checked the news every couple of hours or less and 30.0% of them checked it three times a day. Lower rates were observed among parents as only 27.0% of fathers checked the news every couple of hours versus 22.0% of mothers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe most frequently used source of information was social media networks. It was reported by 89.0% of students, 46.0% of fathers and 51.0% of mothers. Television is still a main source of news for parents.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (3):\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eDASS - 21 Scale levels\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;among the studied participants (students and their parent)\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eDASS- 21 levels\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eStudents\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eFathers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMothers\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eSignificance test\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u003cstrong\u003en\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e%\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e1-Depression\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e-Normal\u003c/p\u003e\n \u003cp\u003e- Mild to moderate\u003c/p\u003e\n \u003cp\u003e-Severe to extremely Severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e54\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003cp\u003e54.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e39\u003c/p\u003e\n \u003cp\u003e26\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e35.0\u003c/p\u003e\n \u003cp\u003e39.0\u003c/p\u003e\n \u003cp\u003e26.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e36\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e23.0\u003c/p\u003e\n \u003cp\u003e41.0\u003c/p\u003e\n \u003cp\u003e36.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u003cem\u003eX\u003csup\u003e2\u003c/sup\u003e\u003c/em\u003e\u003c/strong\u003e=\u003cstrong\u003e28.696\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP= \u0026lt; 0. 001*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003eMean \u0026plusmn;SD\u003c/p\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e22.8 \u0026plusmn;9.5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp; \u003cstrong\u003e22\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e15.0\u0026plusmn; 10\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e17.6\u0026plusmn; 10.5\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKruskal-Wallis test\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP= \u0026lt; 0. 001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2- Anxiety\u003c/strong\u003e:\u003c/p\u003e\n \u003cp\u003e-Normal\u003c/p\u003e\n \u003cp\u003e- Mild\u003cstrong\u003e\u0026nbsp;to\u0026nbsp;\u003c/strong\u003eModerate\u003c/p\u003e\n \u003cp\u003e-Severe to extremely severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e32.0\u003c/p\u003e\n \u003cp\u003e35\u003c/p\u003e\n \u003cp\u003e33\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e27\u003c/p\u003e\n \u003cp\u003e24\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41\u003c/p\u003e\n \u003cp\u003e31\u003c/p\u003e\n \u003cp\u003e28\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e41.0\u003c/p\u003e\n \u003cp\u003e31.0\u003c/p\u003e\n \u003cp\u003e28.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eX\u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e\u003c/em\u003e=\u003cstrong\u003e6.025\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP=\u003c/strong\u003e\u003cstrong\u003e0.197\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003eMean \u0026plusmn;SD\u003c/p\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10.8 \u0026plusmn; 8.1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;10\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp;\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10.1\u0026plusmn; 8.1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e8\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e11.4\u0026plusmn; 8\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e10\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKruskal\u0026ndash;Wallis test\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP= 0. 476\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3-Stress\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e-Normal\u003c/p\u003e\n \u003cp\u003e- Mild\u003cstrong\u003e\u0026nbsp;to\u0026nbsp;\u003c/strong\u003emoderate\u003c/p\u003e\n \u003cp\u003e-Severe to Extremely severe\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u003cspan dir=\"RTL\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n \u003cp\u003e34\u003c/p\u003e\n \u003cp\u003e37\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 36px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 42px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e55\u003c/p\u003e\n \u003cp\u003e25\u003c/p\u003e\n \u003cp\u003e20\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 48px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49\u003c/p\u003e\n \u003cp\u003e29\u003c/p\u003e\n \u003cp\u003e22\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 54px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e49.0\u003c/p\u003e\n \u003cp\u003e29.0\u003c/p\u003e\n \u003cp\u003e22 .0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u003cem\u003eX\u003c/em\u003e\u003cstrong\u003e\u003csup\u003e2\u003c/sup\u003e\u003c/strong\u003e=\u003cstrong\u003e9.436\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP=\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003e0.051*\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 201px;\"\u003e\n \u003cp\u003eMean \u0026plusmn;SD\u003c/p\u003e\n \u003cp\u003eMedian\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e21.2\u0026plusmn; 7.9\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;18\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 78px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e14.2\u0026plusmn;9.7\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e14\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e19.4\u0026plusmn; 7.1\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e16\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 120px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eKruskal\u0026ndash;Wallis test\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eP= \u0026lt; 0. 001*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 3 pointed to depression levels; severe or extremely severe depression symptoms were expressed by more than half of students (54.0%) followed by 36.0% of mothers and lastly 26.0% of fathers. Depression scale had the highest mean among students reflecting the highest affection (22.08\u0026plusmn;9.5), followed by mothers who had mean of 17.6\u0026plusmn;10.5 and eventually fathers who were the least affected with a mean of 15.0+10.0. these differences were statistically significant (P= \u0026lt; 0. 001*) \u003cstrong\u003e\u003cem\u003e(figure 1).\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAs regards anxiety levels, one third of students (33.0%) had severe to extremely severe anxiety followed by 28.0% of mothers and lastly 24.0% of fathers. For anxiety scale means, mothers had the highest score (11.4\u0026plusmn;8.0), followed by both students and fathers (10.1\u0026plusmn;8.1 for each of them), however, these differences were not statistically significant (\u003cstrong\u003e\u003cem\u003efigure 2).\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePointing to stress levels, 29.0% of students had severe to extremely severe stress score followed by 22.0% of mothers and 20.0% of fathers. As regards stress scale means, students had the highest mean reflecting the highest affection (21.2\u0026plusmn; 7.9), followed by mothers who had mean of 19.4\u0026plusmn; 7.1 and eventually fathers who were the least affected with a mean of 14.2\u0026plusmn;9.7 and these differences were statistically significant (P= \u0026lt; 0. 001) \u003cstrong\u003e\u003cem\u003e(figure 3).\u003c/em\u003e\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTable (4) showed univariant and multivariant analysis for the effect sociodemographic characteristics of all participants groups and frequency of war news checkup on depression, anxiety and stress disorders\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe univariant analysis showed statistically significant association between age and level of depression (p\u0026lt;0.001) and stress (p=0.013) where young age students\u0026nbsp;(\u0026le; 24 years) reported more severe and extremely severe manifestations of depression and stress (54% and 29% respectively) Vs parents (31%, and 21%) respectively. Also, sex showed significant difference (p=0.004) with severe and extremely severe depression level (45.3%) females Vs. 28.9% for males. There was significant difference between rural and urban participants regarding level of anxiety (p=0.004) where urban participants were more associated with severe and extremely severe levels. Frequent checkup up of war news was significantly associated with high levels of depression(p=0.003), anxiety and stress (p\u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003eMultivariant logistic regression analysis showed that the only predictor that pointed to severe and extremely severe level of depression (p .004), Anxiety and stress (p\u0026lt;0.001) was frequently checkup of war news. \u0026nbsp;On the other hand, young age (p\u0026lt;0.001) and female sex (p=0.023) were significant predictors for depression and urban residence was a significant predictor for severe and extremely severe level of anxiety.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTable (5): Impact of\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003ewar events on study /or work performance among the studied participants (students and their parent\u003c/strong\u003e\u003cstrong\u003e).\u003c/strong\u003e\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eStudents\u003c/p\u003e\n \u003cp\u003e(n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eFathers\u003c/p\u003e\n \u003cp\u003e(n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eMothers\u003c/p\u003e\n \u003cp\u003e(n=100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003cp\u003e(n=300)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003eSig.\u003c/p\u003e\n \u003cp\u003etest\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"2\" valign=\"top\"\u003e\n \u003cp\u003ep-value\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 91px;\"\u003e\n \u003cp\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 89px;\"\u003e\n \u003cp\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\" style=\"width: 90px;\"\u003e\n \u003cp\u003en \u0026nbsp; \u0026nbsp; \u0026nbsp; \u0026nbsp;%\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eDesire to study or work decreases due to the events of the war:\u003c/p\u003e\n \u003cp\u003e-To a great degree\u003c/p\u003e\n \u003cp\u003e-To some degree\u003c/p\u003e\n \u003cp\u003e-Not at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e30 \u0026nbsp; 30.0\u003c/p\u003e\n \u003cp\u003e48 \u0026nbsp; 48.0\u003c/p\u003e\n \u003cp\u003e22 \u0026nbsp; 22.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e16 \u0026nbsp; \u0026nbsp;16.0\u003c/p\u003e\n \u003cp\u003e31 \u0026nbsp; \u0026nbsp;31.0\u003c/p\u003e\n \u003cp\u003e53 \u0026nbsp; \u0026nbsp;53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e18 \u0026nbsp; \u0026nbsp;18.0\u003c/p\u003e\n \u003cp\u003e30 \u0026nbsp; \u0026nbsp;30.0\u003c/p\u003e\n \u003cp\u003e52 \u0026nbsp; \u0026nbsp;52.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e64 \u0026nbsp; 21.3\u003c/p\u003e\n \u003cp\u003e109 36.3\u003c/p\u003e\n \u003cp\u003e127 42.3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e25.669\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eNumber of hours you study /or work affected:\u003c/p\u003e\n \u003cp\u003e-To a great degree\u003c/p\u003e\n \u003cp\u003e-To some degree\u003c/p\u003e\n \u003cp\u003e-Not at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e21 \u0026nbsp; \u0026nbsp;21.0\u003c/p\u003e\n \u003cp\u003e50 \u0026nbsp; \u0026nbsp;50.0\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e29 \u0026nbsp; \u0026nbsp;29.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e15 \u0026nbsp; \u0026nbsp;15.0\u003c/p\u003e\n \u003cp\u003e24 \u0026nbsp; \u0026nbsp;24.0\u003c/p\u003e\n \u003cp\u003e61 \u0026nbsp; \u0026nbsp;61.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 \u0026nbsp; \u0026nbsp;14.0\u003c/p\u003e\n \u003cp\u003e33 \u0026nbsp; \u0026nbsp;33.0\u003c/p\u003e\n \u003cp\u003e53 \u0026nbsp; \u0026nbsp;53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e50 \u0026nbsp; \u0026nbsp; 16.7\u003c/p\u003e\n \u003cp\u003e107 \u0026nbsp; 35.7\u003c/p\u003e\n \u003cp\u003e143 \u0026nbsp; 47.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e23.132\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003ePerformance /or grades decrease due to the events of the war:\u003c/p\u003e\n \u003cp\u003e-To a great degree\u003c/p\u003e\n \u003cp\u003e-To some degree\u003c/p\u003e\n \u003cp\u003e-Not at all\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e14 \u0026nbsp; \u0026nbsp;14.0\u003c/p\u003e\n \u003cp\u003e56 \u0026nbsp; \u0026nbsp;56.0\u003c/p\u003e\n \u003cp\u003e30 \u0026nbsp; \u0026nbsp;30.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e8 \u0026nbsp; \u0026nbsp; \u0026nbsp; 8.0\u003c/p\u003e\n \u003cp\u003e31 \u0026nbsp; \u0026nbsp;31.0\u003c/p\u003e\n \u003cp\u003e61 \u0026nbsp; \u0026nbsp;61.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e11 \u0026nbsp; \u0026nbsp;11.0\u003c/p\u003e\n \u003cp\u003e36 \u0026nbsp; \u0026nbsp;36.0\u003c/p\u003e\n \u003cp\u003e53 \u0026nbsp; \u0026nbsp;53.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003cp\u003e33 \u0026nbsp; \u0026nbsp; 11.0\u003c/p\u003e\n \u003cp\u003e123 \u0026nbsp; 41.0\u003c/p\u003e\n \u003cp\u003e144 \u0026nbsp; 48.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026chi;\u003csup\u003e2\u003c/sup\u003e\u003c/p\u003e\n \u003cp\u003e20.965\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u0026lt;0.001\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eTotal score of impact of war on the study participants\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"3\" valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\"\u003e\n \u003cp\u003eF\u003c/p\u003e\n \u003cp\u003e3.250\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd rowspan=\"3\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e0.040\u003cstrong\u003e*\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eMean \u0026plusmn; SD\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e7.4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e1.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e6.7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e6.9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e7.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e\u0026plusmn;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e2.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 190px;\"\u003e\n \u003cp\u003eRange\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e3.0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 24px;\"\u003e\n \u003cp\u003e-\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 33px;\"\u003e\n \u003cp\u003e9.0\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 5 revealed that\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003ewar events had significant effect on study /or work performance among the studied participants (students and their parents) [p=0.040]. But a statistically significant difference between students and their parents (fathers and mothers) was observed (p\u0026lt;0.001). The desire for study, hours of study and grades were affected to some degree for most of students (48%,50% and 56% respectively) corresponding to only about one third of fathers and mothers. Also, most fathers (61%) and mothers (53%) their work performance was not affected at all. \u0026nbsp;\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study was conducted at the Faculty of Medicine, Tanta University. The target population enrolled fifth-year medical students and their parents representing two different generations of Egyptian population. It included various age groups and both sexes. The overarching goal of this study was to shed light on the mental health burden of Gaza war \u0026minus;\u0026thinsp;23 among youth and adult Egyptian population. The primary objectives were to assess depression, anxiety and stress, effect of war news on level of these mental disorders and their effect on academic/or work performance among fifth-year medical students and their parents.\u003c/p\u003e \u003cp\u003eTo the best of our knowledge, this is the first study that dealing with mental health burden among population of different generations in Egypt (a country that has share borders with the conflict zone). At the time of carrying out of this study, Gaza war-23 was about to end its second month. The key findings of this study could be summarized as follows: Firstly, females constituted higher proportion of the student participants Second, during first months of Gaza war \u0026minus;\u0026thinsp;23, there was great mental distress among the studied population with significant difference between students (youth) and adults (parents). Third, frequent checkup of following war news through media was significantly associated with high levels of depression, anxiety and stress. Fourth, females whether youth or adults were more susceptible to mental distress when exposed to stressed environment. Fifth, social media networks are the favorite source of news for youth and television still constitutes important for adults. Sixth, war events had a noticeable effect on youth than adults manifested by the significant differences in degree of desire to study/or work, hours of study/or work and total score of impact of war events.\u003c/p\u003e \u003cp\u003eWars are public health emergencies that affect human lives at multiple levels. The immediate effect of wars is military and civilian casualties, suffering, death and maiming but war changes the lives of survivors forever [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eGaza war-23 could be considered as a massive humanitarian crisis that occurred after Russian Ukrainian War-2022 (RUW-22). The destruction of the district is a source of trauma not only for the district population but also for neighboring countries and even all over the world. Occurrence of a wide variety of mental disorders (psychological symptoms and syndromes) in populations of conflict areas is widely documented by available research [\u003cspan additionalcitationids=\"CR20\" citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] but after RUW-22 some research was concerned with populations far from areas directly affected by armed conflict but exposed to suffering from accounts of war and images circulating in media. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The present study investigated this problem among the Egyptian generations represented by medical students and their parents.\u003c/p\u003e \u003cp\u003eFindings of the study showed that female students constituted higher proportion of the student participants this was mostly due to the high female to male ratio among the target population. Similarly, \u003cb\u003eSelmo P et al. (2021), in Syria\u003c/b\u003e, reported in their study which included around 387 university students from different areas of Syria that most of them were females [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOn assessment of mental burden by using DASS-21 of the studied participants; more than one half of students (54%) expressed manifestations of severe to extremely severe depression corresponding to 36% and 26% of mothers and fathers respectively, Mothers reported mild to moderate level of depression more than students and fathers (41% vs 39% and 39% respectively). One third (33%) of students experienced symptoms of severe anxiety corresponding to 28% and 24% of mothers and fathers respectively. On the other hand, mild to moderate anxiety symptoms reported by 35% of students and 28% and 24% of mothers and fathers respectively. Also, more students (29%) exhibited severe stress than mothers (22%) and fathers (20%) while more than one third (37%) of students and 22% of mothers and 20% of fathers exhibited mild to moderate degree of stress.\u003c/p\u003e \u003cp\u003eAt the current study, prevalence of severe depression among students was more than of university students (40%) in Czech Republic following RUW-22. [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e] and that of parents were more that was reported among general population in Poland and Taiwan which represented two populations affected with RUW-22 indirectly [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. This variation may be emotional nature of Egyptian population besides the close relationship between Egyptians and Palestinians Also, Hendawy et al. (2024) reported that being an Egyptian as one of univariant predictors that elevate general distress. [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eOn studying depression, anxiety and posttraumatic stress during the 2022 RussoUkrainian war, among Poland, Ukraine, and Taiwan populations, multivariate linear regression analyses showed that females were significantly associated with higher DASS-21 [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. The findings of the present study ensured that females whether youth or adults when exposed to stressed environment, were more susceptible to mental distress. Many previous studies were in consistence with sex difference in perception of stressed environment. [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e, \u003cspan additionalcitationids=\"CR25 CR26\" citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe risk of psychological consequences in those indirectly affected by war was linked to exposure to violence and suffering from accounts of war and images that were circulated on social media [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eNearly all participants of our study were following news of Gaza war-23 with variations at the rate of follow up and source of news information. About half of students were checkup news every couple of hours or less corresponding to only around one fifth of parents. Also, vast majority of students (89%) were depending on social media networks on following up war news but parents depending on both social media and television. This may explain the higher level of DASS-21 score among students than their parents and this was in consistence of previous studies which revealed that population z was mostly dependent on social media on following news. [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e, \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eOur results also confirmed the observation of Chudzicka-Czupała et.al. (2023) that people living outside a war zone can develop mental health problems through viewing war news and scenes via television and social media. Additionally, the war in Gaza was almost reported continuously in the media, and drastic images and scenes can be seen by virtually anyone with access to the Internet and television. Similar to the findings of the current study, prior studies proved that heightened exposure of individuals to violence and suffering due to reports of armed conflicts and images presented on social media increased level of mental distress (18,21\u0026ndash;24,30). Recently, Hendawy et al. 2024 found that it was a predictor for both elevated general distress and for moderate and marked general distress.[\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eFollow up rate of Gaza war news was decreased among participants since beginning of the war especially students (57%), this was noticed by De Bruin et al (2021) who stated that shift in behavior could be attributed largely to the overwhelming amount of information that individuals were exposed to and the negative emotions often associated with consuming news. [\u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e] Besides, this decrease in the follow up rate was probably a coping strategy followed by participants especially students as in a study carried out by Xu W et al., (2022) in Ukraine which showed that Self-distraction coping decreased the level of anxiety, depression, and insomnia. [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eThe findings of the present study revealed that war events leading to mental distress (depression, stress and anxiety) among participants with different levels between students and parents (mothers and fathers). Zhang et.al (2024) showed a significant association between stress, depression, and anxiety levels with academic performance of the students and pointed out that regression analysis identified mental health as a potential predictor of academic performance. [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e] Moreover, Ntoiti et.al (2024) explained that high mental distress levels, in terms of depression, anxiety, and stress, may result in low academic achievement among undergraduate students. [\u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e]\u003c/p\u003e \u003cp\u003eAso, Elotla et al. (2021) in Egypt [\u003cspan citationid=\"CR34\" class=\"CitationRef\"\u003e34\u003c/span\u003e] and de Oliveira et al. (2023) [\u003cspan citationid=\"CR35\" class=\"CitationRef\"\u003e35\u003c/span\u003e] in their systematic review documented that There was clear evidence that poor mental health was associated with lost productivity (i.e., absenteeism and presenteeism) all these studies were in agreement of results of the present study where desire for study, hours of study and academic / or work performance were affected among students and to a lesser degree among parents (mothers and father) who may be busy with other responsibilities of life. Also, the total score of impact of war on mental distress on academic/or work performance of students was higher than that of fathers and mothers. These findings point to the difference between generations where youth were affected more than adults.\u003c/p\u003e \u003cp\u003e \u003cstrong\u003eLimitations of the study\u003c/strong\u003e \u003cp\u003eAs the study was a cross-sectional one it misses the causality relationships. Also, it included a single academic year from a single medical university with a lack of comparability in addition to the smaller number of students enrolled in the study. There may be recall bias as the participants were asked to describe their condition two months ago. The study's reliance on self-reported data, which could result in errors because of recall bias or forgetfulness, is another drawback. Multicenter research and community-based studies on the topic can offer additional insights into mental burden of war on youth and adult population who represent the core population of Egypt community.\u003c/p\u003e \u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThe mental health of both generations was affected by Gaza-23 war events with significant difference between students and their parent. Students were following up the war events and expressing more depression and stress than their parents. Students and mothers were more affected than fathers. No significant difference between the students and their parent regarding Anxiety. Although Students\u0026rsquo; desire to study and study hours were affected to some degree, their grades were not affected to the same degree. However, among most parent, work performance was not affected.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Standards Disclosure:\u003c/strong\u003e \u0026quot;This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving research study participants were approved by the Ethical Committee of Scientific Research of Faculty of Medicine, Tanta University, Federal Wide Assurance (FWA 00022834), (IRB 0010038) and approval code was 36264PR697. Informed consent was obtained from all subjects. \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication\u003c/strong\u003e: \u0026quot;None.\u0026quot; As the manuscript does not contain any individual person\u0026rsquo;s data in any form.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent:\u003c/strong\u003e Formal consent was obtained from all participants.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and material:\u003c/strong\u003e The data presented in this study are available on request from the corresponding author\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests:\u0026nbsp;\u003c/strong\u003e\u0026quot;None.\u0026quot; \u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding:\u0026nbsp;\u003c/strong\u003e\u0026quot;None.\u0026quot;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026apos; contributions: NH:\u0026nbsp;\u003c/strong\u003eConceptualization, supervision and direction throughout the research, reviewing methodology, data curation, the original draft and final manuscript for submission\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRabab Ahmed\u003c/strong\u003e: data collection, sharing in designing of questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAmira M Abd El Kareem\u003c/strong\u003e: Conceptualization, methodology, share collection, data analysis and writing the original draft.\u003c/p\u003e\n\u003cp\u003eAll authors read and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements:\u0026nbsp;\u003c/strong\u003e thanks to medical students at Tanta University; Khaled Hesham, Khlood Esmaeel, Khlood Khaled, Khlood Abel-Nasser, Khlood Mahmood, Khlood Mostafa, Khlood Walid, Khaleel Gadalla, Dalia Ibraheem, and Dana Abdelaziz who contributed actively in data collection. \u0026nbsp;\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eBarry S, Levy, Victor W, Side. 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Acta Psychol (Amst). 2024;248:104351. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.actpsy.2024.104351\u003c/span\u003e\u003cspan address=\"10.1016/j.actpsy.2024.104351\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2024 Jun 20. PMID: 38905949.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNtoiti AK, Kigen EM, Kinai TK, Mawang LL, Mental, Distress. Coping Strategies, and Academic Achievement among University Students. South Fla J Dev. 2024;5(2):845\u0026ndash;52. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.46932/sfjdv5n2-034\u003c/span\u003e\u003cspan address=\"10.46932/sfjdv5n2-034\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eElotla SF, Gafaar SEM, Ameen AE, Fouad AM. Association between mental health distress and work productivity: A cross-sectional study. Egypt J Occup Med. 2021;45(2):51\u0026ndash;68.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ede Oliveira C, Saka M, Bone L, Jacobs R. The Role of Mental Health on Workplace Productivity: A Critical Review of the Literature. Appl Health Econ Health Policy. 2023;21(2):167\u0026ndash;93. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s40258-022-00761-w\u003c/span\u003e\u003cspan address=\"10.1007/s40258-022-00761-w\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Epub 2022 Nov 15. PMID: 36376610; PMCID: PMC9663290.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 4 is available in the Supplementary Files section.\u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"War, Mental health, Depression, Anxiety, Stress, DASS-21, Students, Adults, associated factors","lastPublishedDoi":"10.21203/rs.3.rs-5852378/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-5852378/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e: \u003c/strong\u003e\u003c/em\u003eExposure to unfavorable environmental circumstances including conflicts and wars increases people’s risk of experiencing mental health disturbances. Prevalence rates of anxiety, depression and stress disorders were two- to three-fold higher between people exposed to war or those interested in war news.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eObjectives\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e: \u003c/strong\u003e\u003c/em\u003eto explore prevalence of depression, anxiety and stress among Tanta university students and their parent representing different Egyptian generations, identify associated factors and their effect on study/or work performance\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e \u003c/strong\u003e\u003c/em\u003eA cross-sectional study was conducted to collect data from undergraduate medical students at Tanta University and their parent by using random cluster sampling technique. The study included 100 medical students and 200 parent. A self-administrated questionnaire was used which included sociodemographic data, DASS-21 (Depression, Anxiety Stress Scale) to measure levels of depression, anxiety and stress and the impact of war on studying /or work performance.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e: \u003c/strong\u003e\u003c/em\u003eFemales were constituting 79.0% of students. All students and vast majority of fathers and mothers reported that they follow war news. Social media networks were the most frequently used source of information especially among students. Depression symptoms were expressed by 97.0% of students, 77.0% of mothers and 65.0% of fathers. Anxiety and stress were reported by about two thirds of students and 51% of mothers and 45.0% of fathers. Multivariant logistic regression analysis showed that the shared predictor that pointed to severe and extremely severe level of depression (p .004), Anxiety and stress (p\u0026lt;0.001) was frequently checkup of war news. On the other hand, young age (p\u0026lt;0.001) and female sex (p=0.023) were significant predictors for depression and urban residence was a significant predictor for severe and extremely severe level of anxiety.\u003c/p\u003e\n\u003cp\u003eStudents’ desire to study and study hours were affected to some degree but among most parent, work performance was not affected.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003cem\u003e\u003cstrong\u003e: \u0026nbsp;\u003c/strong\u003e\u003c/em\u003eMental health problems were more prevalent among students followed by mothers and finally fathers. The students representing the younger generation were following war news frequently and were the worst affected generation. This study pointed that in countries outside wars, screening for different mental health problems, their determinants and predictors among different generations is crucial for identification of people whose condition requires specialized interventions\u003c/p\u003e","manuscriptTitle":"Effect of Gaza War on Mental Health of Different Egyptian Generations","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-01-24 11:13:21","doi":"10.21203/rs.3.rs-5852378/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-28T18:28:54+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-28T11:42:15+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-14T10:37:04+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"66740048146222210170879560542483766962","date":"2025-03-14T09:41:09+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"60637616325367918965630766503421629775","date":"2025-03-08T15:20:12+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-02-17T09:07:00+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"50418813808788166651545134415342162350","date":"2025-02-16T15:01:46+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"203477767396065096375983313511893847745","date":"2025-02-09T16:02:29+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-02-09T14:59:15+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-01-29T14:22:33+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-01-22T12:17:40+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-01-22T12:15:38+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-01-18T02:23:01+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6f4e0a8f-1bd1-430c-b334-9d0aae9293d1","owner":[],"postedDate":"January 24th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-07-07T16:01:52+00:00","versionOfRecord":{"articleIdentity":"rs-5852378","link":"https://doi.org/10.1186/s40359-025-03032-0","journal":{"identity":"bmc-psychology","isVorOnly":false,"title":"BMC Psychology"},"publishedOn":"2025-07-03 15:57:29","publishedOnDateReadable":"July 3rd, 2025"},"versionCreatedAt":"2025-01-24 11:13:21","video":"","vorDoi":"10.1186/s40359-025-03032-0","vorDoiUrl":"https://doi.org/10.1186/s40359-025-03032-0","workflowStages":[]},"version":"v1","identity":"rs-5852378","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-5852378","identity":"rs-5852378","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}