A Framework for Integrating Oncology Palliative Care in Doctor of Nursing Practice (DNP) Education

Doctor of Nursing Practice (DNP) faculty play a critical role in preparing students to meet the complex needs of the nation as the number of cancer rates and survivors rise (National Cancer Institute, 2018) and as an unprecedented number of older Americans enter into the healthcare system with complicated comorbidities (Whitehead, 2016). Palliative care has dramatically expanded over the past decade and has been increasingly accepted as a standard of care for people with cancer and other serious, chronic, or life-limiting illnesses. Advanced practice registered nurses (APRNs) are recognized as important providers of palliative care (Walling et al., 2017). A 2-day course was held with support from the National Cancer Institute to enhance integration of palliative oncology care into DNP curriculum. The course participants (N = 183), consisting of DNP faculty or deans, practicing DNP clinicians, and students, received detailed annotated slides, case studies, and suggested activities to increase student engagement with the learning process. Course content was developed and delivered by palliative care experts and DNP faculty skilled in curriculum design. Participants were required to develop goals on how to enhance their school\u27s DNP curriculum with the course content. They provided updates regarding their progress at integrating the content into their school\u27s curriculum at 6, 12, and 18 months post course. Results demonstrated an increase in incorporating oncology palliative care in DNP scholarly projects and clinical opportunities. Challenges to inclusion of this content in DNP curricula included lack of: perceived time in curriculum; faculty educated in palliative care; and available clinical sites

Velocity plateaus and jumps in carbon nanotube sliding

The friction between concentric carbon nanotubes sliding one inside the other has been widely studied and simulated, but not so far using external force as the driving variable. Our molecular dynamics (MD) simulations show that as the pulling force grows, the sliding velocity increases by jumps and plateaus rather than continuously as expected. Dramatic friction peaks (similar to that recently noted by Tangney {\it et al.} in Phys. Rev. Lett. 97 (2006) 195901) which develop around some preferential sliding velocities, are at the origin of this phenomenon. The (stable) rising edge of the peak produces a velocity plateau; the (unstable) dropping edge produces a jump to the nearest stable branch. The outcome is reminiscent of conduction in ionized gases, the plateau correspon ding to a current stabilization against voltage variations, the jump corresponding to a discharge or breakdown.Comment: 9 pages, 5 color figures, format latex Elsart. Surface Science, in press, http://dx.doi.org/10.1016/j.susc.2007.05.03

Dysfunctional stem and progenitor cells impair fracture healing with age

Successful fracture healing requires the simultaneous regeneration of both the bone and vasculature; mesenchymal stem cells (MSCs) are directed to replace the bone tissue, while endothelial progenitor cells (EPCs) form the new vasculature that supplies blood to the fracture site. In the elderly, the healing process is slowed, partly due to decreased regenerative function of these stem and progenitor cells. MSCs from older individuals are impaired with regard to cell number, proliferative capacity, ability to migrate, and osteochondrogenic differentiation potential. The proliferation, migration and function of EPCs are also compromised with advanced age. Although the reasons for cellular dysfunction with age are complex and multidimensional, reduced expression of growth factors, accumulation of oxidative damage from reactive oxygen species, and altered signaling of the Sirtuin-1 pathway are contributing factors to aging at the cellular level of both MSCs and EPCs. Because of these geriatric-specific issues, effective treatment for fracture repair may require new therapeutic techniques to restore cellular function. Some suggested directions for potential treatments include cellular therapies, pharmacological agents, treatments targeting age-related molecular mechanisms, and physical therapeutics. Advanced age is the primary risk factor for a fracture, due to the low bone mass and inferior bone quality associated with aging; a better understanding of the dysfunctional behavior of the aging cell will provide a foundation for new treatments to decrease healing time and reduce the development of complications during the extended recovery from fracture healing in the elderly

Modeling of graphene-based NEMS

The possibility of designing nanoelectromechanical systems (NEMS) based on relative motion or vibrations of graphene layers is analyzed. Ab initio and empirical calculations of the potential relief of interlayer interaction energy in bilayer graphene are performed. A new potential based on the density functional theory calculations with the dispersion correction is developed to reliably reproduce the potential relief of interlayer interaction energy in bilayer graphene. Telescopic oscillations and small relative vibrations of graphene layers are investigated using molecular dynamics simulations. It is shown that these vibrations are characterized with small Q-factor values. The perspectives of nanoelectromechanical systems based on relative motion or vibrations of graphene layers are discussed.Comment: 19 pages, 4 figure

Say That The River Turns: Social Justice Intentions in Progressive Public School Classrooms

Fennimore confronts the deficit-based talk prevalent in many schools serving marginalized students in “Say that the River Turns.” She argues that teaching for social justice begins by replacing deficit-based talk with clearly articulated intentions that subsequently transform into actions

Are They Really Just Cosmetic? the Impact of Cosmetic Items on Fortnite\u27s Gameplay and Game Design

Cosmetic microtransactions, the act of paying for virtual items that customize certain parts of video games and virtual worlds such as skins that change the appearance of the avatar, are looked upon more favorably in the gaming community than performance-enhancing microtransactions, where one pays for virtual items that enhance the abilities of avatars or speed up the progression of the game. Video game industry spokespeople have adapted this rhetoric and emphasized that the microtransactions in their games are for cosmetic items only with no bearing on gameplay. However, the way players use cosmetic items in games and the way cosmetic items inspire certain game mechanics suggest that their function in games isn’t purely ornamental. Using Fortnite as a case study, I argue that cosmetic items can influence gameplay and that the lucrative aspects of cosmetic microtransactions influence game design. Players use cosmetic items not only to be fashionable, but as tools to fashion their own metagames - games within, around, and outside of games. Game companies know that players care about cosmetic items and avatar customization, and they design their games to make cosmetic items as desirable as possible. Cosmetic microtransactions help us understand that visual design is one of the biggest influences on gameplay and the business of games

Grassroots: Developing a Location-Based Game through a Decolonial Lens

This paper details our design process for “Grassroots: Unite, Reclaim, Maintain,” a location-based mobile game (LBMG) about fostering community through decolonial practices emphasizing mobility justice. Many mainstream LBMGs tend to reinforce a colonialist rhetoric through competitive gameplay based upon claiming and exploiting territories in the virtual world overlaid on the physical world. Through the ludic experience within the virtual world of “Grassroots,” we hope to encourage a new sense of connection, accessibility, and understanding of physical places

Nanomechanical Properties and Phase Transitions in a Double-Walled (5,5)@(10,10) Carbon Nanotube: ab initio Calculations

The structure and elastic properties of (5,5) and (10,10) nanotubes, as well as barriers for relative rotation of the walls and their relative sliding along the axis in a double-walled (5,5)@(10,10) carbon nanotube, are calculated using the density functional method. The results of these calculations are the basis for estimating the following physical quantities: shear strengths and diffusion coefficients for relative sliding along the axis and rotation of the walls, as well as frequencies of relative rotational and translational oscillations of the walls. The commensurability-incommensurability phase transition is analyzed. The length of the incommensurability defect is estimated on the basis of ab initio calculations. It is proposed that (5,5)@(10,10) double-walled carbon nanotube be used as a plain bearing. The possibility of experimental verification of the results is discussed.Comment: 14 page