Adventure Tourism and Adventure Sports Injury: the New Zealand experience

The primary aims of this study were to establish a client injury baseline for the New Zealand adventure tourism and adventure sport sector, and to examine patterns and trends in claims for injury during participation in adventure activities. Content analysis of narrative text data for compensated injuries occurring in a place for recreation and sport over a 12-month period produced over 15,000 cases involving adventure tourism and adventure sport. As found in previous studies in New Zealand, highest claims counts were observed for activities that are often undertaken independently, rather than commercially. Horse riding, tramping, surfing and mountain biking were found to have highest claims counts, while hang gliding/paragliding/parasailing and jet boating injuries had highest claims costs, suggesting greatest injury severity. Highest claims incidence was observed for horse riding, with female claimants over-represented for this activity. Younger male claimants comprised the largest proportion of adventure injuries, and falls were the most common injury mechanism

The current state and future directions of percolation leaching in the Chinese mining industry : challenges and opportunities

China is one of the most rapidly growing economies in the world and this growth is underpinned by growing demand for natural resources to meet base and precious metals and energy requirements. Even though China is currently the largest producer of several mined commodities, such as gold and the rare earth elements, meeting the future demands for metal consumption will require China to either develop new mining projects or increase material imports. In terms of nuclear energy requirements the country still depends on uranium imports. To meet this growth in Chinese demand, there has been a strong interest in technologies suited for mining and processing of low grade ore bodies. Percolation leaching methods have been very effective in extracting metals from low grade ores, which could not otherwise be economically extracted. Percolation leaching techniques, such as heap leaching, dump leaching, bio-leaching and in-situ leaching have been extensively employed in the Chinese mining industry in recent decades, primarily to extract gold, copper, rare earth elements and uranium. This paper discusses the application of various percolation leaching techniques in the Chinese mining industry and offers a scientific and extensive literature overview on technological developments in commercial percolation leaching operations in China. It also presents the current challenges of percolation leaching and recent technological and research developments and regulatory frameworks pertaining to the application of percolation leaching in China. The future directions of percolation leaching in the Chinese mining industry will also be presented to extract the low grade natural resources both economically and in an environmentally sustainable manner

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

Background: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. Methods: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. Findings: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96–1·28). Interpretation: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. Funding: National Institute for Health Research Health Services and Delivery Research Programme

Effectiveness of a national quality improvement programme to improve survival after emergency abdominal surgery (EPOCH): a stepped-wedge cluster-randomised trial

BACKGROUND: Emergency abdominal surgery is associated with poor patient outcomes. We studied the effectiveness of a national quality improvement (QI) programme to implement a care pathway to improve survival for these patients. METHODS: We did a stepped-wedge cluster-randomised trial of patients aged 40 years or older undergoing emergency open major abdominal surgery. Eligible UK National Health Service (NHS) hospitals (those that had an emergency general surgical service, a substantial volume of emergency abdominal surgery cases, and contributed data to the National Emergency Laparotomy Audit) were organised into 15 geographical clusters and commenced the QI programme in a random order, based on a computer-generated random sequence, over an 85-week period with one geographical cluster commencing the intervention every 5 weeks from the second to the 16th time period. Patients were masked to the study group, but it was not possible to mask hospital staff or investigators. The primary outcome measure was mortality within 90 days of surgery. Analyses were done on an intention-to-treat basis. This study is registered with the ISRCTN registry, number ISRCTN80682973. FINDINGS: Treatment took place between March 3, 2014, and Oct 19, 2015. 22 754 patients were assessed for elegibility. Of 15 873 eligible patients from 93 NHS hospitals, primary outcome data were analysed for 8482 patients in the usual care group and 7374 in the QI group. Eight patients in the usual care group and nine patients in the QI group were not included in the analysis because of missing primary outcome data. The primary outcome of 90-day mortality occurred in 1210 (16%) patients in the QI group compared with 1393 (16%) patients in the usual care group (HR 1·11, 0·96-1·28). INTERPRETATION: No survival benefit was observed from this QI programme to implement a care pathway for patients undergoing emergency abdominal surgery. Future QI programmes should ensure that teams have both the time and resources needed to improve patient care. FUNDING: National Institute for Health Research Health Services and Delivery Research Programme

Assessing Water Risks in the Mining Industry using Life Cycle Assessment Based Approaches

Recent advances life cycle assessment methodology provide an opportunity to gain a more holistic understanding of how the mining industry interacts with water resources. A detailed review of assessment methodology and water management in the mining industry was undertaken to identify research needs. Global datasets of water use statistics for mining operations were also developed, and an exhaustive analysis of how global mineral resources and production are spatially distributed across local water and climate contexts was performed. The project has made a significant advance in our understanding of how the global minerals industry interacts with water resources

Status of specific energy intensity of copper: Insights from the review of sustainability reports

There are a range of major industry factors placing upward pressure on the energy intensity of primary copper production. Copper ore grades are declining, mines are becoming deeper and deposits are becoming more complex. However, at the same time the individual processes employed during mining, mineral processing and metal production are becoming more efficient. Given these competing trends, a good question to ask: has the rate of innovation by engineers and the research community been exceeding the upward pressure on energy intensity created by trends at the mine-sites