Continuing education needs and barriers for public health nurses in aboriginal townships in Taitung, Taiwan.

International audienc

Increased hospitalizations for decompensated heart failure and acute myocardial infarction during mild winters: A seven-year experience in the public health system of the largest city in Latin America.

In high-income temperate countries, the number of hospitalizations for heart failure (HF) and acute myocardial infarction (AMI) increases during the winter. This finding has not been fully investigated in low- and middle-income countries with tropical and subtropical climates. We investigated the seasonality of hospitalizations for HF and AMI in Sao Paulo (Brazil), the largest city in Latin America.This was a retrospective study using data for 76,474 hospitalizations for HF and 54,561 hospitalizations for AMI obtained from public hospitals, from January 2008 to April 2015. The average number of hospitalizations for HF and AMI per month during winter was compared to each of the other seasons. The autoregressive integrated moving average (ARIMA) model was used to test the association between temperature and hospitalization rates.The highest average number of hospital admissions for HF and AMI per month occurred during winter, with an increase of up to 30% for HF and 16% for AMI when compared to summer, the season with lowest figures for both diseases (respectively, HF: 996 vs. 767 per month, p<0.001; and AMI: 678 vs. 586 per month, p<0.001). Monthly average temperatures were moderately lower during winter than other seasons and they were not associated with hospitalizations for HF and AMI.The winter season was associated with a greater number of hospitalizations for both HF and AMI. This increase was not associated with seasonal oscillations in temperature, which were modest. Our study suggests that the prevention of cardiovascular disease decompensation should be emphasized during winter even in low to middle-income countries with tropical and subtropical climates

Average number of hospitalizations per month for acute myocardial infarction, per season, according to gender and age group.

<p>Average number of hospitalizations per month for acute myocardial infarction, per season, according to gender and age group.</p

ARIMA analysis on the seasonal variation of the rates of hospitalizations for acute myocardial infarction and heart failure, and on the association between hospitalization rates and temperature levels.

<p>ARIMA analysis on the seasonal variation of the rates of hospitalizations for acute myocardial infarction and heart failure, and on the association between hospitalization rates and temperature levels.</p

Monthly average temperature levels and number of hospitalizations per month for heart failure.

<p>Monthly average temperature levels and number of hospitalizations per month for heart failure.</p

Monthly average temperature levels and number of hospitalizations per month for acute myocardial infarction.

<p>Monthly average temperature levels and number of hospitalizations per month for acute myocardial infarction.</p