Letter to the Editor

Adams, Laurie Davies

doi:10.2458/azu_rangelands_v33i4_adams

Cited by 2 publications

(2 citation statements)

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“…May we please, through your pages, express our thanks to the residents of the area for spending time, money and energy setting up the wonderful displays on their homes and allowing people to wander in awe and delight through their subdivision. To see the many families taking advantage of these wonderful displays made us realize that the Christmas spirit is still around (Adams 1998). A great big thank you to the people of Halswell who lit up Christmas with their fairy lights.…”

Section: Pleasures and Tensionsmentioning

confidence: 99%

Remaking the Anglophilic city: Visual spectacles in suburbia

Cupples

2009

New Zealand Geographer

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In the late 1990s, the residents of the Christchurch suburb of Halswell began to extensively engage in the practice of adorning their homes with Christmas lights. While the lights attract many visitors from other parts of the city, many Christchurch people are highly critical of them on grounds of taste. An exploration of the diverse attitudes toward this cultural practice demonstrates the complex ways in which local urban identities are articulated. While the Christmas lights reproduce processes of suburban social conformity and normativity, they also constitute a more postmodern site in which the established heritage meanings of Christchurch based on notions of Englishness are disrupted.

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Section: Pleasures and Tensionsmentioning

confidence: 99%

Remaking the Anglophilic city: Visual spectacles in suburbia

Cupples

2009

New Zealand Geographer

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“…The integration of the drug exception system into a physician controlled clinical review process appears to have minimized the potential problems of the implementation of such systems predicted elsewhere 4 The fact that the majority of exceptions were justified is inconsistent with the concerns about computer control of pharmacologic prescribing practices. The clinicians were clearly not merely obeying the computer.…”

Section: Nature Of the Clinician-computer Interactionmentioning

confidence: 99%

Clinician-computer interaction: automated review of psychotropic drugs five years later

Craig¹,

Mehta²

The Seventh Annual Symposium on Computer Applications in Medical Care, 1983. Proceedings.

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Five years after its introduction at a state mental hospital, an automated drug exception review system continues to show a long-term impact on the prescribing practices of hospital physicians. While the overall rate of exceptions has remained low, approximately one quarter of all new exceptions pointed out by the computer result in a change in the order by the physician. The fact that 60% of new exceptions are justified suggests that some forms of polypharmacy may be appropriate. The integration of the exception reporting system into the clinical review process has avoided the danger of the computer being seen as an adversary to the clinician or as exerting a "big-brother"-like control over psychopharmacologic prescription practices.An automated drug exception system which provides a quality assurance review for psychotropic drug orders in exception to predetermined prescribing guidelines has been in place at Rockland Psychiatric Center (RPC) under the auspices of the Multi-1 State Information System (MSIS) since 1975 . The present study was an attempt to examine the longterm impact of this system as regards: (1) the appropriateness of the guidelines; (2) the nature of the clinician-computer interaction and (3) the longterm impact on prescribing practices. MethodThe automated drug review system consists of a drug ordering segment which captures all psychotropic drug prescriptions ordered for RPC inpatients and an exception review module which automatically reviews all new drug prescriptions against a predetermined set of guidelines falling into two broad categories: dosage and polypharmacy. In addition, polypharmacy guidelines include both prescription of more than one drug within the same drug class (e.g., neuroleptics (NL), tricyclic antidepressants (TCA), antiparkinson drugs (AP), antianxiety agents (AA) and hypnotics (HY)), and prescription of potentially hazardous combinations of differing drug classes.When an exception is identified, the computer produces a letter to the prescribing physician with a copy forwarded to the physician's immediate physician supervisor. In consultation, these physicians decide whether the exception is acceptable, based on the patient's clinical needs, or whether a change in medication orders is indicated. When agreement is reached, the decision is referred to a Drug Monitoring Committee (DMC) of physicians for review which also arbitrates in the event a consensus cannot be reached by the prescribing physician and supervisor. Thus, the computer triggers a physician clinical review process.The present study focused on the computer exception reports generated during the period January, 1981 through January, 1982. The authors retrieved three broad categories of consultation outcome from these reports: (1) justification; (2) medication change; (3) other. ResultsDuring an average month, approximately 7% of the total patient population receiving psychotropic drugs had exceptions reported by the automated system. During the study period, there was a total of 263 exceptions. The most com...

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Letter to the Editor

Cited by 2 publications

References 0 publications

Remaking the Anglophilic city: Visual spectacles in suburbia

Remaking the Anglophilic city: Visual spectacles in suburbia

Clinician-computer interaction: automated review of psychotropic drugs five years later

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