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BACKGROUND: Survival from in-hospital cardiac arrest is poor. Clinical features, including abnormal vital signs, often indicate patient deterioration prior to severe adverse events. Early warning systems and rapid response teams are commonly used to assist the health profession in the identification and management of the deteriorating patient. Education programs are widely used in the implementation of these systems. The effectiveness of the education is unknown. AIM: The aims of this study were to identify: (i) the evidence supporting educational effectiveness in the recognition and management of the deteriorating patient and (ii) outcome measures used to evaluate educational effectiveness. METHODS: A mixed methods systematic review of the literature was conducted using studies published between 2002 and 2014. Included studies were assessed for quality and data were synthesized thematically, while original data are presented in tabular form. RESULTS: Twenty-three studies were included in the review. Most educational programs were found to be effective reporting significant positive impacts upon learners, patient outcomes and organisational systems. Outcome measures related to: i learners, for example knowledge and performance, ii systems, including activation and responses of rapid response teams, and iii patients, including patient length of stay and adverse events. All but one of the programs used blended teaching with >87% including medium to high fidelity simulation. In situ simulation was employed in two of the interventions. The median program time was eight hours. The longest program lasted 44h however one of the most educationally effective programs was based upon a 40min simulation program. CONCLUSION: Educational interventions designed to improve the recognition and management of patient deterioration can improve learner outcomes when they incorporate medium to high-fidelity simulation. High-fidelity simulation has demonstrated effectiveness when delivere

The Mobrun VMS (volcanogenic massive sulphide) deposit in the Abitibi Greenstone Belt, Quebec, Canada, is hosted mainly by felsic volcanic rocks. Primary facies of mineralisation resulted from deposition and reworking of sulphides by synvolcanic hydrothermal fluids. Secondary facies of mineralisation resulted from greenschist-grade metamorphism and related deformation. The results from the ion-microprobe analysis of sulphide minerals show that primary pyrite contains up to 10 ppm "invisible" gold, inidcating that syngenetic gold is present in the deposit. Concentrations of gold in recrystallised pyrite are significantly lower, indicating that metamorphic recrystallisation resulted in the release of gold. Remobilised gold was deposited in tectonic veins as easily recoverable electrum and invisible gold in chalcopyrite., The Mobrun VMS (volcanogenic massive sulphide) deposit in the Abitibi Greenstone Belt, Quebec, Canada, is hosted mainly by felsic volcanic rocks. Primary facies of mineralisation resulted from deposition and reworking of sulphides by synvolcanic hydrothermal fluids. Secondary facies of mineralisation resulted from greenschist-grade metamorphism and related deformation. The results from the ion-microprobe analysis of sulphide minerals show that primary pyrite contains up to 10 ppm "invisible" gold, inidcating that syngenetic gold is present in the deposit. Concentrations of gold in recrystallised pyrite are significantly lower, indicating that metamorphic recrystallisation resulted in the release of gold. Remobilised gold was deposited in tectonic veins as easily recoverable electrum and invisible gold in chalcopyrite.

To evaluate the volumetric importance of magnetite and ilmenite as hosts for Au in igneous rocks and hydrothermal deposits it is necessary to quantify Au in FeTi oxide minerals. The use of secondary-ion mass spectrometry (SIMS) to analyse magnetite and ilmenite standards implanted with Au-197 is described. Measured detection limits obtained were 10 ppb Au in magnetite and 240 ppb Au in ilmenite. The method will contribute to improved exploration models for auriferous intrusion-related deposits, will help to refine mass-balance models for VMS formation and may contribute to evaluating the distribution of Au in a variety of hydrothermal deposit types., To evaluate the volumetric importance of magnetite and ilmenite as hosts for Au in igneous rocks and hydrothermal deposits it is necessary to quantify Au in FeTi oxide minerals. The use of secondary-ion mass spectrometry (SIMS) to analyse magnetite and ilmenite standards implanted with Au-197 is described. Measured detection limits obtained were 10 ppb Au in magnetite and 240 ppb Au in ilmenite. The method will contribute to improved exploration models for auriferous intrusion-related deposits, will help to refine mass-balance models for VMS formation and may contribute to evaluating the distribution of Au in a variety of hydrothermal deposit types.