In 2003, Red Chris Development Company started collecting baseline data to support its application for environmental approvals to mine the Red Chris porphyry copper-gold deposit located in northwestern British Columbia, Canada. An extensive geochemical testing program revealed that the majority of the waste rock has the potential to generate acid. However, the presence of significant quantities of carbonate minerals indicated that most of the rock would probably take several decades to generate acid. This precluded determination of which rock components would leach under acidic conditions using conventional laboratory methods. This information was required to predict future water chemistry and potential requirements for water treatment. As an alternative, waste-rock seepage chemistry data from six operating or recently closed porphyry mines in British Columbia were compiled and evaluated to investigate common hydrogeochemical features which could be used to predict water chemistry at Red Chris. The resulting database contains dissolved ion chemistry spanning the full range of pH conditions. The database indicated that dissolution of aluminum minerals such as biotite and chlorite exert a strong consistent pH control which can be explained by the solubility of basic aluminum sulfates and hydroxide. Likewise, iron concentrations were similar at all sites and appear to follow the solubility of ferric hydroxide. Dissolved concentrations of copper, zinc, cadmium, and molybdenum in waters were related to pH but reflected the variable presence of minerals such as chalcopyrite, sphalerite (zinc, cadmium) and molybdenite (molybdenum). In conclusion, concentrations of major ions affecting drainage acidity (sulfate, aluminum, and iron) are very similar at different sites, but concentrations of other elements depend on the abundance of their sulfide minerals.

Reed, Sean and Remenyte-Prescott, Rasa and Rees, Ben (2017) Effect of venepuncture process design on efficiency and failure rates: a simulation model study for secondary care. International Journal of Nursing Studies,[68][69][70][71][72][73][74][75][76][77][78][79][80][81][82] Access from the University of Nottingham repository: http://eprints.nottingham.ac.uk/41154/1/Effect%20of%20Venepuncture%20process %20design%20on%20efficiency%20and%20failure.pdf Copyright and reuse:The Nottingham ePrints service makes this work by researchers of the University of Nottingham available open access under the following conditions. This article is made available under the Creative Commons Attribution Non-commercial No Derivatives licence and may be reused according to the conditions of the licence. For more details see: http://creativecommons.org/licenses/by-nc-nd/2.5/ A note on versions:The version presented here may differ from the published version or from the version of record. If you wish to cite this item you are advised to consult the publisher's version. Please see the repository url above for details on accessing the published version and note that access may require a subscription.For more information, please contact eprints@nottingham.ac.uk Effect of venepuncture process design on efficiency and failure rates: a simulation model study for secondary care AbstractBackground: Healthcare aims to deliver good patient outcomes. For many clinical procedures there are multiple alternative task sequences that can be performed. These deviations can influence procedure reliability, efficiency of usage of hospital resources and risk to staff and patient safety. Venepuncture is one of the most common invasive procedures in healthcare. Literature of clinical practice shows evidence of wide variability in the procedure order and the duration of each step, which can depend on attributes, such as patient health, sampling method and staff skills.Objective: To use a computer simulation model based on Petri nets to evaluate the impact on outcomes of commonly practiced deviations from the guideline venepuncture procedure and variations in key dependent variables. The outcomes considered include the probability of successfully obtaining a blood sample and the procedure completion time.Design: A computer simulation model was constructed using the Petri net technique which mimics the different variations of the venepuncture procedure. Qualitative and quantitative data for the model was collected from the literature and through interviews and questionnaire responses from doctors and phlebotomists. Statistics on the reliability and duration for different variations were then calculated from the model output.Setting: A digital laboratory to model venepuncture in secondary care.Results: The model showed that the common practice of applying the tourniquet prior to vein identification and releasing it after sample tubes are filled may result in a ten-fold increase in sample haemolysis, compared to the recommended guideline procedure. Equipment la...

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Background and purpose The complexity and breadth of the medical curriculum presents many educational challenges. New technologies and advances in learning enhancement strategies propose a potential shift in the educational paradigm. The integration of virtual patients into the medical curriculum allows for interactive learning; shifting the focus from a passive educator-centred model to an active and individually tailored learning approach. This study builds on the successful Microbiology application. In collaboration with the original Microbiology designers, ‘Student Surgery’ is an application currently in development at Nottingham University Hospitals for medical students on their surgical attachment. It aims to assist in the delivery of core learning objectives, and augment traditional learning strategies during clinical placements. Methodology Six interactive linear cases (Acute Appendicitis, Hyperthyroidism, Inguinal Hernia, Breast cancer, Acute Cholecystitis and Dysphagia cases) were constructed, simulating realistic clinical scenarios that addressed core surgical learning objectives. The content was created by two medical students and reviewed by a surgical teaching fellow. The cases were transcribed into a smartphone/tablet application. A pilot app survey and student focus group will be formed upon completion. Results This innovative application enables users to experience a virtual patient case scenario by assuming the role of a health care professional. Users obtain histories, consider potential diagnostic and therapeutic strategies. Results from the survey and student focus group feedback will assist in targeted improvements and further development of the application. Discussion and conclusions The integration of e-learning into medical education presents an exciting opportunity to develop new and innovative learning resources. User evaluation and constructive feedback will allow for future development of the application. The early results of this study suggest virtual patients are likely to play an increasing role in medical education. The integration of educational applications into the medical curriculum is an exciting development in the teaching resources currently offered to medical students. References Cook DA, Triola MM. Virtual patients: a critical literature review and proposed next steps. Med Educ 2009;43:303–11 Poulton T, Conradi E, Kavia S, Round J, Hilton S. The replacement of ‘paper’ cases by interactive online virtual patients in problem-based learning. Med Teach 2009;31:752–8 Zary N, Johnson G, Boberg J, Fors UG. Development, implementation and pilot evaluation of a Web-based Virtual Patient Case Simulation environment-Web-SP. BMC Med Educ 2006a;6:10

Background/context Research has shown that training in a simulated environment can help surgical trainees acquire technical and non-technical skills that can be applied in the workplace and improve effectiveness of training in the operating theatre environment. Unfortunately, despite the gain in popularity and progress in simulation enhanced learning, surgical training via simulation is still not a mandatory component of all surgical training programs across the world. In the UK, the Joint Committee on Surgical Training and the Intercollegiate Surgical Curriculum Project agreed to integrate simulation from 2012. Methodology In 2013 an electronic questionnaire was sent to all 17 Core Surgical Training Programme Directors across the UK to evaluate the availability of surgical simulation training in the UK. This was followed up with targeted telephone enquiries to explore the frequency and modality of both teaching and simulation sessions available to the core surgical trainees. In 2014 we aim to repeat this audit to assess change and improvement in line with curriculum requirements. Results/outcomes Previous data illustrated a wide variation in both the modalities of simulation training e.g. mannequins, part task, cadaveric and non-technical skills and in the frequency of simulation training. In one region access to simulation training was bi-weekly. We hypothesis that more simulation is becoming available to core trainees and our data should reflect that. Conclusions and recommendations It is apparent that simulation is being incorporated into the Core Surgical training programmes across the UK, but that there is significant regional variation in the provision and access to these educational resources. This ongoing work could provide an annual review of use of surgical simulation, furthermore it could assist in the development of a set of standards within surgical simulation for core trainees. References Gallagher AG, Ritter EM, Champion H, et al. Virtual reality simulation for the operating room: proficiency-based training as a paradigm shift in surgical skills training. Ann Surg 2005;241:364–372 Boris Zevin, Rajesh Aggarwal, Teodor P Grantcharov. Surgical Simulation in 2013: Why Is It Still Not the Standard in Surgical Training? Journal of the American College of Surgeons Available online 28 September 2013 Joint Committee on Surgical training and ISCP