The turkey transcription factor Pit-1/GHF-1 can activate the turkey prolactin and growth hormone gene promoters in vitro but is not detectable in lactotrophs in vivo.

The transcription factor Pit-1/GHF-1 plays an important role in regulating the prolactin (Prl) and growth hormone (GH) genes in mammals. In this study, the role that Pit-1 plays in regulating the prolactin and growth hormone genes in avian species was examined by cotransfection assays and immunofluorescence staining of pituitary sections. In cotransfection assays, turkey Pit-1 activated the turkey Prl, turkey GH, and rat Prl promoters 3.8-, 3.7-, and 12.5-fold, respectively. This activation was comparable to rat Pit-1 activation of these same promoters. A point mutation in the turkey Pit-1 cDNA, which changed leu-219 to ser-219, resulted in a 2-, 2-, and 10-fold reduction in the activation of the turkey Prl, turkey GH, and rat Prl promoters, respectively. Unexpectedly, coexpression of tPit-1 (leu-219) and tPit-1(ser-219) activated turkey Prl and rat Prl promoters 9.4- and 35.9-fold, respectively, but had no effect on the turkey GH promoter. Dual-label immunofluorescence analysis of turkey pituitary sections revealed that Pit-1 was not detectable in prolactin-staining cells but was detectable in GH-staining cells. Taken together, these data indicate that in the domestic turkey, Pit-1 can activate the turkey Prl promoter in vitro, but does not appear to play a role in regulating Prl gene expression in vivo. Pit-1, however, still likely plays a role in regulating GH gene expression.

Synthesis of turkey Pit-1 mRNA variants by alternative splicing and transcription initiation.

The gene encoding turkey Pit-1/GHF-1 (tPit-1) spans approximately 12 kilobases (kb) and consists of 7 exons. One exon, which is located between exons 2 and 3, is designated exon 2a and codes for 38 amino acids not found in mammalian Pit-1. Because all tPit-1 variants contain exon 2a, they are denoted with an asterisk (*) to distinguish them from comparable mammalian Pit-1s. Three tPit-1 variants are generated by alternative splicing and transcription initiation. Splicing of exon 1 to an alternative acceptor splice site in exon 2 results in a 28 amino acid insertion in tPit-1beta* relative to tPit-1*. A transcript unique to the turkey has been identified by RT-PCR and RNase mapping. This transcript, designated tPit-1W*, arises following transcription initiation upstream of the alternative acceptor splice site in exon 2. In turkey pituitary, the mRNA for the tPit-1* variant is the most abundant, the tPit-1W* variant is intermediate, and the tPit-1beta* variant is the least abundant.

Computerization of a nursing financial management system using continuous quality improvement as a framework.

The Nursing Financial Management System, developed by the Department of Nursing Administrative Services (DNAS), depended on a manual data-retrieval and report process to integrate patient acuity, nursing resource, and hospital financial data. Manual processes proved to be extremely labor-intensive and cost inefficient. Approximately 52% of DNAS resources, totaling $45,542 annually, were dedicated to data re-entry functions and report generation. Additionally, time required to produce manual reports created a service gap in that delays caused inefficient management of nursing resources at the unit level. The DNAS used a continuous quality improvement framework to improve data management by automating data retrieval and report generation. Computerization increased department staff productivity with subsequent labor cost savings/avoidance. After computerization, the report process consumed 6% of department labor resources compared with 52% using the manual process. Redistribution of DNAS resources prevented hiring additional staff to manage expanding workload. Finally, timely reporting to unit management resulted in significant reduction in hospital costs, because nursing resource use was matched with patient care demands.

Reusable laparoscopic instrument systems: an analysis of quality and cost issues.

This report is the first in a multihospital study designed to examine quality and cost variables associated wih reusable laparoscopic cholecystectomy instrument systems and the economic impacts of instrument reuse practices in hospitals.

Diabetes education on wheels.

Diabetes education programs remain underdeveloped in the pediatric setting, resulting in increased consumer complaints and financial liability for hospitals. The Diabetes Education on Wheels program was designed to provide comprehensive, outcome-oriented education for patients with juvenile diabetes. The primary goal of the program was to enhance patients' and family members' ability to achieve self-care in the home setting. The program facilitated sequential learning, improved consumer satisfaction, and promoted financial viability for the hospital.

Cost-effective resuscitation education.

Resuscitation education, offered by the American Heart Association, recently has expanded to include three pediatric courses. Nurse educators face internal and external constraints as they attempt to secure funding for these new programs. The Pediatric Resuscitation Course described in this article offers an innovative approach to programming and facilitates funding through the use of an integrated curriculum teaching format. This format reduces program cost without sacrificing valuable resuscitation education.

Needle stick injury in pediatric hospitals.

PURPOSE: To describe the type and source of employee needle stick injuries. METHODOLOGY: A retrospective survey of documents related to 42 needle stick injuries over a 6-month period. RESULTS: Nurses experienced the greatest number of sticks. The injuries occurred most frequently at the bedside and were most often associated with IV/parenteral therapy. CONCLUSION: Needle sticks were peripheral to the problem of product design.

Containerized vegetable gardening for homebound patients.

The containerized vegetable gardening project for homebound patients is a joint project of the Alabama Cooperative Extension Service and Home Health Care Agency of North Alabama. Patients who could benefit by having a container vegetable garden are identified by home health nurses. Volunteers recruited by the Extension Service help set up the gardens and visit patients. Through this project patients receive fresh produce, as well as an increased sense of self-worth.

Using sign language with tracheotomized infants and children.

Children's ability to communicate with others is important for cognitive development. However, the number of infants and young children deprived of vocalization (aphonia) is increasing in the pediatric patient population due to tracheotomy. The Communication Program for Infants and Parents (CPIP) uses sign language as an alternative system to verbal communication.