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The purpose of this paper is to compare data collected by automated form processing with manual data collection for clinical indicators (CIs) in paediatric emergency medicine.

Paediatric patients presenting with croup, asthma, bronchiolitis, head injury and gastroenteritis in August 2006 were identified by ICD 9 coding and a traditional manual audit was performed by two data collectors. Data were collected on a total of 16 CIs for these five illnesses. Manual audit data were then compared to information collected for this same patient population using TELEform™, an automated forms processing (AFP) system that had been employed for over two years.

Teleform™ data were only available for 24 patients compared to information for 127 patients identified by ICD 9 coding and manual audit. Teleform™ data overestimated compliance with clinical guidelines by 17 percent giving an overall departmental agreement with CIs of 90.6 percent compared to 73.5 percent in the manual audit. Additionally, manual audit demonstrated that when the clinical guideline was incorporated into the clinical record, compliance was 92.5 percent compared to 51.3 percent when it was not.

This single center study demonstrates that data collected by AFP such as TELEform™, overestimate emergency department performance regarding CIs compliance. Departments that use automated data collection tools need to establish relationships between such data and data collected via more traditional auditing methods.

The purpose of this paper is to present contrasting approaches to the descriptive case study of tourism to the buried city of Plymouth, Montserrat, an example of the marketing and burying – the supply and demand – of apocalyptic dark tourism on the island.

A case study mixed-methods methodology is adopted, and findings are derived from tour guiding fieldwork, guide and tourist interviews, and an analysis of travel writing and tourism marketing campaigns.

Dark tourism is viewed as a contentious and problematic concept: it attracts and repels tourism to the former capital Plymouth, Montserrat. After 20 years of the volcano crisis, the islanders, government and Tourist Board are commemorating resilience living with the volcano and regeneration in a disaster scenario. Marketing and consumption approaches to dark tourism elucidate different facets to the case study of “the buried city” of Plymouth, Montserrat, and the Montserrat Springs Hotel overlooking Plymouth. The disjunct between these two types of approach to dark tourism, as well as the different criteria attached to working definitions of dark tourism – and the range of interests in apocalyptic dark tourism into the city and its surrounds – show some of the problems and limitations with theoretical and scalar discussions on dark tourism.

The paper’s implications are that both supply and demand approaches to dark tourism are needed to fully understand a dark tourism destination and to reconcile the disjunct between these two approaches and the perspectives of tourist industry and tourism users.

This is a descriptive dark tourism case study of a former capital city examined from both supply and demand perspectives. It introduces the apocalyptic to dark tourism destination analysis.