Conversion of School Nurse Policy and Procedure Manual to Electronic Format

Policy and procedure manuals are essential to establishing standards of practice and ensuring quality of care to students and families. The Olathe District Schools (Kansas) Technology Department created the Virtual File Cabinet to provide online access to employee policies, school board policies, forms, and other documents. A task force of school nurses was formed to convert the nursing department’s policies, procedures, protocols, and forms from hard copy to electronic format and make them available on the district’s Virtual File Cabinet. Having the policy and procedure manuals in electronic format allows for quick access and ease in updating information, thereby guaranteeing the school nurses have access to the most current information. Cost savings were realized by reducing the amount of paper and staff time needed to copy, collate, and assemble materials.

The rise of social work in public mental health through aftercare of people with serious mental illness

In the early years of the 20th century, social work's practice boundaries expanded to include direct work with people with the most serious mental illnesses through the function of aftercare. Using complementary and mutually reinforcing efforts to promote social reform in the care of people with mental illness and then to provide that care directly, the young social work profession established its presence in the emerging public mental health field and significantly broadened prevailing standards of acceptable care. This article presents a historical case analysis of the early events contributing to the identification of social work with aftercare and illustrates processes of creating professional "place" while influencing public perception of social needs relevant for the profession's continued growth and influence in the current reconfiguration of human services systems.

Prolactin induces expression of FGF-2 and a novel FGF-responsive NonO/p54nrb-related mRNA in rat lymphoma cells

The rat Nb2-11C lymphoma cell line expresses high affinity prolactin (PRL) receptors, and requires lactogenic hormones for survival and proliferation. We have applied differential display to identify genes which are differentially induced in Nb2-11C cells following PRL stimulation, or which are constitutively expressed in the PRL-independent Nb2-Sp cells. In the present study we characterized a clone (22c.2) which was expressed in Nb2-Sp cells, and in Nb2-11C cells given PRL for 3 h but not in untreated cells. The 279 bp cDNA had 95% homology with the 3' end of the murine 2.6 kb FGF-inducible gene 14 (FIN14). When clone 22c.2 was used to screen a Nb2-Sp cDNA library to obtain a longer cDNA, a unique 1039 bp clone PNR (Prolactin-responsive/ NonO-Related) was isolated, subcloned and sequenced. The deduced amino acid sequence encoded by the PNR open reading frame had significant homology with a family of RNA- and DNA-binding proteins which include the human polypyrimidine tract-binding protein (PTB)-associated splicing factor (PSF), the murine non-POU-domain-containing octamer-binding protein (NonO) and the human NonO homologue p54nrb. Nb2-11C cells expressed three PNR-related mRNA transcripts of 2.5, 3.0 and > 10 kb. Expression of the 2.5 and 3.0 kb transcripts were increased at least 4-fold within 3 h of PRL treatment. PNR expression was also significantly stimulated within 3 h by addition of FGF-2 to either Nb2-11C or Nb2-Sp cells, although alone FGF-2 was not mitogenic for either cell line. Reverse transcription-polymerase chain reaction (RT-PCR) confirmed the expression of both FGF-2 and FGF receptor mRNA in Nb2 cells. raising the possibility of an autocrine or paracrine function for FGF-2 in lymphoma cells. Furthermore, PRL rapidly stimulated the expression of FGF-2 mRNA in a time- and dose-dependent manner in both Nb2-11C and Nb2-Sp cells. FGF-2 expression was increased within 1 h and was maintained at a high level for at least 10 h following treatment with 2 ng/ml PRL. Western blotting with anti-FGF2 antisera demonstrated PRL stimulation of intracellular accumulation, but not secretion of immunoreactive FGF-2. The observation of PRL-responsive expression of FGF-2 in Nb2 cells suggests a previously unrecognized pathway for PRL action in lymphoid cells.

FGF-2 antisense RNA encodes a nuclear protein with MutT-like antimutator activity

Bidirectional transcription of the basic fibroblast growth factor (FGF-2) gene gives rise to multiple polyadenylated sense mRNAs and a unique 1.5 kb antisense transcript (FGF-AS) which is complementary to the 3'-untranslated region of the FGF-2 mRNA. The rat FGF-AS cDNA encodes a novel 35 kDa nuclear protein (GFG) with homology to the MutT family of antimutator NTPases. Antibodies against the deduced amino acid sequence of GFG detected intense immunoreactivity in the nuclei of adult rat hepatocytes. Subcellular fractionation and Western blotting confirmed the presence of a 35 kDa immunoreactive protein in the nuclear fraction and, to a lesser extent, in the mitochondrial fractions of rat liver homogenates. Recombinant GFG suppressed the spontaneous mutation rate of MutT-deficient E. coli in a complementation assay. In-frame deletion of the 53 amino acids encompassing the MutT domain eliminated this activity, confirming the catalytic function of this region in the FGF antisense gene product. These findings demonstrate for the first time that the FGF-AS transcript encodes a functional nuclear protein with MutT-related enzymatic activity.

Regulation of gene expression by natural antisense RNA transcripts

The use of synthetic antisense oligonucleotides as specific inhibitors of gene expression exploits the susceptibility of mRNA to functional blockade at several levels, including mRNA processing, transport, translation and degradation. It is becoming increasingly apparent that the actions of these synthetic oligomers are analogous to those of endogenous RNA molecules involved in the regulation of gene expression in both prokaryotes and eukaryotes. A growing number of eukaryotic genes are now thought to be regulated at least in part by natural antisense RNA transcribed from the presumptive non-coding DNA strand. This possibility is supported by the presence of a complex system of double-stranded (ds) RNA-specific proteins and dsRNA-induced signal transduction pathways in eukaryotic cells. The presence of functional open reading frames in a number of recognized natural antisense RNA transcripts indicates that, in addition to regulating gene function at the RNA level, the antisense strand of many genes may code for as yet unidentified proteins. In the present study we review the current literature on the role(s) played by natural antisense RNA in eukaryotic cells, with an emphasis on genes for which clear evidence of regulation, or potential regulation by natural antisense RNA is available.

Characterization and tissue-specific expression of the rat basic fibroblast growth factor antisense mRNA and protein

An RNA transcribed from the antisense strand of the FGF-2 gene has been implicated in the regulation of FGF-2 mRNA stability in amphibian oocytes. We have now cloned and characterized a novel 1. 1-kb mRNA (fgf-as) from neonatal rat liver. In non-central nervous system (CNS) tissues the fgf-as RNA is abundantly expressed in a developmentally regulated manner. The FGF-AS cDNA contains a consensus polyadenylylation signal and a long open reading frame (ORF) whose deduced amino acid sequence predicts a 35-kDa protein with homology to the MutT family of nucleotide hydrolases. Western blot analysis with antibodies against the deduced peptide sequence demonstrates that the FGF-AS protein is expressed in a broad range of non-CNS tissue in the postnatal period. In the developing brain, the abundance of sense and antisense transcripts are inversely related, suggesting a role for the antisense RNA in posttranscriptional regulation of FGF-2 expression in this tissue. The FGF-AS is complementary to two widely separated regions in the long 3' untranslated region of the FGF-2 mRNA, in the vicinity of the proximal and distal polyadenylylation sites. These findings demonstrate that the FGF-2 and fgf-as RNAs are coordinately transcribed on a tissue-specific and developmentally regulated basis and suggest that interaction of the sense and antisense RNAs may result in posttranscriptional regulation of FGF-2 in some tissues.

Decline in basic fibroblast growth factor (FGF-2) mRNA expression in female rat hypothalamus at puberty

There is a growing acceptance of the importance of hypothalamic growth factors in the control of sexual maturation. Basic fibroblast growth factor (bFGF, FGF-2), a potent mitogen and neurotropic factor for brain cells in vitro, including hypothalamic cells, is widely expressed in the post-natal CNS but its physiological functions there are largely unknown. Previously, studies of FGF-2 mRNA regulation in vivo have been hampered by the low levels of FGF-2 mRNA present in post-natal tissues. We have applied a sensitive semi-quantitative procedure based on reverse transcription followed by polymerase chain reaction amplification (RT-PCR) to detect and estimate relative amounts of mRNAs encoding FGF-2 and its receptor in the hypothalamic-hypophyseal axis in individual female rats undergoing sexual maturation. FGF receptor and FGF-2 mRNAs were detectable in all brain regions examined. Injections of the glutamate agonist N-methyl-D-aspartic acid (NMDA) or pregnant mare's serum gonadotropin (PMSG) were used to advance the onset of puberty in immature female rats, and the levels of FGF-2 and FGF receptor mRNA in MBH and cortex were examined. Daily injections of NMDA (20 mg/kg) from day 24-28 resulted in advancement of first ovulation and vaginal opening (VO) in 5 of 9 treated rats. None (0/4) of the saline treated controls achieved first ovulation during the course of the experiment. Expression of FGF-2 mRNA in the medial-basal hypothalamus of the NMDA-treated VO animals, but not nonVO animals, was significantly (P<0.05) reduced by 50% vs saline-treated nonVO controls. There was no effect of NMDA on FGF-2 expression in cerebral cortex of VO Vs nonVO animals. FGF receptor mRNA levels were unaffected by NMDA treatment. To assess the possibility that the decline in hypothalamic FGF-2 mRNA levels was related to puberty and not just to an effect of NMDA, pregnant mare's serum gonadotropin was used to induce first ovulation and vaginal opening. Injection of PMSG to immature female rats on day 26 resulted in precocious first ovulation on day 29. This was accompanied by a significant 40% reduction in the steady-state level of FGF-2 mRNA in the medial basal hypothalamus compared to saline treated controls. As with NMDA treatment, PMSG did not affect FGF-2 mRNA abundance in the cortex, nor the FGF receptor mRNA in MBH or cortex. Immunohistochemical detection of FGF-2 protein in the arcuate nucleus revealed that FGF-2 immunoreactivity was also significantly modified in peri-ovulatory NMDA-treated animals. FGF-2 immunoreactivity in NMDA treated rats was significantly elevated at day 29 (the day of ovulation), but significantly inhibited by day 33. These findings suggest that alterations in the level of FGF-2 mRNA in the hypothalamus may be associated with first ovulation and the onset of sexual maturation in the female rat.

Non-Hodgkin's lymphoma of the central nervous system after treatment of Hodgkin's disease

A case of a 34-year-old man with stage IIIB nodular sclerosis Hodgkin's disease complicated by the development of a central nervous system non-Hodgkin's lymphoma is described. The second tumor became symptomatic eight months after the initial diagnosis of Hodgkin's disease, but a tissue diagnosis was not made until autopsy two months later. The Hodgkin's disease was, at that time, in remission, and the autopsy revealed no persistent or recurrent Hodgkin's disease. Despite radiotherapy, the brain lymphoma had progressed to involve the spinal leptomeninges extensively, but there was no lymphoma outside the central nervous system (CNS) at autopsy. The significance of this unique case is discussed in light of the known risk for non-Hodgkin's lymphoma as a second malignancy after Hodgkin's disease and in view of recent information concerning CNS lymphoma.

Concomitant boost radiotherapy for advanced squamous cell carcinoma of the head and neck

The concomitant boost technique is a variant of accelerated fractionation whereby the boost is delivered as a second daily fraction during the basic treatment course to reduce the total duration of treatment. From April 1972 through June 1983, 53 patients with advanced squamous cell carcinoma of various sites in the head and neck region were treated for cure at U.T. M. D. Anderson Hospital with this technique. In 12 patients, the concomitant boost was used because of rapid recurrence following surgical resection either before or after initiation of planned postoperative radiotherapy; the remaining patients had rapidly growing untreated or recurrent disease in the primary site, neck, or both. In most cases, the concomitant boost was delivered in fractions of 120-150 cGy, separated by 3-6 h from the basic daily treatment of 180-200 cGy. The boost treatments were given 2-3 times a week for 3-5 weeks, delivering an average of about 17 Gy in 12 fractions. Two different treatment techniques were used. Patients with predominantly neck disease (30) were treated with glancing AP and PA fields or with appositional electron beam portals to spare the mucous membranes, while those with advanced or rapidly progressive primary lesions, with or without nodal disease (23), received their concomitant boost through lateral photon or high energy electron beams to include the primary tumor site. As expected, the acute mucosal reactions were most severe in the latter group, but only three patients required interruption of treatment because of severe mucositis.(ABSTRACT TRUNCATED AT 250 WORDS)