Day and night surgery: is there any influence in the patient postoperative period of urgent colorectal intervention?

Background Medical activity performed outside regular work hours may increase risk for patients and professionals. There is few data with respect to urgent colorectal surgery. The aim of this work was to evaluate the impact of daytime versus nighttime surgery on postoperative period of patients with acute colorectal disease. Methods A retrospective study was conducted in a sample of patients with acute colorectal disease who underwent urgent surgery at the General Surgery Unit of Braga Hospital, between January 2005 and March 2013. Patients were stratified by operative time of day into a daytime group (surgery between 8:00 and 20:59) and the nighttime group (21:00–7:59) and compared for clinical and surgical parameters. A questionnaire was distributed to surgeons, covering aspects related to the practice of urgent colorectal surgery and fatigue. Results A total of 330 patients were included, with 214 (64.8 %) in the daytime group and 116 (35.2 %) in the nighttime group. Colorectal cancer was the most frequent pathology. Waiting time (p?<?0.001) and total length of hospital stay (p?=?0.008) were significantly longer in the daytime group. There were no significant differences with respect to early or late complications. However, 100 % of surgeons reported that they are less proficient during nighttime. Conclusions Among patients with acute colorectal disease subjected to urgent surgery, there was no significant association between nighttime surgery and the presence of postoperative medical and surgical morbidities. Patients who were subjected to daytime surgery had longer length of stay at the hospital

Filipina American women's breast cancer knowledge, attitudes, and screening behaviors

BACKGROUND: Filipino Americans are the fastest growing Asian minority group in the United States. There is limited knowledge about their breast cancer knowledge, screening practices and attitudes. METHODS: As part of the evaluation of the Asian Grocery Store-Based Cancer Education Program, 248 Filipino American women completed baseline and follow-up surveys, while an additional 58 took part in focus groups. RESULTS: Compliance with annual clinical breast exam guidelines among women 40 to 49 years old was 43%, and annual mammography use among women 50 and over was 56%. The Asian Grocery Store-Based Cancer Education Program and complementary focus group study identified multiple barriers that hindered women from attending education programs, with time as the most frequently reported barrier. CONCLUSION: The Asian Grocery Store-Based Cancer Education Program was reported to be a culturally acceptable and effective way of disseminating breast cancer information and one that addressed the women's most frequently reported barrier, lack of time

Climate change impact on wave energy in the Persian Gulf

Excessive usage of fossil fuels and high emission of greenhouse gases have increased the earth’s temperature, and consequently have changed the patterns of natural phenomena such as wind speed, wave height, etc. Renewable energy resources are ideal alternatives to reduce the negative effects of increasing greenhouse gases emission and climate change. However, these energy sources are also sensitive to changing climate. In this study, the effect of climate change on wave energy in the Persian Gulf is investigated. For this purpose, future wind data obtained from CGCM3.1 model were downscaled using a hybrid approach and modification factors were computed based on local wind data (ECMWF) and applied to control and future CGCM3.1 wind data. Downscaled wind data was used to generate the wave characteristics in the future based on A2, B1, and A1B scenarios, while ECMWF wind field was used to generate the wave characteristics in the control period. The results of these two 30-yearly wave modelings using SWAN model showed that the average wave power changes slightly in the future. Assessment of wave power spatial distribution showed that the reduction of the average wave power is more in the middle parts of the Persian Gulf. Investigation of wave power distribution in two coastal stations (Boushehr and Assalouyeh ports) indicated that the annual wave energy will decrease in both stations while the wave power distribution for different intervals of significant wave height and peak period will also change in Assalouyeh according to all scenarios.Full Tex