The effect of a bundle intervention for ambulatory otorhinolaryngology procedures on same-day case cancellation rate and associated costs.

Cancellations within 24 h of planned elective surgical procedures reduce operating theatre efficiency, add unnecessary costs and negatively affect patient experience. We implemented a bundle intervention that aimed to reduce same-day case cancellations. This consisted of communication tools to improve patient engagement and new screening instruments (automated estimation of ASA physical status and case cancellation risk score plus four screening questions) to identify patients in advance (ideally before case booking) who needed comprehensive pre-operative risk stratification. We studied patients scheduled for ambulatory surgery with the otorhinolaryngology service at a single centre from April 2021 to December 2022. Multivariable logistic regression and interrupted time-series analyses were used to analyse the effects of this intervention on case cancellations within 24 h and costs. We analysed 1548 consecutive scheduled cases. Cancellation within 24 h occurred in 114 of 929 (12.3%) cases pre-intervention and 52 of 619 (8.4%) cases post-intervention. The cancellation rate decreased by 2.7% (95%CI 1.6-3.7%, p < 0.01) during the first month, followed by a monthly decrease of 0.2% (95%CI 0.1-0.4%, p < 0.01). This resulted in an estimated $150,200 (£118,755; €138,370) or 35.3% cost saving (p < 0.01). Median (IQR [range]) number of days between case scheduling and day of surgery decreased from 34 (21-61 [0-288]) pre-intervention to 31 (20-51 [1-250]) post-intervention (p < 0.01). Patient engagement via the electronic health record patient portal or text messaging increased from 75.9% at baseline to 90.8% (p < 0.01) post-intervention. The primary reason for case cancellation was patients' missed appointment on the day of surgery, which decreased from 7.2% pre-intervention to 4.5% post-intervention (p = 0.03). An anaesthetist-driven, clinical informatics-based bundle intervention decreases same-day case cancellation rate and associated costs in patients scheduled for ambulatory otorhinolaryngology surgery.

Parapsychology and the neurosciences: a computer-based content analysis of abstracts in the database "MEDLINE" from 1975 to 1995.

A computer-based content of 109 abstracts retrieved by the subject heading "parapsychology" from the database MEDLINE for the years 1975-1995 is presented. Data were analyzed by four categories to terms denoting (1) research methods, (2) neurosciences, (3) humanities/psychodynamics, and (4) parapsychology. Results indicated a growing interest in neuroscientific and neuropsychological explanations and theories.

Intercultural differences in the bioethical assessment of abortion: preliminary results and a proposal for further research.

Descriptor terms related to 37 articles dealing with the moral question of abortion and taken from a printed database specializing in Catholic applied ethics were scanned for clusters with respect to the Anglo-American or European origin of the articles. To identify types within the data Configural Frequency Analysis was used. Application indicated a dominant interest in the process of ethical decision-making in Anglo-American Catholic bioethics. The assumption that European Catholic bioethicists discuss the morality of abortion primarily in terms of an anthropological debate focused on the moral status of prenatal life could not be validated statistically.

[Comorbidity of substance abuse and antisocial behavior. Analysis of an adolescent psychiatric population]. / Zur Komorbidität von Drogenmissbrauch und Dissozialität. Analyse einer jugedpsychiatrischen Inanspruchnahmepopulation.

Comorbidity, the simultaneous occurrence of different psychiatric disorders, is a common phenomenon in child and adolescent psychiatry. Usually, it affects the prognosis negatively. For example, drug abuse increases the risk of drug dependency among adolescents with conduct disorders. In this study, a high-risk group of 30 adolescents with conduct disorders at a regional psychiatric hospital was examined regarding drug abuse. Half of the adolescents were taking drugs. This influenced the course in a way which limited the therapeutic possibilities. The comorbidity of drug abuse and conduct disorders is discussed in connection with prevention.