AN ASSESSMENT OF KNOWLEDGE AND ATTITUDES OF GENETIC COUNSELING SERVICES IN U.S. HTCs

Hemophilia is a hereditary bleeding disorder which requires lifelong specialized care. A network of Hemophilia Treatment Centers (HTCs) exists to meet the medical needs of patients affected by hemophilia. Genetic counseling services are an integral part of the HTC model of care; however, many HTCs do not have genetic counselors on staff. As a result, the duty to provide these services must fall to other healthcare providers within the HTC. To assess the knowledge and attitudes of these providers we developed a 49 question survey that was distributed electronically to hematologists and nurses at U.S. HTCs. The survey consisted of a three sections: demographic information, knowledge of hemophilia genetics, and attitudes towards genetic services. A total of 111 complete responses were received and analyzed. The average knowledge score among all participants was 74.8% with a total of 81 participants receiving a passing score of 70% or above. Thirty participants scored below 70% in the knowledge section. In general, attitude scores were high indicating that the majority of hematologists and nurses in HTCs feel confident in their ability to provide genetic counseling services. Over 90% of participants reported that they have some form of access to genetic counseling services at their center. Hematologists and nurses practicing in U.S. HTCs demonstrate sufficient knowledge of the genetics of hemophilia, and they generally feel confident in their ability to provide genetic counseling services to their patients. While their knowledge is sufficient, the average knowledge score was lower than 75%. Certain questions covering new genetic technologies and testing practices were more commonly missed than questions asking about more basic aspects of hemophilia genetics, such as inheritance and carrier testing. Finally, many clinics report having access to a counselor, but it is oftentimes a hematologist or nurse who is providing genetic counseling services to patients. Given the inconsistency in knowledge among providers coupled with the high confidence in one’s ability to counsel patients, it leaves room to question whether information about the genetics of hemophilia is being communicated to patients in the most appropriate and accurate manner.

Major element concentrations in spinel, olivine and pyroxene from peridotites of ODP Hole 210-1277 of the Newfoundland margin

Serpentinized spinel peridotites of the Newfoundland margin drilled during ODP Leg 210 at Site 1277 have preserved, relic mineral compositions similar to the most depleted abyssal peridotites worldwide and different from those of the conjugate Iberian margin. The samples are derived from mass flows containing clasts of peridotite and gabbro and from in-situ basement, and are mostly mylonitic cpx-poor spinel harzburgites with Cr-rich spinels (Cr#0.35-0.66). Melting of the Newfoundland mantle occurred in the spinel peridotite field and probably exceeded the cpx-out phase boundary for some samples. Using proposed spinel peridotite melting models and experimentally derived phase diagrams, the Newfoundland harzburgites can be modeled as a residue after extraction of 14 to 20-25% melting. Basalts that are interleaved with mass flow deposits on top of the peridotite basement resemble normal to transitional mid-ocean ridge basalt. This, together with the unusually high Cr# of some spinel harzburgites suggest that the formation of basalts and partial melting of the underlying peridotite are not cogenetic. Among mantle samples some of the Newfoundland harzburgites approach mineral compositions of the Bay of island ophiolite and ophiolites from Japan that represent peridotites formed in an arc-setting. Thus, the peridotites drilled at Site 1277 may represent inherited (Caledonian or older) subarc mantle that was exhumed close to the ocean floor during the rifting evolution of the Atlantic. Compared to the spinel harzburgites from Newfoundland, the peridotites from the conjugate Iberian margin are, on average, less depleted and provide evidence for local equilibration in the plagioclase stability field. This can either be explained by an inherited, primary, Ca-richer composition of the Iberia peridotite, or, alternatively, by local melt impregnation and stagnation during continental rifting, and thus refertilizing previously depleted (arc-related) peridotite.

MARECHIARA-mesozooplankton long-term time-series at the fixed coastal station in the Gulf of Naples: abundance and biomass, data for the years 1984-2006

The MARECHIARA-mesozooplankton dataset contains mesozooplankton data collected in the ongoing time-series at Sation MC (40°48.5' N, 14°15' E) in the Gulf of Naples. This dataset spans over the period 1984-2006 and contains data of mesozooplankton abundance and species composition as well as biomass (as dry weight). Mesozooplankton was regularly sampled in 1984-1990 and 1995-2006, only a few samples were collected in 1991-1992 and no samples in 1993-1994. During the first period of the series sampling frequency was fortnightly, and weekly since 1995.

Texture description and distribution of components in ODP Hole 103-639D (Figure 2)

A detailed analysis of the texture, matrix, and elements of the microfacies from the carbonate sequence recovered in ODP Hole 639D resulted in a typological classification of 10 major microfacies types and their variants. The variations in distribution and succession of type microfacies allowed us to divide the carbonate sequence into 12 facies-defined subunits. Based on the analyzed characteristics and their relations, we also propose a paleoenvironmental interpretation involving a mixed carbonate/terrigenous ramp model instead of the previous, classical zoned carbonate platform.

Chemistry and mineralogy of ODP Leg 124 sediment samples

From X-ray mineralogical studies and chemical analyses of the whole rocks and the fine fractions (<2 µm) of ten to fifteen samples at each site of ODP Leg 124, two major sources were identified in the sedimentary components of the Celebes and Sulu basins: (1) a terrestrial and continental contribution; (2) a volcanic influx that gives way to well-defined volcanic units or to a dilute contamination, consisting of coarse-grained minerals (Plagioclase, pyroxene, olivine, spinel) or a smectitic-rich fraction produced by the alteration of volcanic glasses and ashes. The continental signature increases the amount of quartz in the rocks and the phyllitic association is complex: micas, kaolinite, disordered interstratified clay-minerals. The chemical compositions of the bulk rocks and the fractions <2 µm are more potassic and aluminum-rich. The volcanic imprint depends on the grain-size and chemical properties of the components. Ca/Na contents highly variable compared to the K content of the bulk composition are due to the presence of coarse-grained volcanic Plagioclase. The fractions <2 µm are more magnesian than in the continental regime. The diagenesis is revealed by the crystallization of zeolites, the fixation of magnesium into the smectites that depletes the pore fluids in this element. Smectitization of the disordered interstratified clay minerals enriches the alkalinity of the pore fluids. Some deep formations of the Sulu Basin are affected by a thermal event, but no thermal event was recognized in the Celebes Basin.

Mineralogy and geochemistry of sedimentary deposits at DSDP Leg 55 Holes

The four holes (including a re-entry hole) drilled at Site 433 allow determination of the sedimentary sequence of Suiko Seamount in the Emperor chain. The holes are in a small graben basin situated within a lateral lagoon on the seamount. The sedimentary deposits range from the Paleocene to the upper Pliocene and are not uniform and continuous. A major hiatus exists at the top of the lower Eocene reef sediment, below the lower and upper Miocene pelagic sediments. The depositional history and succession of environments are shown by mineralogical and geochemical changes in the sediments.

Docket books and fee book, 1791-1806

Consists of 7 notebooks and 1 account book. Notebooks list cases heard before the Massachusetts Court of Common Pleas for Middlesex and Worcester counties and the Massachusetts Supreme Judicial Court (March 1794-Sept. 1797; Sept. 1800-March 1802; June 1805-September 1806) and before the New Hampshire Court of Common Pleas for Hillsborough and Merrimack counties (March 1798-March 1805). The account book includes cases from Sept. 1791-July 1797.

Notes on cases in Lennox and Worcester, 1789

Contains notes on cases before the Supreme Court in Lennox and Worcester, Massachusetts relating to counterfeiting, libel, and fraud.

Notes on cases in Boston and Springfield, 1790-1793

Notes by unknown author on cases of land rights, debt, and theft.

Notes on cases in Plymouth, Barnstable and Duke Counties, 1785

Includes notes on cases of property law, and assault and battery.

Deed of sale of property, Hingham, Massachusetts, 1686

Deed acknowledging Sprague's sale of land in Hingham to Israel Fering. Signed by Sprague, Nathaniel Beale, Sr., and John Parsens, Jr.