Prevalence and risk factors of depression in U.S. adults post mass shootings: evidence from population-based surveys of multiple communities.

OBJECTIVES: Mass violence incidents (MVIs) involving firearms, commonly referred to as "mass shootings" have become increasingly frequent in the United States. These shootings often result in immediate casualties and have far-reaching psychological impacts on survivors, witnesses, and the broader community. This study aimed to assess the prevalence and risk factors of depression within affected communities. STUDY DESIGN: Population-based cross-sectional study. METHODS: Data were collected from six communities affected by MVIs involving firearms that occurred between 2015 and 2020. Participants were randomly selected through address-based sampling, and depression was assessed using Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) diagnostic-level major depressive episode (MDE). RESULTS: Overall, the MDE prevalence was 17·2% since the MVI, 15·4% in the past year, and 8·2% in the past month. Significant risk factors for MDE since MVIs include high exposure to the incident (adjusted relative risk [aRR] = 1·32, 95% confidence interval [CI]: 19-1·60), being aged 18-29 years (aRR = 2·52, 95% CI: 1·61-3·95), being a woman (aRR = 1·58, 95% CI: 1·27-1·96), having low social support (aRR = 1·80, 95% CI: 1·46-2·22), and experiencing past sexual or physical trauma (aRR = 2·20, 1·52-3·19). CONCLUSION: Our study reveals a high burden of depression within communities affected by MVIs involving firearm use. Persons with high exposure to the MVIs and certain demographic groups had greater risks for MDE. These findings highlight the long-term mental health burden in communities affected by MVIs and underscore the necessity of providing mental health services in its aftermath.

Assessment of parent knowledge and perception towards the importance of child immunization in Sudair region, Saudi Arabia.

OBJECTIVE: According to WHO, global coverage of immunization was 86% in 2019, which dropped to 83% in 2020. The objective of this study is to assess parental knowledge and identify their perception towards the importance of child immunization. This study has also tried to determine the possible influencing factors for parental decision-making towards child immunization. PATIENTS AND METHODS: A community-based cross-sectional study was conducted in 2020 in Sudair region of Saudi Arabia. The study was done among parents residing in Sudair region, where the sample was randomly selected based on the household. The sample of 436 was taken using the population proportion formula. Data were collected and analyzed using SPSS version 18 (SPSS Inc., Chicago, IL, USA). Both the descriptive and inferential statistics were used to draw the results. RESULTS: In this study the three-fourth (77.1%) of respondents were female and the remaining were male (23%). The majority of the respondent's knowledge was reported to have some form of influence on their idea of immunization followed by Ministry of Health, family members, medical staff, social media and others. A significant association was seen between age, marital status, occupational status and parents' knowledge on the importance of immunization (thinking if all child immunization was important). Association was also seen between parents' perception that immunization causes serious side effects and the age of the respondents. CONCLUSIONS: The specific programs and bcc materials are needed to enhance the knowledge and perception of individuals regarding the need for complete immunization and also regarding the fact of vaccine-preventable diseases.

Stroke prevention: knowledge of the general population in Riyadh Region, Saudi Arabia.

OBJECTIVE: Stroke is a medical emergency that may lead to permanent neurological damage, complications, and disability. It is the second leading cause of death worldwide and one of the main causes of adult-acquired disabilities. Stroke can be prevented by controlling modifiable risk factors and the early detection of stroke warning signs. The current study aimed to assess the knowledge of the general population in the Riyadh region of Saudi Arabia about stroke. MATERIALS AND METHODS: A cross-sectional and community-based design was employed in this study. The sample was calculated as 432. A pre-tested structured questionnaire was used to collect data. The data was analyzed by SPSS software, version 23. Descriptive statistics were used. The Chi-square test was employed to test differences between qualitative variables, and a p-value less than 0.05 was considered significant. RESULTS: Results showed that 26.6 % of the population had good knowledge about stroke. Population with average and poor knowledge were 50.5% and 22.9%, respectively. The level of stroke knowledge is related to age; the older population aged 45 and more acquired the highest level of knowledge (50%) compared to the other groups. Age group 35-44 years received the least level of stroke knowledge (19.9%). The school teaching had the highest level (40.0%) of stroke knowledge than the other occupations. CONCLUSIONS: Stroke knowledge among the population of Saudi Arabia is inadequate. The stroke knowledge is related to age and occupation.

Factors associated with patient delay in accessin pulmonary tuberculosis care, Gezira State, Sudan, 2009.

Analyses of patient delays in seeking treatment for tuberculosis (TB) provide useful evidence for national TB control programmes. The objectives of this study in Gezira State, Sudan were to estimate the extent of, and factors associated with, pulmonary TB patient delay in accessing care. A cross-sectional phase was conducted to determine the length of delay, followed by a nested case-control phase comparing patients delaying above or below the median time. The mean patient delay was 27.2 days, median 4 days (range 0-365 days). There were no significant differences between case and control groups in terms of age, sex, marital status, educational level or smoking status. However, patients living in urban areas, with low income status and who were housewives or unemployed were more likely to delay. Also patients with a history of contact with a TB patient, those who suspected TB and those with a history of chronic obstructive pulmonary disease were more likely to delay.

Factors associated with patient delay in accessing pulmonary tuberculosis care, Gezira State, Sudan, 2009

Analyses of patient delays in seeking treatment for tuberculosis [TB] provide useful evidence for national TB control programmes. The objectives of this study in Gezira State/ Sudan were to estimate the extent of, and factors associated with, pulmonary TB patient delay in accessing care. A cross-sectional phase was conducted to determine the length of delay, followed by a nested case-control phase comparing patients delaying above or below the median time. The mean patient delay was 27.2 days, median 4 days [range 0-365 days]. There were no significant differences between case and control groups in terms of age/ sex, marital status, educational level or smoking status. However, patients living in urban areas, with low income status and who were housewives or unemployed were more likely to delay. Also patients with a history of contact with a TB patient, those who suspected TB and those with a history of chronic obstructive pulmonary disease were more likely to delay

HER2 over expression in malignant palpable breast lumps of pre and postmenopausal women attending RICK

Back ground: Human Epidermal growth factor Receptor 2 (HER-2/neu) over expression in breast cancer is associated with poor outcome and decrease disease free survival (DFS). The aim of this study was to evaluate the over expression of HER2/neu among premenopausal and postmenopausal females presented with malignant palpable breast lumps to Radio Isotope Center Khartoum (RICK). Methods: The study was a case-control conducted among patients attending Radiation Isotopes Centre Khartoum (RICK). A total of 328 women were randomly selected. Data were collected by a pre coded; pre tested questionnaire. Tissue biopsies of breast lumps had been analyzed using immunohistochemical techniques for HERR-2/neu over expression and its relation to other prognostic factors was evaluated. Results: HER-2/neu + vein first pregnancy at 23 years; were 32 (41) in the cases; 6 (35) in the controls of premenopausal women; and 21(44) in the cases; 5 (38) in the controls of postmenopausal women. HER-2/neu + veexpression in relation to age at menarche 12 years was 39 (51) in the cases; 7(39) in the controls of premenopausal women; and 36 (56) in the cases; 7 (45) in the controls of postmenopausal women. HER-2/neu+ vein relation to Body Mass Index 29 kg/m2 showed 7 (37) in the cases; 2 (33) in the controls of premenopausal women (x2=0.024); and 8(38) in the cases; 2(40) in the controls of postmenopausal women (x2= 0.006). HER-2/neu+ veexpression in relation to history of abortion or miscarriage (ever) was found to be 21 (39) in the cases; 4 (33) in the controls of premenopausal women; and 18 (44) in the cases; 3 (33) in the controls among postmenopausal women. HER-2/neu+ veexpression in relation to the history of breast cancer in a first degree relatives was 3 (25) in the cases; 1(50) in the controls of premenopausal women; and 4 (22) in the cases; 2 (28) in the controls of postmenopausal women. HER-2/neu+ veexpression in relation to the use of oral contraceptives was 3 (37) in the cases; 1(50) in the controls among premenopausal women; and 3 (27) in the cases; 1 (50) in the controls of postmenopausal women. Conclusion: The study confirmed an etiological association between HER2/neu+ve and HER2/neu - ve and age at first pregnancy . 23 years; age of menarche at _ 12 years; abortion or miscarriage in premenopausal and post menopausal Sudanese women; while an etiological association was confirmed between HER2/neu+ve and HER2/neu -ve; and BMI in pre menopausal women; and the family history of cancer in post menopausal women

Contributing factors of Vesico-Vaginal Fistula (VVF) among Fistula Patients in Dr.Abbo's National Fistula et Urogynecology Centre - Khartoum 2008

"Background: Vesico-vaginal Fistula (VVF) is defined as an abnormal communicating tract extending between the bladder (vesico-) and the vagina resulting in continuous involuntary discharge of urine into the vaginal vault. Vesico-vaginal fistula is still a persisting scourge in the developing countries; including Sudan in which new cases of obstetric fistula were estimated to occur every year"" #he ob$ectives of this work were to study the contributing factors of vesico-vaginal fistula in Sudanese patients"" Methods: the design was descriptive; cross-sectional; community-based study"" A total of 2 patients with vesicovaginal fistula presented to the Fistula (entre in )Khartoum Teaching hospital from July to August 2 ;; were investigated using an administrated; semi-structured questionnaire"" Results: The study revealed that 44""2of patients were 1;-24 years old; "";were teenagers when married (1; yrs old)"" While 7of the patients were illiterates; 62"";were married to illiterate husbands"" (; "";) were poor; (4 ""4) were from western regions of Sudan"" The study showed that labor was responsible for 9 ""4of VVF of whom 9""6were primiparous; 42""6delivered at home"" It was found that 4 ""4of the total deliveries were by forceps as long as 27""7were emergency caesarian sections"" (3""2) of the deliveries were attended by traditional birth attendants and ""3of cases stayed in labor for more than 24 hours; as long as 3""2were not in regular antenatal care"" Conclusion:The vesico-vaginal fistula in Sudan resulted mainly from obstructed labor"" the victim was mostly a young woman; a primigravida; who was poor; illiterate; not on regular antenatal care et being in labor more than 24 hours"" Most deliveries were carried at home; attended by traditional Birth Attendants in most cases"" the deliveries were mostly assisted by forceps; or conducted as emergency caesarian sections"" To prevent VVF; the study suggested raising awareness of women at bearing age; improve transportation; besides inclusion of the issue in the curricula of schools and universities"""