Revisión de la literatura integradora acerca de intervenciones de la enfermería volcadas hacia el incremento del autocuidado entre pacientes con insuficiencia cardiaca

Objective: to analyze and summarize knowledge concerning critical components of interventions that have been proposed and implemented by nurses with the aim of optimizing self-care by heart failure patients.Methods: PubMed and CINAHL were the electronic databases used to search full peer-reviewed papers, presenting descriptions of nursing interventions directed to patients or to patients and their families and designed to optimize self-care. Forty-two studies were included in the final sample (n=4,799 patients).Results: this review pointed to a variety and complexity of nursing interventions. As self-care encompasses several behaviors, interventions targeted an average of 3.6 behaviors. Educational/counselling activities were combined or not with cognitive behavioral strategies, but only about half of the studies used a theoretical background to guide interventions. Clinical assessment and management were frequently associated with self-care interventions, which varied in number of sessions (1 to 30); length of follow-up (2 weeks to 12 months) and endpoints.Conclusions: these findings may be useful to inform nurses about further research in self-care interventions in order to propose the comparison of different modalities of intervention, the use of theoretical background and the establishment of endpoints to evaluate their effectiveness.Objetivo:analisar e sintetizar o conchecimento relacionado aos componentes críticos das intervençoes que têm, sido propostas e implementadas por enfermeiros(as) com objetivo de optimizar o auto-cuidado de pacientes portadores de insuficiência cardíaca.Método:PubMed e CINAHL foram as bases de dados electrônicas utilizadas para investigar artigos revisados por pares (peer review), apresentando as descrições das intervenções dirigidas ao paciente ou ao paciente e sua familia, visando melhorar o auto-cuidado. Foram incluídos 42 estudos na amostra final (n=4799 pacientes).Resultados:esta revisão apontou variedade e complexidade das intervenções de enfermagem. Como o auto-cuidado envolve diferentes comportamentos, as intervenções visaram em média 3,6 comportamentos. As Atividades de educação e aconselhamento foram combinadas ou não com estratégias cognitivo-comportamentais, mas somente a metade dos estudos utilizaram suporte teórico para guiar as intervenções. A avaliação e o manejo clínico foram frequentemente associados às intervenções de auto-cuidado, as quais variam em número de sessões (1 a 30), duração do seguimento (2 semanas a 12 meses) e desfechos.Conclusão:estes resultados podem ser úteis para guiar os enfermeiros no que se refere à futuros estudos sobre intervenções de auto-cuidado, de maneira a propor a comparação de diferentes modalidades de intervenção, uso de suporte teórico e estabelecimento de desfechos para melhor avaliar sua eficácia.Objetivo:analizar y sintetizar el conocimiento relacionado a componentes críticos de intervenciones que han sido propuestas e implementadas por enfermeros(as) con el objetivo de optimizar el autocuidado entre pacientes con insuficiencia cardiaca.Método:PUBMED y CINAHL han sido las bases de datos electrónicas usadas para investigar artículos revisados por pares (peer review), presentando descripciones de intervenciones destinadas a perfeccionar el autocuidado dirigido al paciente o al paciente y a su familia. Se incluyeron 42 estudios en la muestra final (n=4799 pacientes).Resultados:esta revisión apuntó a una variedad y complejidad de intervenciones de enfermería. Como el autocuidado abarca varios comportamientos, las intervenciones tuvieron como blanco, en media, 3,6 comportamientos. Actividades de educación/consejería fueron combinadas o no con estrategias cognitivo-comportamentales, pero tan solo cerca de la mitad de los estudios tenían aporte teórico para guiar intervenciones. La gestión y la evaluación clínica fueron frecuentemente asociadas a intervenciones de autocuidado, las cuales oscilaron en número de sesiones (1 a 30), duración del seguimiento (2 semanas a 12 meses) y objetivos.Conclusiones:estos resultados pueden ser útiles para informar a las enfermeras acerca de nuevas investigaciones en intervenciones de autocuidado, de modo a proponer la comparación de distintas modalidades de intervención, el uso de un aporte teórico y el establecimiento de objetivos para evaluar su eficacia

Contrasting Granite Metallogeny through the Zircon Record: A Case Study from Myanmar

Granitoid-hosted mineral deposits are major global sources of a number of economically important metals. The fundamental controls on magma metal fertility are tectonic setting, the nature of source rocks, and magma differentiation. A clearer understanding of these petrogenetic processes has been forged through the accessory mineral zircon, which has considerable potential in metallogenic studies. We present an integrated zircon isotope (U-Pb, Lu-Hf, O) and trace element dataset from the paired Cu-Au (copper) and Sn-W (tin) magmatic belts in Myanmar. Copper arc zircons have juvenile εHf (+7.6 to +11.5) and mantle-like δ18O (5.2–5.5‰), whereas tin belt zircons have low εHf (−7 to −13) and heavier δ18O (6.2–7.7‰). Variations in zircon Hf and U/Yb reaffirm that tin belt magmas contain greater crustal contributions than copper arc rocks. Links between whole-rock Rb/Sr and zircon Eu/Eu* highlight that the latter can monitor magma fractionation in these systems. Zircon Ce/Ce* and Eu/Eu* are sensitive to redox and fractionation respectively, and here are used to evaluate zircon sensitivity to the metallogenic affinity of their host rock. Critical contents of Sn in granitic magmas, which may be required for the development of economic tin deposits, are marked by zircon Eu/Eu* values of ca. ≤0.08

Multimillion year thermal history of a porphyry copper deposit: application of U–Pb, 40Ar/39Ar and (U–Th)/He chronometers, Bajo de la Alumbrera copper–gold deposit, Argentina

Application of multiple chronometers (including U–Pb and 40Ar/39Ar geochronology and zircon and apatite (U–Th)/He thermochronology) to porphyry intrusions at the Bajo de la Alumbrera porphyry copper–gold deposit, Argentina, reveals a complex history of reheating that spans millions of years. Previous U–Pb geochronology, combined with our new 40Ar/39Ar data, shows that the multiple porphyritic intrusions at Bajo de la Alumbrera were emplaced during two episodes, the first at about 8.0 Ma (P2 and associated porphyries) and the second about a million years later (Early and Late P3 porphyries). Complex overprinting alteration events have obscured the earliest hydrothermal history of the deposit. By contrast, 40Ar/39Ar data reveal the close temporal relationship of ore-bearing potassic alteration assemblages (7.12 ± 0.13 Ma; biotite) to the emplacement of the P3 intrusions. Consistent with low closure temperatures, younger ages have been determined for associated hydrothermal alkali feldspar (6.82 ± 0.05 Ma and 6.64 ± 0.09 Ma). The temperature-sensitive Ar data also record an unexpected prolonged cooling history (to below 200°C) extending to 5.9 Ma. Our data suggest that the Bajo de la Alumbrera system underwent protracted cooling, after the collapse of the main hydrothermal system, or that one or more low-temperature (~100–200°C) reheating events occurred after emplacement of the porphyritic intrusions at Bajo de la Alumbrera. These have been constrained in part by our new 40Ar/39Ar data (including multidomain diffusion modeling) and (U–Th)/He ages. Single-grain (U–Th)/He ages (n = 5) for phenocrystic zircon from P2 and P3 intrusive phases bracket these thermal events to between 6.9 (youngest crystallization of intrusion) and 5.1 Ma. Multidomain modeling of alkali feldspar data (from both igneous and hydrothermal crystals) is consistent with the deposit cooling rapidly from magmatic temperatures to below about 300°C, with a more protracted history down to 150°C. We conclude that the late-stage low-temperature (150 to 200°C) thermal anomaly localized at Bajo de la Alumbrera resulted from radiation of heat and/or fluids sourced from deeper-seated magma bodies, emplaced beneath the deposit. To produce the observed thermal longevity of the porphyry system, magma bodies underlying the Bajo de la Alumbrera deposit must have been repeatedly replenished by new magma batches. Without replenishment, crystallization of the source magma will occur, and heat release will stop, leading to rapid cooling (in less than ten thousand years). The influx of deep-seated magma may have caused the development of late low-temperature hydrothermal alteration assemblages at Bajo de la Alumbrera, at the same time that mineralization formed at Agua Rica, some 25 km away. All available chronologic data for the Bajo de la Alumbrera deposit suggest that the hydrothermal system was active episodically over at least a three-million and possibly up to a four-million-year period

Cl/Br ratios and stable chlorine isotope analysis\ud of magmatic–hydrothermal fluid inclusions from Butte,\ud Montana and Bingham Canyon, Utah

A bulk geochemical study has been carried out\ud on fluid inclusion leachates extracted from quartz veins\ud from porphyry Cu deposits in Butte, Montana, USA and\ud Bingham Canyon, Utah, USA. The leachates mostly represent\ud low-salinity magmatic–hydrothermal fluid inclusions.\ud Their halogen ratios (Br/Cl) of fluid inclusion leachates were\ud determined by ion chromatography, and δ37Cl values of the\ud leachates were measured by continuous-flow isotope ratio\ud mass spectrometry. Br/Cl ratios from early pre-Main stage\ud and later Main stage veins at Butte range from 0.60 to\ud 1.88×10−3M. Ratios are similar in pre-Main stage veins with\ud sericite bearing selvages and Main stage samples ranging\ud from 0.81 to 1.08×10−3 and from 0.92 to 1.88×10−3M,\ud respectively, clustering below seawater (1.54×10−3M) and\ud overlapping mantle values (~1–2×10−3M). Two samples\ud associated with early pre-Main stage potassic alteration yield\ud distinctly lower Br/Cl ratios of 0.60 and 0.64 × 10−3M. Butte\ud δ37Cl values range from −0.8‰ to −2.3‰ with no\ud significant difference between pre-Main stage and Main\ud stage samples. Br/Cl ratios for quartz veins from Bingham\ud Canyon range from 0.18 to 3.68×10−3M. Br/Cl ratios from\ud Bingham range above and below previously reported for\ud porphyry copper deposits. In contrast to Butte, δ37Cl values\ud for Bingham are lower, ranging from −0.9‰ to −4.1‰. In\ud the absence of any processes which can significantly\ud fractionate chlorine isotopes at high temperatures, we\ud suggest that the porphyry system at Bingham, and to a\ud lesser extent at Butte, have inherited negative chlorine\ud isotopic signatures from the subducting slab generated at\ud low temperatures