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School nurses may be underestimating the power of their documentation to advance the visibility of their work and the needs of the students they serve. The first step toward unlocking the value of their documentation is recognizing the role that quality documentation plays in advancing these goals. The purpose of this article is to demonstrate the utility of the nursing process for improving the quality of documentation and provide examples of how to use nursing documentation formats.The National Association of School Nurses developed the Framework for 21st Century School Nursing Practice™ (Framework) to guide school nursing practice and help school nurses articulate their role to educators. Since its introduction, the Framework has been accepted and adopted by many. At the same time, several misunderstandings and misinterpretations of the Framework have come to light. The purpose of this article is to clarify the terminology in order to create a common understanding among practicing school nurses to be able to implement the Framework more fully and with integrity.Background A human-milk-based diet is the best option for nutritional therapy for preterm and/or sick newborns. Research aim The study aims were to restructure the reimbursement rates to hospitals in Poland for infants' tube feedings to favor the use of donor human milk over formula for newborns who required supplementation of expressed mother's milk and evaluate the results of the financing change during the first year of implementation (2018). Methods Financial data from hospitals were collected (2015-2016) by the Human Milk Bank Foundation using a data sheet designed by the Agency for Health Technology Assessment and Tariff System. We used data to restructure the reimbursement rates to hospitals for infants' tube feedings and implemented the changes in late 2017. The National Health Fund was requested to share reported data in 2018 concerning tube feeding services. Results More than half (61%) of NICUs introduced human milk tube feeding for newborns. It was provided to participants (N = 5,530), most frequently to seriously ill preterm infants (66.6%). Of these infants, 2,323 were fed donor human milk. Only 1,925 newborns received formula tube feeding. However, there were large differences in frequency of services reported among various parts of the country. Conclusions Based on our knowledge, Poland is the only European country where the reimbursement cost for human-milk-based nutritional therapy has been implemented in a manner intended to increase the quality of health care services for preterm newborns. Equal reimbursement for expressed mother's milk and donor milk did not appear to cause overuse of donor milk based on our analysis of the 2018 data.Models of positive youth development suggest that athletes may be influenced by parent education programmes; however, there is little research examining the impact of such programmes on athlete outcomes. This study examined the impact of the Respect in Sport Parent Program on athlete outcomes among minor hockey players over three years. This study consisted of cross-sectional and longitudinal online surveys measuring athletes' positive and negative developmental experiences, prosocial and antisocial behaviours, parental support and pressure, and sport enjoyment and commitment. Athletes completed at least one online survey during the study period (N = 366; 84.2% males; 14-19 years of age; M = 15.4 years), and 83 athletes completed multiple surveys for longitudinal analyses. Cross-sectional results comparing athletes in leagues adopting the programme at different time points indicated significant differences in prosocial behaviours towards teammates. Multilevel longitudinal analyses revealed improvements in athletes' antisocial behaviours towards opponents, initiative, goal setting, and cognitive skills over time, regardless of whether they were in a league that implemented the programme. However, athletes in leagues that implemented the programme during the study reported greater improvements in antisocial behaviours towards opponents, and there were trends with respect to improved personal and social skills. These findings provide suggestions to improve the delivery and impact of parent education programmes in youth sport.Social identity (i.e., the strength with which individuals identify with a group) is a key mechanism through which youth sport participants derive developmental benefits. However, despite the importance of one's social identity in promoting these benefits, our understanding of the correlates of social identity within the sport context is limited by the absence of evidence. To address this gap, this study investigated the relations between perceived social support from coaches, family, and friends and social identification. Method Male adolescent athletes (N = 344) completed measures of social support and social identity as part of a cross-sectional design. Latent profile analysis was used to identify distinct social support profiles. Results Four latent profiles were identified higher support, average support, diminished support, and lower support. ANCOVA results indicated that profile membership corresponded to significant differences in social identity perceptions, p less then .001, partial η2 = .26. Participants in the higher social support profile perceived significantly higher social identity when compared with profiles of average, diminished, and lower support (ps less then .05, Cohen's d ≥.67). Conclusion Results highlight the association between support from different social agents and social identity in youth sport. Better understanding the correlates of social identity may be critical in enhancing the developmental benefits of participation in organized team sports given the relationship with social identity.Satellite cells (SCs), the resident adult stem cells of skeletal muscle, are required for tissue repair throughout life. While many signaling pathways are known to control SC self-renewal, less is known about the mechanisms underlying the spatiotemporal control of self-renewal during skeletal muscle repair. Here, we measured biomechanical changes that accompany skeletal muscle regeneration and determined the implications on SC fate. Using atomic force microscopy, we quantified a 2.9-fold stiffening of the SC niche at time-points associated with planar-oriented symmetric self-renewal divisions. Immunohistochemical analysis confirms increased extracellular matrix deposition within the basal lamina. To test whether three-dimensional (3D) niche stiffness can alter SC behavior or fate, we embedded isolated SC-associated muscle fibers within biochemically inert agarose gels tuned to mimic native tissue stiffness. Time-lapse microscopy revealed that a stiff 3D niche significantly increased the proportion of planar-oriented divisions, without effecting SC viability, fibronectin deposition, or fate change. We then found that 3D niche stiffness synergizes with WNT7a, a biomolecule shown to control SC symmetric self-renewal divisions via the non-canonical WNT/planar cell polarity pathway, to modify stem cell pool expansion. Our results provide new insights into the role of 3D niche biomechanics in regulating SC fate choice. [Media see text] [Media see text].The human Ska complex (Ska) localizing to both spindle microtubules and kinetochores is essential for proper chromosome segregation during mitosis. Although several mechanisms have been proposed to explain how Ska is recruited to kinetochores, it is still not fully understood. By analyzing Ska3 phosphorylation, we identified six critical Cdk1 sites, including the previously identified Thr358 and Thr360. click here Mutations of these sites to phospho-deficient alanine (6A) in cells completely abolished Ska3 localization to kinetochores and Ska functions in chromosome segregation. In vitro, Cdk1 phosphorylation on Ska complexes enhanced WT, not phospho-deficient 6A, binding to Ndc80C. Strikingly, the phosphomimetic Ska 6D complex formed a stable macro-complex with Ndc80C, but Ska WT failed to do so. These results suggest that multisite Cdk1 phosphorylation-enabled Ska-Ndc80 binding is decisive for Ska localization to kinetochores and its functions. Moreover, we found that Ska decrease at kinetochores triggered by the microtubule-depolymerizing drug nocodazole is independent of Aurora B but can be overridden by Ska3 overexpression, suggestive of a role of spindle microtubules in promoting Ska kinetochore recruitment. Thus, based on the current and previous results, we propose that multisite Cdk1 phosphorylation is critical for the formation of Ska-Ndc80 macro-complexes that are essential for chromosome segregation.Myeloid differentiation protein 1 (MD1) is exerted an anti-arrhythmic effect in obese mice. Therefore, we sought to clarify whether MD1 can alter the electrophysiological remodeling of cardiac myocytes from obese mice by regulating voltage-gated potassium current and calcium current. MD1 knock-out (KO) and wild type (WT) mice were given a high-fat diet (HFD) for 20 weeks, starting at the age of 6 weeks. The potential electrophysiological mechanisms were estimated by whole-cell patch-clamp and molecular analysis. After 20-week HFD feeding, action potential duration (APD) from left ventricular myocytes of MD1-KO mice revealed APD20, APD50, and APD90 were profoundly enlarged. Furthermore, HFD mice showed a decrease in the fast transient outward potassium currents (Ito,f), slowly inactivating potassium current (IK, slow), and inward rectifier potassium current (IK1). Besides, HFD-fed mice showed that the current density of ICaL was significantly lower, and the haft inactivation voltage was markedly shifted right. These HFD induced above adverse effects were further exacerbated in KO mice. The mRNA expression of potassium ion channels (Kv4.2, Kv4.3, Kv2.1, Kv1.5, and Kir2.1) and calcium ion channel (Cav1.2) was markedly decreased in MD1-KO HFD-fed mice. MD1 deletion led to down-regulated potassium currents and slowed inactivation of L-type calcium channel in an obese mice model.Background Informal carers are essential in enabling discharge home from hospital at end of life and supporting palliative patients at home, but are often ill-prepared for the role. Carers' support needs are rarely considered at discharge. If carers are less able to cope with home care, patient care may suffer and readmission may become more likely. Aim To investigate the implementation of an evidence-based Carer Support Needs Assessment Tool (CSNAT) intervention to support carers during hospital discharge at end of life. Design Longitudinal qualitative study with thematic analysis. Setting/participants One National Health Service Trust in England 12 hospital practitioners, one hospital administrator and four community practitioners. We provided training in CSNAT intervention use and implementation. Practitioners delivered the intervention for 6 months. Data collection was conducted in three phases (1) pre-implementation interviews exploring understandings, anticipated benefits and challenges of the intervention; (2) observations of team meetings and review of intervention procedures and (3) follow-up interviews exploring experiences of working with the intervention. Results Despite efforts from practitioners, implementation was challenging. Three main themes captured facilitators and barriers to implementation (1) structure and focus within carer support; (2) the 'right' people to implement the intervention and (3) practical implementation challenges. Conclusions Structure and focus may facilitate implementation, but the dominance of outcomes measurement and performance metrics in health systems may powerfully frame perceptions of the intervention and implementation decisions. There is uncertainty over who is best-placed or responsible for supporting carers around hospital discharge, and challenges in connecting with carers prior to discharge.