Transplant ( NODAT ) Risk Factors For Overcome...

Abstract New onset diabetes after transplant (NODAT) is an important complication after transplantation that increases risk for poor patient and graft outcomes. Recent studies in children identified older age, extremes of body mass index (BMI), and corticosteroid use at discharge as risk factors for NODAT. However, these studies were conducted in a national sample which underrated certain patient groups like deceased donor transplants and African American recipients. The purpose of this study was to determine the association between acute rejection (a surrogate for increased corticosteroid exposure) and NODAT in a pediatric kidney transplant program. A retrospective chart review was performed on a cohort of 121 consecutive pediatric kidney†¦show more content†¦The main risk factors include age ≠¥50 years old, male gender, family history of diabetes, and high systolic pulmonary artery pressure (PAP) 50mmHg.1,2 A review of data from the United States Renal Data System for primary renal transplant recipients ≠¤21 years old transplanted between 1995 and 2004 found the following risk factors for NODAT: African American children, BMI ≠¥ 30, increased age of child at time of transplant (≠¥13 years old), discharged on tacrolimus, and cytomegalovirus donor positive/recipient negative status.2 Cytomegalovirus (CMV) is herpes virus that is present in over sixty percent of adults that generally only causes non-specific fever and flu-like symptoms in immunocompetent hosts. In immunosuppressed transplant patients however, the virus can develop into a systemic infection involving several organ systems and increase the risk for transplant rejection.3 Other studies in children also identified corticosteroid use at discharge as a risk factors for NODAT.4 There have been no studies exploring the risk factors for NODAT in a population similar to that at Children’s of Alabama, which is distinct due to a large number of deceased donor transplants and African-American recipients with higher immunologic risk. The purpose of this study was to determine the association between acute rejection (a surrogate for increased corticosteroid exposure) and NODAT in this kidney transplant program. Methods Before initiation of this research, a literature

Would You Rather, an Icebreaker Game for Adults

This party game is perfect for use in the classroom, at a seminar or workshop, or any gathering of adults. Its easy and lots of fun. Would you rather be bald or completely hairy? Give your students impossible questions to answer and help them ease into learning together. Why Use Ice Breaker Games? Icebreakers are important tools for teachers of adults.  If youre teaching adults, you know they learn differently than children. They come to the classroom with a lot of life experience, some more than others, of course, and some of them bring wisdom, too, depending on their age. When you begin a new class or start a new lesson, an icebreaker game can help your adult students feel more comfortable participating by getting them to laugh, helping them to meet fellow students, and relaxing everyone. Have fun. People engage in learning more quickly when the experience is fun. Starting a session or a lesson plan with an icebreaker can help your adult students focus on whatever you have gathered to learn. Instructions The game takes 30-60 minutes, depending on the size of the group. Break large groups into smaller groups by counting off if you have less time for this exercise. Give the participants a minute to think of a Would You Rathe question. Give some examples. There are published Would You Rather books and game cards available for sale if you have the budget to purchase them, but once you get going, you can easily make questions up yourself. If your group does not seem creative at all, you can always print handouts with question ideas and let your students choose from the list. Introduce yourself and ask the first person your question. Example: My name is Deb, and I want to know if you would rather speak to a large group or hold a snake. After the person answers, he or she should give their name and ask the next person their question. And so on. Save time for laughter and explanations if appropriate! Depending on the purpose of your class or meeting, ask participants to come up with a meaningful or thought-provoking question. If you use this game as an energizer, encourage people to just be silly. Debriefing Is Not Necessary No debriefing is necessary unless you’ve asked the group to come up with questions related to your topic. If so, some of the choices probably inspired some remarkable responses. Choose a few to discuss further or to use as a lead-in to your first lecture or activity. This icebreaker game makes a good warm-up exercise for adult education lesson plans. Would You Rather Ideas If you need some questions to get the game rolling, start with these and see if they inspire others: Would you rather play Monopoly or chess?Would you rather have super hearing or x-ray vision?Would you rather be good at drawing or singing?Would you rather be a cat or a fish?Would you rather be Catwoman or Wonder Woman?Would you rather babysit a couples child or their dog?Would you rather go one year without TV or without reading books?Would you rather attend a big party or have an intimate dinner with a few friends?Would you rather lose your hearing or lose your sight?Would you rather be able to breathe underwater or fly?

An Unforgettable Experience 5 Free Essays

The Mid-Autumn Festival also known as the Moon Festival is an important holiday in Taiwan. On this day, everyone enjoys the glorious full moon, eats juicy pomelos and tastes various kinds of moon cakes. Nowadays, having BBQ on Moon Festival becomes an indispensable activity to Taiwanese since the TV commercial started the BBQ(Barbecue) advertisement two decades ago. We will write a custom essay sample on An Unforgettable Experience 5 or any similar topic only for you Order Now Back in 2008, I was only in my second year of high school stressing over all the tests and schoolwork and the College Entrance Exam. The Moon Festival was a good excuse for my friends and me to take our minds off our heavy schoolwork and enjoy some holidays.We decided to have a BBQ right downstairs of my house. The day before our BBQ party, my friends and I went to the Wellcome supermarket to get all the grilling equipments and prepping material, such as portable BBQ-grill, coal, tinder, barbecue sauce, etc. Wellcome was a good place to shop since they have everything we needed; we soon collected all the goods on the list. Unfortunately, the weather wouldn’t cooperate and determine to rain on that day. The dreadful weather forced us to move our party into the balcony of my house. After getting the fire started, which really took us a long time, we began our delightful BBQ party.We prepared many kinds of foods. We were so exciting that we couldn’t wait until the fire to get warm enough to put the meat on the grill. We distributed the work so that each of us will be in charge of a task. Some took care of the BBQ, and some took charge of preparing the skewers, and others made clam soup with garlic in it. We all crowded on the couch in the living room, enjoying the meal, singing Karaoke, and taking turns to play cards at the living room, and ate lots of medium rare beef and pork with toasts. After finishing our party, I was in charge of doing the dishes.I walked toward the kitchen and saw that it was full of smoke and the other side of the kitchen was hardly visible. I was totally freaked out because my parents are about to be home, if they saw what was happening in the house they will definitely be shocked and then get upset at me. I quickly rushed to get fans from different bedrooms. We took out four fans to blow the smokes off, two fans in the balcony, one in the living room and the other one in the kitchen. We even opened the entrance door of my house which caused the whole floor to become smoky as well.With my friends helped, we quickly cleaned up the mess. Fortunately, the smoke eventually dispersed before my parents get home. Since then, when it comes to the Moon Festival, â€Å"the BBQ horror experience† will always come into my mind. From this event, I learned that we should never have the kitchen window closed while we are BBQing at the balcony. However, it was really an unforgettable experience which left me with many warm and funny memories. BBQ is really a good activity for us to promote the friendship and having a pleasant time with our family. I think that is why we enjoy BBQ every year. How to cite An Unforgettable Experience 5, Papers

Boundary Violations Physicians

Question: Is there a difference between a boundary crossing and boundary violation? Explain Answer: Boundary Crossing and Boundary Violation in psychotherapy refer to any deviation from traditional therapy which involves sessions only in the office. Non-traditional therapy could be a home or hospital visit, attending client wedding, lunch with client etc. Maintaining a professional relationship varies from client to client and should be tailored to meet the clients needs (Hamel, 2014). Therapist/Physicians behavior towards the patient should always be in the patients best interest thus strengthening the therapist-client relationship. Boundary Crossing and Boundary Violation can arise from either patient or the therapist. Boundary crossings once incorporated in the plan are harmless, supportive of the therapy and can be beneficial to the patient. Boundary Violations are potentially harmful to the patient and the therapy session (Kilpatrick and Wilson, 2013). Boundary Crossings occur when the therapists provide moral support to the patients and make them feel comfortable and assist them with the tasks they otherwise would be hesitant for example, assisting them for a dreaded yet important doctors appointment or meeting with family members and discussing the problem to find a solution (Hamel, 2014). Boundary Violation occurs when the therapist is engaged in sexual contacts or exploitative business relationship and breaking the therapist-client confidentiality (Kilpatrick and Wilson, 2013). Professional Associations do not prohibit Boundary Crossing but prohibit Boundary Violation. To conclude, yes, Boundary Crossing and Boundary Violations are different. References Hamel, L. (2014). Boundary Violation in Common Law and Psychoanalysis.International Journal of Applied Psychoanalytic Studies, 11(3), pp.265-268. Kilpatrick, S. and Wilson, B. (2013). Boundary crossing organizations in regional innovation systems.Regional Science Policy Practice, 5(1), pp.67-82.