Geological evolution of the Neoproterozoic Bemarivo Belt, northern Madagascar

The broadly east-west trending, Late Neoproterozoic Bemarivo Belt in northern Madagascar has been re-surveyed at 1: 100 000 scale as part of a large multi-disciplinary World Bank-sponsored project. The work included acquisition of fourteen U-Pb zircon dates and whole-rock major and trace element geochemical data of representative rocks. The belt has previously been modelled as a juvenile Neoproterozoic arc and our findings broadly support that model. The integrated datasets indicate that the Bemarivo Belt is separated by a major ductile shear zone into northern and southern “terranes”, each with different lithostratigraphy and ages. However, both formed as Neoproterozoic arc/marginal basin assemblages that were translated southwards over the north-south trending domains of “cratonic” Madagascar, during the main collisional phase of the East African Orogeny at ca. 540 Ma. The older, southern terrane consists of a sequence of high-grade paragneisses (Sahantaha Group), which were derived from a Palaeoproterozoic source and formed a marginal sequence to the Archaean cratons to the south. These rocks are intruded by an extensive suite of arc-generated metamorphosed plutonic rocks, known as the Antsirabe Nord Suite. Four samples from this suite yielded U-Pb SHRIMP ages at ca. 750 Ma. The northern terrane consists of three groups of metamorphosed supracrustal rocks, including a possible Archaean sequence (Betsiaka Group: maximum depositional age approximately 2477 Ma) and two volcano-sedimentary sequences (high grade Milanoa Group: maximum depositional age approximately 750 Ma; low grade Daraina Group: extrusive age = 720 to 740 Ma). These supracrustal rocks are intruded by another suite of arc-generated metamorphosed plutonic rocks, known as the Manambato Suite, 4 samples of which gave U-Pb SHRIMP ages between 705 to 718 Ma. Whole-rock geochemical data confirm the calc-alkaline, arc-related nature of the plutonic rocks. The volcanic rocks of the Daraina and Milanoa groups also show characteristics of arc-related magmatism, but include both calc-alkaline and tholeiitic compositions. It is not certain when the two Bemarivo terranes were juxtaposed, but ages from metamorphic rims on zircon suggest that both the northern and southern terranes were accreted to the northern cratonic margin of Madagascar at about 540 to 530 Ma. Terrane accretion included the assembly of the Archaean Antongil and Antananarivo cratons and the high-grade Neoproterozoic Anaboriana Belt. Late- to post tectonic granitoids of the Maevarano Suite, the youngest plutons of which gave ca. 520 Ma ages, intrude all terranes in northern Madagascar showing that terrane accretion was completed by this time

Systematic care for caregivers of people with dementia in the ambulatory mental health service: designing a multicentre, cluster, randomized, controlled trial

Contains fulltext : 81435.pdf (publisher's version ) (Open Access)BACKGROUND: Care for people with dementia and their informal caregivers is a challenging aim in healthcare. There is an urgent need for cost-effective support programs that prevent informal caregivers of people with dementia from becoming overburdened, which might result in a delay or decrease of patient institutionalization. For this reason, we have developed the Systematic Care Program for Dementia (SCPD). The SCPD consists of an assessment of caregiver's sense of competence and suggestions on how to deal with competence deficiencies. The efficiency of the SCPD will be evaluated in our study. METHODS AND DESIGN: In our ongoing, cluster, randomized, single-blind, controlled trial, the participants in six mental health services in four regions of the Netherlands have been randomized per service. Professionals of the ambulatory mental health services (psychologists and social psychiatric nurses) have been randomly allocated to either the intervention group or the control group. The study population consists of community-dwelling people with dementia and their informal caregivers (patient-caregiver dyads) coming into the health service. The dyads have been clustered to the professionals. The primary outcome measure is the patient's admission to a nursing home or home for the elderly at 12 months of follow-up. This measure is the most important variable for estimating cost differences between the intervention group and the control group. The secondary outcome measure is the quality of the patient's and caregiver's lives. DISCUSSION: A novelty in the SCPD is the pro-active and systematic approach. The focus on the caregiver's sense of competence is relevant to economical healthcare, since this sense of competence is an important determinant of delay of institutionalization of people with dementia. The SCPD might be able to facilitate this with a relatively small cost investment for caregivers' support, which could result in a major decrease in costs in the management of dementia. Implementation on a national level will be started if the SCPD proves to be efficient. TRIAL REGISTRATION: NCT00147693