A survey of the professional program for teacher training in nursery school education in twenty-nine post-secondary institutions

Thesis (M.A.)--Boston University, 1949. This item was digitized by the Internet Archive

Can screening for genetic markers improve peripheral artery bypass patency?

AbstractObjective: Three genetic mutations have been associated with an increased risk of thromboembolic events: factor V Leiden R506Q, prothrombin G20210A, and methylenetetrahydrofolate reductase C677T (MTHFR) mutations. The aim of this study was to determine the effect of these mutations on patency of peripheral bypass procedures and preoperative and postoperative thromboembolic events. Methods: Two hundred forty-four randomly selected volunteers participating in the Veterans Affairs Cooperative Study #362 were tested for factor V Leiden, prothrombin, or MTHFR mutations with polymerase chain reaction. Patients enrolled in the study were randomized to receive aspirin therapy or aspirin and warfarin therapy after a peripheral bypass procedure. The frequencies of preoperative and postoperative thromboembolic events and primary patency (PP), assisted primary patency (APP), and secondary patency (SP) rates were compared among carriers of the various mutations. Results: Fourteen patients (5.7%) were heterozygous for the factor V Leiden mutation, seven (2.9%) were heterozygous for the prothrombin mutation, and 108 (44.6%) were heterozygous and 15 (6.2%) homozygous for the MTHFR mutation. After surgery, patients homozygous for the MTHFR gene mutation had increased graft thrombosis, compared with patients who were heterozygous (33.3% versus 11.1%; P = .01), and lower PP, APP and SP rates (P < .05). Furthermore, patients heterozygous for the MTHFR mutation had fewer graft thromboses (11.1% versus 24.4%; P = .01), fewer below-knee amputations (0.9% versus 7.6%; P = .02), and higher PP, APP, and SP rates (PP, 79.6%; APP, 88.9%; SP, 90.7%; P < .05) compared with wild-type control subjects (PP, 63%; APP, 75.6%; SP, 76.5%; P < .05). Conclusion: Patients with either factor V Leiden or prothrombin mutations were not at an increased risk for postoperative graft occlusion or thromboembolic events. Patients heterozygous for MTHFR mutation had a lower risk of graft thrombosis and higher graft patency rates compared with both homozygous and wild-type control subjects. Patients homozygous for the MTHFR mutation had lower graft patency rates compared with patients who were heterozygous, and a trend was seen toward lower patency rates compared with wild-type control subjects. Therefore, screening for the MTHFR gene mutation before surgery may identify patients at an increased risk of graft thrombosis. (J Vasc Surg 2002;36:1198-206.

Process and impact of dialectical behaviour therapy: a systematic review of perceptions of clients with a diagnosis of borderline personality disorder

Purpose: To identify, appraise and synthesise findings from qualitative studies of individuals diagnosed with Borderline Personality Disorder who have experienced Dialectical Behaviour Therapy, to gain further understanding of their perceptions of the process and impact of therapy. Methods: We conducted a comprehensive systematic search of the literature from several online databases, and appraised them using an adapted version of the Critical Appraisal Skills Programme tool. A meta-ethnographic approach was used to synthesise the data. Results: Seven studies met the criteria to be included and their quality subsequently appraised. Four main themes were identified through the synthesis process: Life before DBT; the relationships that support change; developing self-efficacy; a shift in perspectives. Conclusions: The findings of the synthesis highlight the importance of a number of key factors in the process of DBT, and the impact that the therapy has both on day to day life and on individuals’ identity