Assessing the relationship of maternal short stature with coexisting forms of malnutrition among neonates, infants, and young children of Pakistan.

Evidence from previous studies suggests a strong association between pediatric undernutrition and maternal stature. However, there's a scarcity of evidence regarding the relationship between maternal stature and pediatric coexisting forms of malnutrition (CFM). This study examined the prevalence and trends of CFM at the individual, household, and community levels, using data from the Demographic & Health Surveys (DHS) of Pakistan. Furthermore, this study assessed the association between pediatric CFM and short maternal stature while adjusting for multiple covariates. A panel cross-sectional analysis was conducted using data from the 2012-2013 and 2017-2018 Pakistan Demographic & Health Survey (PDHS). We included data from 6194 mother-child dyads aged 15-49 years and 0-59 months, respectively, while excluding data from pregnant mothers and dyads with incomplete anthropometric variables and anthropometric outliers. Across the two survey periods, our findings reveal a significant decline in pediatric malnutrition, including CFM, alongside a concurrent increase in maternal overweight/obesity. Three out of four households had either a malnourished mother, and/or a malnourished child, and/or both. Our study demonstrates that short maternal stature increased the odds of various forms of pediatric undernutrition by two-to-threefolds (p < .041), but we did not find an association with wasting, overweight/obesity, and nutritional paradox. This underscores the heightened vulnerability of children born to short-stature mothers to various forms of pediatric undernutrition. Addressing the high prevalence of pediatric undernutrition among children of short-stature mothers necessitates a comprehensive approach that considers an individual's nutritional status throughout their entire life cycle.

Robust clustering of COVID-19 cases across U.S. counties using mixtures of asymmetric time series models with time varying and freely indexed covariates.

In this paper, we develop a mixture of autoregressive (MoAR) process model with time varying and freely indexed covariates under the flexible class of two-piece distributions using the scale mixtures of normal (TP-SMN) family. This novel family of time series (TP-SMN-MoAR) models was used to examine flexible and robust clustering of reported cases of Covid-19 across 313 counties in the U.S. The TP-SMN distributions allow for symmetrical/ asymmetrical distributions as well as heavy-tailed distributions providing for flexibility to handle outliers and complex data. Developing a suitable hierarchical representation of the TP-SMN family enabled the construction of a pseudo-likelihood function to derive the maximum pseudo-likelihood estimates via an EM-type algorithm.

Culturally and Linguistically Diverse Gamblers of East Asian Descent in Australia: A Comprehensive Review of Current Evidence.

As a country with one of the highest per capita gambling losses per year in the world, and an evolving multicultural profile, Australia has become an important setting in which to examine the harms and benefits related to gambling. The Australian population includes people from East Asian cultural backgrounds who are a key demographic of interest for gambling operators planning to grow revenue. However, Australian gambling research has concentrated primarily on those belonging to the dominant cultural group. Most of the previous and limited number of studies to examine gambling among culturally and linguistically diverse (CALD) residents have focused on people of Chinese descent, and much of the literature is now becoming relatively old. This review examines the current evidence around cultural variations in gambling prevalence, motivations, beliefs, behaviours, and help service utilisation, focusing on gamblers with an East Asian cultural background. Numerous domains in which gambling motivations and behaviours vary across cultural groups are identified, and methodological considerations related to ethnographic gambling research are discussed. This review found that while barriers and predictors to help-seeking for CALD gamblers have been studied extensively, contemporary evidence of help service utilisation and effectiveness in Australia is lacking. Further research providing an accurate assessment of the impacts of gambling for CALD gamblers is needed to ensure that harm minimisation resources are effective for those most vulnerable to harm.

The adverse effect of ambient temperature on respiratory deaths in a high population density area: the case of Malta.

BACKGROUND: The effect of ambient temperature on respiratory mortality has been consistently observed throughout the world under different climate change scenarios. Countries experiencing greater inter-annual variability in winter temperatures (and may not be lowest winter temperatures) have greater excess winter mortality compared to countries with colder winters. This study investigates the association between temperature and respiratory deaths in Malta which has one of the highest population densities in the world with a climate that is very hot in summer and mild in winter. METHODS: Daily number of respiratory deaths (7679 deaths) and meteorological data (daily average temperature, daily average humidity) were obtained from January 1992 to December 2017. The hot and cold effects were estimated at different temperatures using distributed lag non-linear models (DLNM) with a Poisson distribution, controlling for time trend, relative humidity and holidays. The reference temperature (MMT) for the minimum response-exposure relationship was estimated and the harvesting effects of daily temperature (0-27 lag days) were investigated for daily respiratory mortality. Effects were also explored for different age groups, gender and time periods. RESULTS: Cooler temperatures (8-15 °C) were significantly related to higher respiratory mortality. At 8.9 °C (1st percentile), the overall effect of daily mean temperature was related to respiratory deaths (RR 2.24, 95%CI 1.10-4.54). These effects were also found for males (95%CI 1.06-7.77) and males across different age groups (Males Over 65 years: RR 4.85, 95%CI 2.02-11.63 vs Males between 16 and 64 years: RR 5.00, 95%CI 2.08-12.03) but not for females. Interestingly, colder temperatures were related to respiratory deaths in the earliest time period (1992-2000), however, no strong cold effect was observed for later periods (2000-2017). In contrast, no heat effect was observed during the study period and across other groups. CONCLUSIONS: The higher risk for cold-related respiratory mortality observed in this study could be due to greater inter-annual variability in winter temperatures which needs further exploration after adjusting for potential physical and socio-demographic attributes. The study provides useful evidence for policymakers to improve local warning systems, adaptation, and intervention strategies to reduce the impact of cold temperatures.

Association of Infant Feeding Indicators and Infant Feeding Practices with Coexisting Forms of Malnutrition in Children under Six Months of Age.

Breastmilk is the only recommended source of nutrition for infants below six months of age. However, a significant proportion of children are either on supplemental breastfeeding (SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids (SSF) before six months of age. There is good evidence that exclusive breastfeeding (EBF) in infants below six months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition (CFMs) has not yet been explored. This study examined the association of different feeding indicators (continuation of breastfeeding, predominant feeding, and SSF) and feeding practices (EBF, SBF, and complete weaning) with CFM in infants aged below six months in Pakistan. National and regional datasets for Pakistan from the last ten years were retrieved from the Demographic Health Surveys (DHS) and UNICEF data repositories. In Pakistan, 34.5% of infants have some form of malnutrition. Among malnourished infants, 44.7% (~15.4% of the total sample) had a CFM. Continuation of breastfeeding was observed in more than 85% of infants, but less than a quarter were on EBF, and the rest were either SBF (65.4%) or weaned infants (13.7%). Compared to EBF, complete weaning increased the odds of coexistence of underweight with wasting, and underweight with both wasting and stunting by 1.96 (1.12-3.47) and 2.25 (1.16-4.36), respectively. Overall, breastfed children had lower odds of various forms of CFM (compared to non-breastfed), except for the coexistence of stunting with overweight/obesity. Continuation of any breastfeeding protected infants in Pakistan from various types of CFM during the first six months of life.

A Bayesian approach on the two-piece scale mixtures of normal homoscedastic nonlinear regression models.

In this application note paper, we propose and examine the performance of a Bayesian approach for a homoscedastic nonlinear regression (NLR) model assuming errors with two-piece scale mixtures of normal (TP-SMN) distributions. The TP-SMN is a large family of distributions, covering both symmetrical/ asymmetrical distributions as well as light/heavy tailed distributions, and provides an alternative to another well-known family of distributions, called scale mixtures of skew-normal distributions. The proposed family and Bayesian approach provides considerable flexibility and advantages for NLR modelling in different practical settings. We examine the performance of the approach using simulated and real data.

A review of the prevalence, trends, and determinants of coexisting forms of malnutrition in neonates, infants, and children.

OBJECTIVE: Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an individual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. METHODS: A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in individuals were included. The quality of included studies was assessed using the Joanna Briggs Institute (JBI) critical appraisal tools for prevalence and longitudinal studies. RESULTS: The search retrieved 14,207 articles, of which 24 were included in this review. The prevalence of CFM varied by geographical area and specific types. In children under 5 years, the coexistence of stunting with overweight/obesity ranged from 0.8% in the United States to over 10% in Ukraine and Syria, while the prevalence of coexisting wasting with stunting ranged from 0.1% in most of the South American countries to 9.2% in Niger. A decrease in CFM prevalence was observed in all countries, except Indonesia. Studies in China and Indonesia showed a positive association between rurality of residence and coexisting stunting with overweight/obesity. Evidence for other risk and protective factors for CFM is too minimal or conflicting to be conclusive. CONCLUSION: Evidence regarding the prevalence, determinants and trends for CFM is scarce. Apart from the coexistence of stunting with overweight/obesity, the determinants of other types of CFM are unclear. CFM in any form results in an increased risk of health adversities which can be different from comparable standalone forms, thus, there is an urgent need to explore the determinants and distribution of different types of CFM.

Short-Term and Long-Term COVID-19 Pandemic Forecasting Revisited with the Emergence of OMICRON Variant in Jordan.

Three simple approaches to forecast the COVID-19 epidemic in Jordan were previously proposed by Hussein, et al.: a short-term forecast (STF) based on a linear forecast model with a learning database on the reported cases in the previous 5-40 days, a long-term forecast (LTF) based on a mathematical formula that describes the COVID-19 pandemic situation, and a hybrid forecast (HF), which merges the STF and the LTF models. With the emergence of the OMICRON variant, the LTF failed to forecast the pandemic due to vital reasons related to the infection rate and the speed of the OMICRON variant, which is faster than the previous variants. However, the STF remained suitable for the sudden changes in epi curves because these simple models learn for the previous data of reported cases. In this study, we revisited these models by introducing a simple modification for the LTF and the HF model in order to better forecast the COVID-19 pandemic by considering the OMICRON variant. As another approach, we also tested a time-delay neural network (TDNN) to model the dataset. Interestingly, the new modification was to reuse the same function previously used in the LTF model after changing some parameters related to shift and time-lag. Surprisingly, the mathematical function type was still valid, suggesting this is the best one to be used for such pandemic situations of the same virus family. The TDNN was data-driven, and it was robust and successful in capturing the sudden change in +qPCR cases before and after of emergence of the OMICRON variant.

Catalytic behaviour of the Cu(i)/L/TEMPO system for aerobic oxidation of alcohols - a kinetic and predictive model.

Here, we disclose a new copper(i)-Schiff base complex series for selective oxidation of primary alcohols to aldehydes under benign conditions. The catalytic protocol involves 2,2,6,6-tetramethylpiperidine-N-oxyl (TEMPO), N-methylimidazole (NMI), ambient air, acetonitrile, and room temperature. This system provides a straightforward and rapid pathway to a series of Schiff bases, particularly, the copper(i) complexes bearing the substituted (furan-2-yl)imine bases N-(4-fluorophenyl)-1-(furan-2-yl)methanimine (L2) and N-(2-fluoro-4-nitrophenyl)-1-(furan-2-yl)methanimine (L4) have shown excellent yields. Both benzylic and aliphatic alcohols were converted to aldehydes selectively with 99% yield (in 1-2 h) and 96% yield (in 16 h). The mechanistic studies via kinetic analysis of all components demonstrate that the ligand type plays a key role in reaction rate. The basicity of the ligand increases the electron density of the metal center, which leads to higher oxidation reactivity. The Hammett plot shows that the key step does not involve H-abstraction. Additionally, a generalized additive model (GAM, including random effect) showed that it was possible to correlate reaction composition with catalytic activity, ligand structure, and substrate behavior. This can be developed in the form of a predictive model bearing in mind numerous reactions to be performed or in order to produce a massive data-set of this type of oxidation reaction. The predictive model will act as a useful tool towards understanding the key steps in catalytic oxidation through dimensional optimization while reducing the screening of statistically poor active catalysis.

Mapping the Morbidity Risk Associated with Coal Mining in Queensland, Australia.

The populations in the vicinity of surface coal mining activities have a higher risk of morbidity due to diseases, such as cardiovascular, respiratory and hypertensive diseases, as well as cancer and diabetes mellitus. Despite the large and historical volume of coal production in Queensland, the main Australian coal mining state, there is little research on the association of coal mining exposures with morbidity in non-occupational populations in this region. This study explored the association of coal production (Gross Raw Output-GRO) with hospitalisations due to six disease groups in Queensland using a Bayesian spatial hierarchical analysis and considering the spatial distribution of the Local Government Areas (LGAs). There is a positive association of GRO with hospitalisations due to circulatory diseases (1.022, 99% CI: 1.002-1.043) and respiratory diseases (1.031, 95% CI: 1.001-1.062) for the whole of Queensland. A higher risk of circulatory, respiratory and chronic lower respiratory diseases is found in LGAs in northwest and central Queensland; and a higher risk of hypertensive diseases, diabetes mellitus and lung cancer is found in LGAs in north, west, and north and southeast Queensland, respectively. These findings can be used to support public health strategies to protect communities at risk. Further research is needed to identify the causal links between coal mining and morbidity in non-occupational populations in Queensland.

Acceptability of emergency department triage nurse's advice for patients to attend general practice: A cross-sectional survey.

OBJECTIVES: Demand for ED care is increasing at a rate higher than population growth. Strategies to attenuate ED demands include diverting low-acuity general practice-type ED attendees to alternate primary healthcare settings. The present study assessed the ED attendees' receptiveness to accept triage nurse's face-to-face advice to explore alternate options for medical care and what factors influence the level of acceptance. METHODS: The ED attendees of four major public hospital EDs in Brisbane were surveyed between August and October 2018, using a questionnaire informed by Health Belief Model's cues to action. RESULTS: Of the 514 valid responses, 81% of respondents were very likely/likely to accept the triage nurse's advice to see a general practitioner. Self-perceived urgency of presenting condition/s (odds ratio [OR] 0.87, 95% confidence interval [CI] 0.78-0.97), not having confidence in general practitioner (OR 0.37, 95% CI 0.21-0.66) and having a medical record at the hospital (OR 0.60, 95% CI 0.36-0.99) were negatively associated with the likelihood of accepting the advice. For every point increase in perceived seriousness, the odds of accepting the advice decreased by 16% (95% CI 6-25%). CONCLUSION: Most of the participants believed that EDs were for emergent care and they attended the ED because they perceived their presenting condition/s to be serious and/or urgent. The acceptability of face-to-face advice by triage nurse to seek help in general practice was influenced by perceived threats of the illness, and the underlying beliefs about availability, accessibility, suitability and affordability of the service.

Prevalence, Trends, and Socioeconomic Determinants of Coexisting Forms of Malnutrition Amongst Children under Five Years of Age in Pakistan.

In Pakistan, malnutrition is a chronic issue. Concerns regarding coexisting forms of malnutrition (CFM) in an individual child are emerging, as children suffering from CFM have a 4 to 12-fold higher risk of death compared with healthy children. This study assessed the prevalence, trends, and socioeconomic determinants of various types of CFM using Pakistan Demographic and Health Survey (PDHS) datasets. Data from children aged 0-5 years old, with complete height and weight information, and valid anthropometry, from all regions of Pakistan (except residents of Azad Jammu Kashmir (AJK) and Federally Administered Tribal Areas (FATA), and non-de jure residents), were included. The prevalence of CFM was 30.6% in 2012-2013 and 21.5% in 2017-2018 PDHS. Both PDHSs reported a significantly higher prevalence of CFM in Sindh and Baluchistan compared with other regions of Pakistan. Improved socioeconomic status significantly reduced the odds of various types of CFM, except the coexistence of underweight with wasting. The high prevalence of CFM in Pakistan can be averted by multisectoral collaboration and by integrating nutrition-sensitive and nutrition-specific interventions.

COVID-19 Pandemic Development in Jordan-Short-Term and Long-Term Forecasting.

In this study, we proposed three simple approaches to forecast COVID-19 reported cases in a Middle Eastern society (Jordan). The first approach was a short-term forecast (STF) model based on a linear forecast model using the previous days as a learning data-base for forecasting. The second approach was a long-term forecast (LTF) model based on a mathematical formula that best described the current pandemic situation in Jordan. Both approaches can be seen as complementary: the STF can cope with sudden daily changes in the pandemic whereas the LTF can be utilized to predict the upcoming waves' occurrence and strength. As such, the third approach was a hybrid forecast (HF) model merging both the STF and the LTF models. The HF was shown to be an efficient forecast model with excellent accuracy. It is evident that the decision to enforce the curfew at an early stage followed by the planned lockdown has been effective in eliminating a serious wave in April 2020. Vaccination has been effective in combating COVID-19 by reducing infection rates. Based on the forecasting results, there is some possibility that Jordan may face a third wave of the pandemic during the Summer of 2021.

University Staff and Students' Attitudes towards a Completely Smoke-Free Campus: Shifting Social Norms and Organisational Culture for Health Promotion.

A large university in Queensland, Australia with a diverse staff and student community introduced a campus wide smoke-free policy in 2016. The purpose of this enquiry was to understand attitudes about a new smoke-free policy, its potential impact and the shift in social norms and organizational culture to inform the next phase of implementation. An electronic survey was distributed to all staff and students approximately 12 weeks after the smoke-free policy was implemented. The survey consisted of multiple-choice questions about demographics, smoking behaviour, attitudes towards smoking and tobacco control, awareness of the smoke-free policy, and attitudes towards the effect of a completely smoke-free campus on quality of life, learning and enrolment. The survey was completed by 641 university staff and students. Respondents reported seeking out (80.4%) and socialising in smoke-free environments (86.6%) and supported smoke-free buildings (96.1%), indoor areas (91.6%), and outdoor areas (79%). The results revealed overwhelming support for a completely smoke-free campus (83%) and minority support for designated smoking areas (31%). Overall, respondents reflected positively towards a campus wide smoke-free policy. These findings suggest Queensland's early adoption of tobacco control laws influenced the social environment, de-normalised smoking, changed behaviour, preference for smoke-free environments and shifted social norms. These findings provide convincing evidence for organisational change and suggest health promotion policy makers should progress the implementation of smoke-free policies nationally across the higher education sector.

Assessing evidence for seasonality of hospital admissions for schizophrenia in Queensland, Australia: a time series observational study.

Most evidence on seasonal admission patterns for schizophrenia derives from the Northern Hemisphere with results from the Southern Hemisphere less documented. This study examines seasonal patterns in hospital admissions due to schizophrenia in Queensland, Australia, a large area that has a range of different climatic features. Daily hospital admissions data for people with the primary diagnosis of schizophrenia were collected from Queensland Health Department for the period from January 1996 to December 2015. A generalised linear regression model with Quasi-Poisson distribution was used to assess seasonal admission patterns across different climatic regions. The evidence for seasonality was also explored in subgroups that had different socio-demographic characteristics or history of prior hospitalisation for psychiatric disorders. Overall, a significant winter pattern (RR 1.05, 95%CI 1.01-1.13) was found with a peak in August (RR 1.08, 95%CI 1.03-1.17) in temperate Southeast Queensland. However, the hot humid North and Far North Queensland showed a peak in October (RR 1.10, 95%CI 1.02-1.22). Males (RR 1.11, 95%CI 1.07-1.14), people aged 40-59 years old (RR 1.10, 95%CI 1.05-1.15) and those who had never married (RR 1.09, 95%CI 1.06-1.12), were Australian by birth (RR 1.07, 95%CI 1.04-1.10) or were unemployed (RR 1.13, 95%CI 1.09-1.18) had significantly higher risk for hospital admissions, particularly during the winter months. The seasonal admission pattern for schizophrenia did not change significantly according to admission status and history of outpatient or community psychiatric treatment. The study found some evidence for seasonality of hospital admissions for schizophrenia that differed from northern tropical to southern temperate regions of Queensland.

Immediate and delayed effects of climatic factors on hospital admissions for schizophrenia in Queensland Australia: A time series analysis.

BACKGROUND: Evidence of immediate and delayed effects of climatic drivers on hospital admissions for schizophrenia is limited and inconsistent. We aimed to assess the association between climatic factors and daily hospital admissions for schizophrenia in Queensland, Australia. METHODS: Daily hospital admissions for schizophrenia from January 1, 1996 to December 31, 2015 in all private and public hospitals of Queensland were obtained from Queensland Health. The association between climatic factors and hospital admissions for schizophrenia were analysed using Generalised Linear Models with Poisson distribution (GLM) and Distributed Lag non-linear Models (DLNM) across different climatic zones. RESULTS: In South East Queensland, only daily mean temperature showed an immediate negative effect on schizophrenia admissions (RR 0.93, 95%CI 0.90-0.98, p value < 0.001). For other regions, the adverse effect of temperature on hospital admissions was not significant, however, relative humidity (North: RR 1.01, 95%CI 1.00-1.02, p = 0.05) and air pressure (North: RR 1.03, 95%CI 1.00-1.05, p = 0.04; South West: RR 1.01, 95%CI 1.00-1.02, p = 0.05) had an immediate and positive effect on hospital admissions. Moreover, climatic factors had some delayed effects on schizophrenia admissions in different regions of Queensland, i.e. temperature over 0-4 lag days (South East: RR 0.97, 95%CI 0.94-0.98, p = 0.05; South West: RR 0.96, 95%CI 0.94-0.98, p = 0.01), relative humidity over 0-7 lag days (North: RR 0.95, 95%CI 0.92-0.98, p = 0.01; Central: RR 1.02, 95%CI 1.00-1.03, p = 0.05) and rainfall over 0-21 lag days (North: RR 1.03, 95%CI 1.01-1.04, p = 0.01). Meta-analysis showed significant pooled delayed effects of temperature (0-15 days lag: RR 0.95, 95% CI 0.93-0.98, p value < 0.001), relative humidity (0-7 days: RR 0.96, 95%CI 0.92-0.99, p < 0.001); rainfall (0-21 lag days: RR 1.03, 95%CI 1.01-1.04, p < 0.001) and air pressure (0-7 days lag: RR 1.02, 95%CI 1.00-1.04, p < 0.001) on schizophrenia admissions in Queensland. DISCUSSION: As this is the largest study from Australia and also internationally to extensively examine both short term and delayed association between climatic factors and daily admissions for schizophrenia, the results of the study indicate that climate plays an important role in the sudden exacerbation of acute episodes of schizophrenia. Thus, preventive measures could be taken to reduce the severity of symptoms as well as hospital admissions due to schizophrenia during vulnerable periods.

Time series modelling to forecast the confirmed and recovered cases of COVID-19.

Coronaviruses are enveloped RNA viruses from the Coronaviridae family affecting neurological, gastrointestinal, hepatic and respiratory systems. In late 2019 a new member of this family belonging to the Betacoronavirus genera (referred to as COVID-19) originated and spread quickly across the world calling for strict containment plans and policies. In most countries in the world, the outbreak of the disease has been serious and the number of confirmed COVID-19 cases has increased daily, while, fortunately the recovered COVID-19 cases have also increased. Clearly, forecasting the "confirmed" and "recovered" COVID-19 cases helps planning to control the disease and plan for utilization of health care resources. Time series models based on statistical methodology are useful to model time-indexed data and for forecasting. Autoregressive time series models based on two-piece scale mixture normal distributions, called TP-SMN-AR models, is a flexible family of models involving many classical symmetric/asymmetric and light/heavy tailed autoregressive models. In this paper, we use this family of models to analyze the real world time series data of confirmed and recovered COVID-19 cases.

Time series modelling to forecast the confirmed and recovered cases of COVID-19.

Coronaviruses are enveloped RNA viruses from the Coronaviridae family affecting neurological, gastrointestinal, hepatic and respiratory systems. In late 2019 a new member of this family belonging to the Betacoronavirus genera (referred to as COVID-19) originated and spread quickly across the world calling for strict containment plans and policies. In most countries in the world, the outbreak of the disease has been serious and the number of confirmed COVID-19 cases has increased daily, while, fortunately the recovered COVID-19 cases have also increased. Clearly, forecasting the "confirmed" and "recovered" COVID-19 cases helps planning to control the disease and plan for utilization of health care resources. Time series models based on statistical methodology are useful to model time-indexed data and for forecasting. Autoregressive time series models based on two-piece scale mixture normal distributions, called TP-SMN-AR models, is a flexible family of models involving many classical symmetric/asymmetric and light/heavy tailed autoregressive models. In this paper, we use this family of models to analyze the real world time series data of confirmed and recovered COVID-19 cases.

Seasonality and schizophrenia: a comprehensive overview of the seasonal pattern of hospital admissions and potential drivers.

Schizophrenia is a severe neuropsychiatric disorder with heterogeneous aetiology mostly affecting younger people and causing immense disability. Seasonal patterns may be observed in schizophrenia hospital admissions with possible association with changing climatic parameters and socio-demographic characteristics. This study critically reviewed studies that have assessed seasonal variations of hospital admissions for schizophrenia and/or explored an association with climate parameters and/or other potential factors. Following PRISMA guidelines, a systematic literature search was conducted using electronic databases (e.g. MEDLINE, Science Direct, PsycINFO, Pub Med) from inception to February 29, 2020. Thirty five papers were identified, of which only six (17.1%) examined evidence for a seasonal pattern or monthly excess of hospital admissions and the remaining twenty nine (82.9%) assessed climatic and socio-demographic attributes relating to the seasonal pattern or increased hospitalisation for schizophrenia. While most studies reported a summer peak in hospital admission rates, other studies reported a winter peak. Most of the evidence indicated that higher temperatures (> 28 °C) were positively correlated with schizophrenia admission rates. The individual effects of other climatic parameters (e.g. relative humidity, rainfall, atmospheric pressure, sunlight) were less frequently assessed. Males, people of 21-60 years old, and those married were more vulnerable to climatic variability specifically to higher temperatures. Further studies using large sample sizes, analysis of a wide range of interacting environmental variables and sophisticated statistical approaches are needed to better understand the underlying mechanisms involved. This will also provide more reliable statistical evidence that will help in the prevention and better management of cases.

Identifying the factors influencing Saudi Arabian nurses' turnover.

AIMS: This study identifies and analyses the risk factors contributing to nursing turnover in Saudi Arabia and identifies practical solutions to decrease turnover and encourage nurses to stay in their jobs. BACKGROUND: Saudi Arabia has a unique nursing profile, as the majority of the nursing workforce are expatriates. The Saudi health care system relies on contracted expatriate nurses to provide most of the direct patient health care. For nurses from other countries, Saudi Arabia can be a challenging place to work due to a range of factors including personal, policy and organisational variables. There is a high turnover of expatriate nurses, and this has been long-standing problem for the Saudi Arabian health care system. METHOD: A cross-sectional survey design among nurses in Saudi Arabia including 502 nurses, of whom 83.7% are female. Structural equation modelling is used to examine the relationships between the study variables. Confirmatory factor analysis is used to create and validate the measurement models for variables. RESULTS: The analysis of the survey data identifies that Filipino nurses are more likely to intend to leave their current position than other expatriates, including Malaysian, Pakistani, Indian or local Saudi nurses. Many expatriates identify discrimination as an important contributing factor for their intention to leave, citing that the national salary remuneration for nurses should be based on competency and delivery of care. Furthermore, several independent variables are found to be significant predictors of anticipated turnover, including discrimination; social support from immediate supervisor; organisational commitment; and autonomy. CONCLUSIONS: This study provides the most comprehensive information available to date about the factors that influence nurses' desire to leave their current job and provides evidence for better health workforce planning in Saudi Arabia. This study strongly indicates that the main factor related to turnover is the unfair and unequal salaries paid to nurses of different nationalities in Saudi Arabia. IMPLICATIONS FOR NURSING MANAGEMENT: The findings relating to both Saudi and foreign nurse employment could be helpful to policymakers and the Ministry of Health in Saudi Arabia.