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  • 1
    Electronic Resource
    Electronic Resource
    Hernia 4 (2000), S. 1-5 
    ISSN: 1248-9204
    Keywords: Inguinal hernia ; Daycase ; Ambulatory ; Cost-savings
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A Hernia Service (HS) was commenced in Derriford Hospital, Plymouth, UK in May 1996 to improve patient outcome following a poor star rating for overall hospital performance in daycase hernia surgery. Between 1996 and December 1998, 576 patients, median age 65 years (range 24–88) with unilateral or bilateral inguinal hernias underwent surgical repair on the HS. During the same time period on the General Surgical Service (GSS) 1722 patients underwent surgical repair. On the HS, patients operated under local anaesthesia (LA) increased from 78.0 to 90.5%, and on the GSS use of LA increased from 7.6 to 22.4%. The percentage of daycases on the HS increased from 53.0 to 81.4% and on the GSS from 2.9 to 28.0%. The actual number of inpatient hospital days saved by the HS was 236 days in 1997 and 284 days in 1998. The potential saving was greater: in 1998 if the GSS daycase rate (28.0%) had been the same as the HS daycase rate (81.4%) 605 inpatient days would have been saved. A hernia satisfaction questionnaire was sent to a ran dom sample of 50 patients who had had their hernia repaired by the HS and 50 patients who had been treated by the GSS. HS patients experienced a mean pain score of 4,7 (range 1–10) compared to 5.7 (range 0–10) (p=0.07) for the GSS. Similarly, HS patients required less post-operative analgesia (mean 2.8 days compared to 5.9 days for the GSS group, p〈0.01) and resumed normal activity at an earlier stage (mean 10.8 days compared to 17.6 days for the GSS patients, p〈0.01). Instigation of a dedicated HS has improved patient outcome and substantially increased the use of local anaesthesia and the number of daycase hernia repairs on both the HS and the GSS, with substantial cost savings.
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Munksgaard International Publishers
    Ecology of freshwater fish 14 (2005), S. 0 
    ISSN: 1600-0633
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Biology , Agriculture, Forestry, Horticulture, Fishery, Domestic Science, Nutrition
    Notes: Abstract –  In past dietary studies kokanee Oncorhynchus nerka were prominent in the diet of Pend Oreille Lake's large piscivores: native bull trout Salvelinus confluentus, cutthroat trout O. clarki and northern pikeminnow Ptychocheilus oregonensis, and introduced lake trout S. namaycush and Kamloops rainbow trout O. mykiss gairdneri. However, kokanee have declined to 10–20% of their former abundance. We therefore initiated this study to understand current predation demands on kokanee and diet overlap among piscivores, using gut content samples and analysis of stable nitrogen (δ15N) and carbon (δ13C) isotopes from the lake's fish and invertebrate community. In gut content samples, kokanee were the main prey item of large [i.e., ≥400 mm total length (TL)] bull and lake trout; a conclusion that was affirmed by stable isotope analysis. Rainbow trout 〉500 mm TL consumed mostly kokanee, thus there was a high degree of diet overlap among large bull, lake and rainbow trout. Small (i.e., 〈400 mm TL) rainbow and cutthroat trout diets overlapped, and were composed mostly of littoral benthic invertebrates. However, gut content and stable isotope analysis did not accord for 400–500 mm TL rainbow trout, small lake trout, and large cutthroat trout. In these instances, a linear mixing model using stable isotope results predicted kokanee consumption for each species, but no kokanee were identified in rainbow or lake trout gut content. Gut content and stable isotope analysis of native northern pikeminnow indicated a diet of mostly littoral benthic invertebrates at smaller (100–150 mm TL) lengths, with kokanee becoming more prominent in the diet of individuals 〉300 mm TL. Percent of kokanee in the diet of northern pikeminnow has declined from a prior study; otherwise piscivore diets have apparently remained unchanged. In this study, judgments as to the feeding of some piscvores, based on gut content alone, would be tenuous because of small sample sizes, but stable isotope analysis provided an efficient means for confirming diets.
    Type of Medium: Electronic Resource
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  • 3
    Sydney, N.S.W. : Periodicals Archive Online (PAO)
    Australasian Journal of Philosophy. 63 (1985) 571 
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