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Tennis Coaching, Courses, Camps and Clubs
The club programme covers all the key development and age groups designed by the LTA. The junior programme has provided "AEGON Team Tennis" winners as well as provided "Road to Wimbledon" county finalists. Squad coaching is very popular along with the school holiday camps.
The LTA Mini Tennis Awards are very popular in the 6 local schools connected with the club. This is a great scheme run nationally giving children a sense of achievement and also gives them a recognised level.
The coaching programme has been very successful with the national schools Yr 3 / 4 tennis tournament, producing 3 county champions and 5 county finalists.
Our adult league teams have also benefitted from the Skills4sport coaching programme and now proudly supports 2 men's teams (A team Div 2 in Summer league), a ladies team (Summer Div 2) and a mixed team (Div 2 summer league) all in the Northants town tennis league. This is a huge increase as the club only ever supported 1 adult team residing in div 3 /4. Adult beginner coaching sessions as well as cardio tennis run throughout the year.
Finding out more about our clubs and courses is easy!
Complete the form or call Alex on 07980 006450.
You can also visit our Tennis Website www.roadetennis.com
Roade Tennis Club
Roade Tennis Club is located just outside Northampton (jct 15 on M1). The club has 3 hard courts and a club house.
I have been head coach of this village club for the past 9 years, and the club has grown from strength to strength during this time. We have 65 juniors in the coaching programme ranging from "Mini & Me" (toddler and parent on court together) to 18yr olds starting to play adult league tennis.


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NBL file format description
Many people share .nbl files without attaching instructions on how to use it. Yet it isn't evident for everyone which program a .nbl file can be edited, converted or printed with. On this page, we try to provide assistance for handling .nbl files.
1 filename extension(s) found in our database.
.nbl - Phantasy Star Universe game data
The NBL game data files are related to Phantasy Star Universe. NBL file is a Phantasy Star Universe game data. Phantasy Star Universe (PSU) is an action role-playing video game developed by Sega's Sonic Team for the Microsoft Windows.
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What's the System? Review of an Angry Workers Pamphlet
The Angry Workers of the World (AWW), a group based in West London which publishes the irregular workplace bulletin WorkersWildWest, has released a pamphlet collecting their articles on history, crisis, and revolution. We want a new society – and don't we need it! seeks to explain in a straightforward manner how the current system emerged and how a new society can replace it.
The Internationalist Communist Tendency
The Current Crisis and the Tasks of Communists
The Internationalist Communist Party
The Italian Communist Left
The value of Noam Chomsky
The necessity of a moral revolution
A leftist history of the U.S. economy
A summary of Richard Du Boff's comprehensive history of the American economy.
Thoughts on "The Reactionary Mind"
Down But Not Out: The Unemployed in Chicago during the Great Depression
This is a Ph.D. dissertation in the field of U.S. labor history. See www.wrightswriting.com/ for more Marxist scholarship.
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In 2006, Lana founded and established Cross. Her goal was to establish an organization that provided best in class service, at competitive rates while providing the best service in our industry. Many years later, we still strive to provide those standards. It is through Lana's commitment to service that Cross has become recognized as one of the 5 largest Women Owned Business in Collin County, and has been recognized by Inc. magazine as one of the 5000 Fastest Growing Private Companies in America. Lana has not only led Cross to remarkable growth over the last several years, but she is a strong community leader as well.
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Youth Concern is a registered charity. As such our valued lifeline for vulnerable young people are dependent on the financial support that we receive through grants, fundraising activities and donations.
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Registered Charity No. 277935. Since 1979.
We stand apart from other youth support agencies because the support we offer is informal, flexible, responsive and designed to meet individual need at a pace which is right for each young person.


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But when COVID-19 forced a city-wide quarantine in New Orleans, Screen wondered what she could do to help.
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"There has been a spiritual awakening that has led to planting of Hispanics churches across the state," said William Ortega, consultant of Hispanic church planting for the Baptist State Convention of North Carolina. Read More
Several state Baptist conventions held online prayer gatherings this week. Those and more are making future plans to continue to engage in persistent, specific, group prayer. Read More
Formed in 1946 by the Southern Baptist Convention, and supported with Cooperative Program funds, Baptist Press (BP) is a daily (Monday-Friday) international news service. Operating from a central bureau in Nashville, Tenn., BP works with a large network of contributing writers, photographers and editorial providers to produce BP News.


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Self care in neurogenic intestine in subjects with spinal cord injury: an integrative review
Adriana Santana de Vasconcelos1, Inacia Sátiro Xavier de França1, Alexsandro Silva Coura1, Bertha Cruz Enders2, Hemília Gabrielly de Oliveira Cartaxo1, Francisco Stélio de Sousa1
1Paraíba State University
2Rio Grande do Norte Federal University
Aim: To identify the nursing interventions that promote self-care in the neurogenic intestine in subjects with spinal cord injury, related to the nursing diagnoses listed as Risk of Constipation, Constipation and Intestinal Incontinence.
Method: This study used the integrative review of electronic databases using descriptors. In the analysis of data, we used the Theory of Self-Care Deficit.
Results: The most mentioned interventions of self-care were; nutritional orientation, consumption of liquids, going to the toilet at the same time every day, abdominal massage, decubitus change and Valsalva maneuver.
Discussion: The gastrointestinal dysfunction can cause constraints and it can also harm interpersonal relationships. The nurse must evaluate the eliminatory standard of this clientele, prioritizing non-pharmacological and less invasive actions, considering dietary preferences, cultural habits and the economic resources of the subjects available to invest in a certain diet.
Conclusion: Nurses can contribute to the promotion of self-care for patients with neurogenic intestine, and the Theory of Self-Care Deficit can be used as an important tool in this process.
Descriptors: Nursing; Spinal Cord Injuries; Self Care; Neurogenic Bowel.
Spinal cord injury (SCI) is a worldwide public health issue, as the number of people with disabilities generated by this aggravation has risen significantly in the last few decades. It is estimated that, in Brazil, around 6,000 new cases arise every year(1). This number is related especially to traumatic lesions (80%) provoked by firearms, traffic accidents, shallow-water diving and falling. However, 20% of the SCI are associated with non-traumatic causes, such as viral and bacterial diseases, and also, schistosomiasis(2).
There are still some difficulties with official data about people with SCI, but there is an estimate that fifty new cases arise every day, for every one million inhabitants worldwide(3). Every year, sixty million subjects acquire SCI in the United States of America alone(4). In Brazil, the annual incidence is of, approximately, 6,000 cases(5).
The subjects with SCI are usually men, between the ages of eighteen and forty years, at the pinnacle of their productive life. Considering this matter, it is possible to deduce that SCI generates negative results for society. Despite evident developments in the area of rehabilitation, SCI produce alterations in organic functioning, which may result in sequels, many times irreversible ones, which generate the need for profound changes in the life of the subjects that are suffering from the injury, as well as their relatives(6).
The disabilities generated by SCI vary according to the level of the lesion; tetraplegia is found in people with lesions located above thoracic vertebra2 (T2) and, below this level, we find paraplegia. Researchers show that the occurrence of complications increases according to the level of the lesion, while the capacity of self-care decreases(7). Hence, the difficulty in performing self-care follows the subject with SCI, which increases their chances of having complications, related to the main issue. For these patients and their relatives, nursing assistance needs to overcome the hospital paradigm, creating strategies for the promotion of health that also promotes the enjoyment of family life, besides the existing sequels.
Among the many consequences that can come with SCI, such as motor deficit, metabolic and hormonal alterations, the reduction of respiratory capacity and blood circulation, it also involves a lack of control over intestinal elimination(8). Then, the occurrence of neurogenic intestine is quite common in people suffering from SCI, as due to the neurological damage, the nervous system cannot control intestinal functions as before, which may lead to constipation or fecal incontinence(7).
Intestinal problems present with variable incidence, reaching up to 75% of people with SCI(9). An investigation, undertaken in the United Kingdom of a sample with above a thousand individuals with SCI , identified that 39% presented with constipation, 36% had hemorrhoids and 31% had abdominal distention(10).
Such complications can generate fear of intestinal accidents, and as a consequence, a fear of leaving home, besides the actual discomfort caused by the accumulation of hardened feces in the intestinal tube. This condition can lead to more difficult situations in for these subjects in their participation in social activities, and possibly, to harming their quality of life.
Within this context, it is important to mention that, with adequate nursing interventions, it is possible to prevent and treat possible complications, helping the person with SCI and their relatives in the process of rehabilitation and self-care to be performed at home, after leaving the hospital(2).
Therefore, from the assumption that the people with SCI experience intestinal problems at home, we can state that; such complications are preventable, that nurses can intervene in this process, in order to promote health within primary care, and that adequate fecal elimination is a human necessity that must be supported(11) This study aimed to identify nursing interventions in the promotion of self-care for the neurogenic intestine of the subjects with SCI, related to the diagnoses of the Risk of Constipation, Constipation and Intestinal Incontinence(12).
We believe in the relevance of this study, due to its potential in offering information that can subsidize nursing praxis in the assistance of people with SCI. The interventions here identified can be used in units of primary health care, so that people with SCI can develop their abilities in self-care, becoming more independent. This study is also justified by a lack of research about strategies in the management of neurogenic intestinal dysfunction, besides the clinical importance of this population(9).
This is a study of integrative review, performed between July and August 2011, through the database SciELO, LILACS, BDENF, MEDLINE, IBECS and PubMed, through an online search of scientific articles published in the last ten years.
In this study, to focus on the key question, we considered people with SCI and neurogenic bladder as the problem in focus; the interventions were related to the nursing diagnoses, of Emergency Urinary Incontinence, Risk of Emergency Urinary Incontinence and Urinary Retention, as interventions to be studied with the promotion of self-care as the expected outcome.
Based on this perspective, to accumulate a higher number of articles that could answer our key question, "Which nursing interventions can be implemented to promote self-care of people with SCI that have neurogenic intestine?", three search strategies were used: I. Search using controlled DeCS/MeSH descriptors: "Traumas in Spinal Cord", "Spinal Cord", "Neurogenic Intestine", "Intestinal Constipation", "Fecal Incontinence" and "Nursing"; II. Search using non-controlled descriptors: Spinal Cord Injury, Spinal Injury and Intestine; and III. Crossed reference, or in other words, identification of a bibliography of pre-selected articles.
The syntax of the descriptors was articulated, based upon the following search expressions; (Spinal Cord Injury OR Spinal Cord Trauma OR Spinal Cord OR Spinal Injury) AND Nursing AND Intestine; (Neurogenic Intestine OR Intestine Constipation OR Fecal Incontinence OR Intestine) AND Nursing.
The initial search identified 839 articles, considered as search limits; articles about human beings, written in Portuguese, English and Spanish, and published in the last ten years from the beginning of the research. As a continuation, there was the analysis of titles and abstracts, considering the following inclusion criteria; articles that dealt with nursing interventions (proposals or implementations in studies), to promote self-care of people with SCI that presented neurogenic intestine, with free and full versions available electronically. Studies that were excluded from the sample of articles mentioned nursing interventions with other neurological syndromes. Therefore, after removing the abstracts that were repeated in more than one database, being counted only once, the final sample was reduced to twelve papers.
The process of data collection and the evaluation of articles was performed by two independent and blinded reviewers who organized, stored and managed the articles analyzed, with support from the software JabRef Reference Manager, version 2.5.
To analyze the study units, the interventions found were organized into spreadsheets and linked to the nursing diagnoses of Risk of Constipation, Constipation and Intestinal Incontinence, according to the North American Nursing Diagnosis Association International (NANDA-I)(12). Besides that, the systems proposed by Dorothea Orem in the Theory of Self-Care Deficit were taken into consideration: I. Fully Compensated System: the nurse performs the self-care, compensating for the inability of the patient, who needs to be supported and protected; II. Partially Compensated System: the nurse supports the patient, performing some actions, but there is bilateral action; and III. Supporting System - Education: the nurse supports self-care, but the patient himself performs the actions(13).
According to the flowchart to be presented later, 839 articles were identified, but only twelve were selected. The papers excluded had the following issues; escape from the topic (n=84), repetition on the same database or in more than one database (n=29), nursing interventions for other neurological syndromes (n=10) and the electronic unavailability of the full and free text (n=707).
On Table 1, the bibliometric data of the twelve chosen papers are presented, indicating the distribution of the articles according to a reference number, then the name of the first author, title of the article in the language found in the journal, year of publication, country and journal of origin. It was seen that 41.7% (n=5) of the articles come from Brazilian nursing publications and that 58.3% (n=7) of them are from medical publications from other countries.
In Table 2, the data regarding the language, any financial support, the conflict of interests and ethical appreciation of the papers are presented, according to the review. There were articles in English and Portuguese, four of them being sponsored and five having proof of ethical appreciation. No article mentioned any conflict of interest of any type.
In Table 3, there is a presentation of possible nursing interventions for people with SCI and neurogenic intestine, according to the parameters of the Theory of Self-Care Deficit. The interventions most frequently mentioned were for the diagnosis of Risk of Constipation; Nutritional Orientation (n=10), Encouraging the consumption of liquids (n=7) and Going to the toilet at the same time every day (n=5). For the diagnosis of Constipation; Use of Medication (n=11), Nutritional Orientation (n=10), Encouraging the consumption of liquids (n=7), Enema (n=6), Manual Removal (n=6) and Going to the toilet at the same time every day (n=5). Lastly, for the diagnosis of Intestinal Incontinence;: Nutritional Orientation (n=10) and Going to the toilet at the same time every day (n=5). However, general interventions that presented the potential for promoting self-care were: Nutritional Orientation (n=10); Encouraging the consumption of liquids (n=7); Going to the toilet at the same time every day (n=5); Abdominal massage (n=4); Indicate the changes in decubitus and avoid lying down (n=3); Indicate how to perform the Valsalva maneuver (n=2); Indicate the stimulus to coughing (n=1); Encourage the practice of physical activities (n=1); Educate relatives who are also caregivers (n=1); and Give instructions about the necessity to install larger doors in the bathrooms (n=1).
Nursing diagnoses are titles given to human reactions that require the presence of a nurse so that health assistance takes place. They help to build effective communication between the members of a nursing team, and then, they are considered an important requisite for the application of nursing interventions, based on clinical evidence. The North American Nursing Diagnosis Association International is one of the most traditional nursing associations to validate these diagnoses(12). Today, there is a necessity to connect the nursing diagnoses to the interventions, aiming to use clinical thinking during this consultation. From this perspective, the most frequent nursing diagnoses are presented to people with SCI and neurogenic intestine, as well as the respective interventions identified in the selected studies. We call attention to the fact that the discussion is based upon the interventions related to the systems, Partially Compensatory and Support System – Education, as they enable the promotion of self-care.
Risk of constipation
People with SCI are at risk of presenting with intestinal constipation and fecal impaction because, due to the severance of the nerves of the spinal cord, the messages that arrive from the rectum do not reach the brain and this can generate insufficient intestinal movement. The Risk of Constipation is a condition in which the person has an elevated risk of presenting with stasis in the large intestine, resulting in a low frequency of elimination and/or hard and dry feces(23).
To start the process of nursing assistance to achieve minimum eliminatory standards, it is necessary to undertake a collection of data, the first stage of which is the nursing consultation(24), composed of a physical exam and interview(9,11). Therefore, it is recommended to interview the subject about the functioning of the eliminatory standard before the SCI. After that, a correlation must be performed with the actual eliminatory standard, followed by a search for signs of abdominal distention that can lead the nurse to suspect of impaction of flatulence; listening carefully to the hydro-aerial noises to determine intestinal motility; to percuss in search of the characteristic swelling of flatulence and touching of the abdomen, searching for bumps that can demonstrate difficulties in the elimination of feces(23).
During this investigation, the nurse must observe and identify factors that increase the possibility of reaching a diagnosis of constipation. These factors are: the use of pharmacological agents, such as the indiscriminate use of laxatives and the use of antidepressants; changes in the physiological functioning, such as inadequate dentition, dehydration, deficient dietary habits, insufficient ingestion of fiber and liquids, reduced gastrointestinal motility and changes in dietary standards; functional changes, such as insufficient physical activity, weakened abdominal muscles; mechanics, such as the level of neurological lesion and psychological, for example, depression and emotional tension(12). After the evaluation of a subject with SCI, and after confirming the diagnosis of Risk of Constipation, or the recognition of a certain risk for this issue, other interventions are suggested for the treatment and/or prevention.
The adoption of healthy habits regarding the diet must be indicated(2,9,11,19-20,22). It can guide the construction of balanced meals, with dishes full of fiber. These meals must be evenly distributed, at least three times throughout the day, following the routine of a pre-established schedule. In cases where the digestive process is slower, it is necessary to deliver the diet in six meals of smaller portions. This routine helps to generate intestinal movements that will assist defecation. It is important to mention that the orientation regarding dietary habits must take into consideration the economic resources that the subjects have to invest in their own diet, as well as their food preferences and cultural habits.
The consumption of liquids should also be encouraged(2,9,11,19,22), as the maintenance of an adequate fluid intake provides help with the hydration of feces and facilitates the passing of feces through the intestine. Also, to go to the toilet at the same time every day(2,19,22), in order to establish a routine. Information must be given about the necessity of installing a larger door to the bathroom, to permit easier access for a wheelchair, together with a caregiver, who also needs to be well informed about how to proceed(9). They must indicate changes of decubitus and avoid laying down(19). They need to give information about the Valsalva maneuver, (to inhale deeply and force down the abdominal and diaphragm muscles) and indicate the stimulation of coughing and abdominal massage(22). In the Rovising Massage, the patient or the caregiver should lightly touch the colon, from right to left, from the bottom up, for a period of twenty minutes. This intervention can be associated with intestinal training, which consists of placing the patient on a toilet seat, if the person can stay by him/herself for thirty minutes, even if the patient does not have the need to evacuate.
The practice of physical activities is also encouraged and indicated(19), in order to help the mobility of feces; the use of pharmacological laxatives is not advised(2), to avoid possible drug dependency. The nurse needs to control the assistance provided and manage the eliminations; to observe, evaluate and register the aspect and approximate quantity of feces(2,9,11), as well as registering the intestine caring program(9).
Constipation is the state in which the person presents stasis in the large intestine, resulting in a low frequency of elimination and/or hard and dry feces. The suspicion of intestinal constipation occurs when the number of eliminations is below three times a week, overstraining to defecate and the elimination of hard feces. When the mobility of the intestine is reduced, the feces stay longer in the large intestine, and then there is a higher absorption of water, which makes them harder to be eliminated. The fecal impaction results in constipation and is characterized by hardened feces the person cannot expel. The signs of fecal impaction are the lack of elimination of feces for days, or when there is elimination of fecal exudation fluids(23).
The intervention indicated for the Risk of Constipation can also be applied to the diagnosis of Constipation, which is also pertinent to show other nursing interventions, such as the administration of drugs(2,9-13,19-20,22-24). In some cases, under medical supervision, it is the nurse who will administer oral laxatives or suppositories, which are indicated as necessary when other non-pharmacological therapies have been unsuccessful. Without evacuation, it is possible to use the glycerin suppository, but if the problem persists for more than three days after these trials, the physician must be consulted. The nurse must evaluate the risk-benefit of the use of natural laxatives which are culturally accepted by the subjects and their relatives, discouraging the use of self-prescribed pharmacological laxatives, because they perpetuate the maintenance of the diagnosis of constipation.
When the diagnosis of constipation is confirmed, a rise of hydric ingestion is indicated, to about 2.5 to 3 liters of liquid on a daily basis. This includes the consumption of water and fruit juices. The consumption of milk and its derivatives must be observed and recorded by the subject and his/her relatives, because these elements can generate flatulence in some people and, therefore, their consumption must be limited. The extra consumption of coffees, teas and sodas are not indicated because they have constipating properties and promote flatulence(2,11,19,22).
Other interventions that can be implemented are; to evaluate the possibility and/or the presence of hemorrhoids(9), because the defecation of hard and dry feces can cause bleeding and secondary complications, besides increasing the difficulty in eliminations; the control of impaction, by digital stimulus, (which consists of the introduction of the gloved and lubricated finger in the rectum, moving in and out for five minutes), digital rectal examination(22), enema(2,9,19,22) and/or manual removal(9,19,22) when the situation is considered critical. After medical prescription, enemas and clysters can be administered. The heating of the liquid to be used in these proceedings improves the emollient capacity. Another important factor is the position of the subject with SCI in left-side decubitus, permitting the liquid to penetrate deeply into the descending colon, and then helping in intestinal eliminations. Other viable alternatives for subjects with SCI are the techniques of body mobilization. It is necessary to determine if this mobility will be active or passive, and the level of participation of the caregivers. The person with SCI can be placed in an orthostatic position, with the lower limbs flexed over the abdomen, as these mobilizations help intestinal movement and reduce flatulence(23).
Intestinal incontinence
Intestinal incontinence is the state in which the individual presents with the incapacity to control the elimination of feces. For this diagnosis, the previously mentioned interventions are used, except those that aim to promote and/or facilitate the elimination of feces.
With regard to nutritional orientation(2,9,11,19-20,22), the consumption of a fiber-rich diet to grow the fecal matter must be encouraged, whilst at the same time, alcoholic beverages and caffeine should be avoided. Concerning the administration of medication, substances that can reduce the frequency of incontinence and modify the consistency of the feces produced can be indicated.
It is important to give guidance and information regarding the necessity of installing a larger door to the bathroom, because with incontinence, it is essential that the path to the bathroom is clear, especially when dealing with a person with SCI on a wheelchair.
Another important issue is an evaluation of the cultural and sexual condition of the users, as a gastrointestinal dysfunction can cause embarrassment and can also harm social relationships. Within this perspective, sexual counseling is an integral and fundamental part of the process of rehabilitation, and it is the role of the nurse to transmit the correct information about possible alternatives, to minimize changes in relationships, due to the complications of SCI(19).
The nurse that assists the person with SCI must observe the evaluation of the eliminatory standard of this clientele, and should also prioritize non-pharmacological, less invasive actions. It would be the ideal to promote self-care for the neurogenic intestine in such a way that the people could watch over themselves, or have reduced support from caregivers.
Besides the pertinent interventions seen in the selected articles, a limitation of this study is to consider only the articles freely available and in full format on electronic databases. This methodological proceeding can, in some cases, make sure that some important studies in the area of investigation, and that have the potential to answer the questions raised in this research, are not included in the sample.
It was observed that there are many nursing interventions that can be implemented in the treatment and promotion of the health of people with SCI and neurogenic intestine, especially in the assistance of people with the nursing diagnoses of Risk of Constipation, Constipation and Intestinal Incontinence. The identification of these interventions offers a set of information with easy access to the nurses that work with this clientele in hospitals, clinics and homes, and is seen as especially relevant to those nurses who support patients with SCI located away from the largest rehabilitation centers.
Sharing the nursing diagnostics and interventions indicated by nurses that support patients with SCI that present neurogenic intestine, offers subsidies that can help to answer two questions. The first is the fostering of assistance with lower risks of malpractice, negligence and recklessness. The second is the overcoming of nursing assistance based on individual experiences for the nursing practice, based on clinical evidence.
In this context, it was seen that nurses can contribute to the promotion of self-care for the neurogenic intestine in subjects with SCI, and that the Theory of Self-Care Deficit can be used as an important tool in this process, once it permits the use of many resources to promote the independence needed to develop the bonds of responsibility and fraternity between caregivers and subjects with SCI. Moreover, it permits the use of the systems, Partially Compensatory and Support – Education, which supports the process of education in health, to live with neurogenic intestine, besides preventing and treating the nursing diagnoses of Risk of Constipation, Constipation and Intestinal Incontinence.
1. Venturini DA, Decésaro MN, Marconi SS. Alterações e expectativas vivenciadas pelos indivíduos com lesão raquimedular e suas famílias. Rev Esc Enferm USP. 2007;41(4):589-96.
2. Vasconcelos AS, França ISX, Coura AS, Sousa FS, Souto RQ, Cartaxo HGO. Nursing interventions on the needs of people with spinal cord injury: an integrative review. Online braz j nurs [ Internet ]. 2010 September [ Cited 2013 Dec 10 ] 9 (2) . Available from: http://www.objnursing.uff.br/index.php/nursing/article/view/3000. doi:http://dx.doi.org/10.5935/1676-4285.20103000 [ included in the review ]
3. Samuel JC, Akinkuoto A, Vilaveces A, Charles AG, Lee CN, Hoffman IF, et al. Epidemiology of Injuries at a tertiary care center in Malawi. World j sur. 2009; 33(9): 1836-41.
4. Faro ACM. A reabilitação da pessoa com lesão medular: tendências da investigação no brasil. Enferm glob 2003;(3):1-6.
5. Utida C, Truzzi JC, Bruschini H, Simonetti R, Cedenho AP, Srougi M, et al. Male infertility in spinal cord trauma. Int braz j urol. 2008; 31(4):375-83.
6. Brito LMO, Chein MBC, Marinho SC, Duarte TB. Avaliação epidemiológica dos pacientes vítimas de traumatismo raquimedular. Rev Col Bras Cir. 2011; 38(5):304-9.
7. Furlan MLS, Caliri MHL, Defino HL. Intestino neurogênico: guia prático para pessoas com lesão medular. Coluna. 2005; 4(3 Pt 1):113-68.
8. Galvin LR, Godfrey HPD. The impact of coping on emotional adjustment to spinal cord injury (SCI): review of the literature and application of a stress appraisal and coping formulation. Spinal cord. 2001; 39(12):615-27.
9. Goetz LL, Nelson AL, Guihan M, Bosshart HT, Harrow JJ, Gerhart KD, et al. Provider adherence to implementation of clinical practice guidelines for neurogenic bowel in adults with spinal cord injury. J spinal cord med. 2005; 28(5):394-406. [included in the review]
10. Coggrave M, Norton C, Wilson-Barnett J. Management of neurogenic bowel dysfunction in the community after spinal cord injury: a postal survey in the United Kingdom. Spinal cord. 2009; 47(4):323-30.
11. Leite VBE, Faro ACM. O cuidar do enfermeiro especialista em reabilitação físico-motora. Rev Esc Enferm USP. 2005; 39(1): 92-6. [ included in the review ]
12. North American Nursing Diagnosis Association International (NANDA-I). Nursing diagnoses: definitions and classification 2009-2011. Indianapolis: Wiley-Blackwell; 2009.
13. Orem DE. Modelo de Orem. Nursing. Concepts of Practice. 6th ed. St. Louis: Mosby; 2001.
14. Lynch AC, Antony A, Dobbs BR, Frizelle FA. Bowel dysfunction following spinal cord injury. Spinal cord [ Internet ]. 2001 [ cited 2013 Jan 24 ] 39(4):193-203. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11420734
15. Benevento BT, Sipski ML. Neurogenic bladder, neurogenic bowel, and sexual dysfunction in people with spinal cord injury. Phys ther [ Internet ]. 2002 [ cited 2013 Jan 24 ] 82(6):601-12. Available from: http://www.ncbi.nlm.nih.gov/pubmed/12036401 [ included in the review ]
16. Bruni DS, Strazzieri KC, Gumieiro MN, Giovanazzi R, Sá VG, Faro ACM. Aspectos fisiopatológicos e assistenciais de enfermagem na reabilitação da pessoa com lesão medular. Rev Esc Enferm USP [ Internet ]. 2004 [ cited 2013 Jan 24 ] 38(1):71-9. Available from: http://www.scielo.br/pdf/reeusp/v38n1/09.pdf
17. Cafer CR, Barros ALBL, Lucena AF, Mahl MLS, Miche JLM. Diagnósticos de enfermagem e proposta de intervenções para pacientes com lesão medular. Acta paul enferm [ Internet ]. 2005. [ cited 2013 Jan 24 ] 18(4):347-53. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0103-21002005000400002 [ included in the review ]
18. Coggrave M, Wiesel PH, Norton C. Management of faecal incontinence and constipation in adults with central neurological diseases. Cochrane database syst rev [ Internet ]. 2006 [ cited 2013 Jan 24 ] 19(2): [ about 10.p] . Available from: http://www.ncbi.nlm.nih.gov/pubmed/16625555 [ included in the review ]
19. Scramin AP, Machado WCA. Cuidar de pessoas com tetraplegia no ambiente domiciliário: intervenções de enfermagem na dependência de longo prazo. Esc Anna Nery Rev Enferm. [Internet]. 2006 [cited 2013 Jan 24] 10(3):501-8. Available from: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1414-81452006000300020 [ included in the review ]
20. Korsten MA, Singal AK, Monga A, Chaparala G, Khan AM, Palmon R, et al. Anorectal stimulation auses increased colonic motor activity in subjects with spinal cord injury. J spinal cord med [ Internet ]. 2007 [ cited 2013 Jan 24 ] 30(1):31-5. Available from: http://www.ncbi.nlm.nih.gov/pubmed/17385267 [ included in the review ]
21. Christensen P, Bazzocchi G, Coggrave M, Abel R, Hulting C, Krogh K, et al. Outcome of Transanal Irrigation for Bowel Dysfunction in Patients With Spinal Cord Injury. J spinal cord med [ Internet ]. 2008 [ cited 2013 Jan 24 ] 31(5): 560–7. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607129/ [ included in the review ]
22. Krassioukov A, Eng LL, Claxton G, Sakakibara BM, Shum S. Neurogenic bowel management after spinal cord injury: a systematic review of the evidence. Spinal cord [ Internet ]. 2010 [ cited 2013 Jan 24 ] 48(10):718-33. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2607129/ [ included in the review ]
23. Potter PA, Perry AG. Fundamentos de enfermagem. Rio de janeiro: Elsevier; 2009.
24. Carpenito-Moyet LJ. Manual de Diagnósticos de Enfermagem. 10 ed. Porto Alegre: Artmed; 2009.
Adriana Santana de Vasconcelos, Inacia Sátiro Xavier de França, Hemília Gabrielly de Oliveira Cartaxo, Alexsandro Silva Coura e Francisco Stélio de Sousa, Paraíba State University. Concept, design, writing, critical review and final approval.
Bertha Cruz Enders, Rio Grande do Norte Federal University. Writing, critical review and final approval.
Received: 01/12/2011
Revised: 07/01/2013
Approved: 18/10/2013
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text:
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Masami is the het ship between Mako and Asami Sato from The Legend of Korra fandom.
Mako first met Asami when she accidentally hit him with her moped. Mako was about to yell at her but was smitten by her beauty and quickly forgave her. Asami felt bad and took him out on a date to Kwong's Cuisine. The two hit it off right away. Mako later explained how he lost his parents to a firebender and Asami explained that she also lost her mother to a firebender but felt safe around Mako. Asami was also a huge fan of Mako's pro-bending team and convinced her father to sponsor his team so that he could enter the tournament.
Asami and Mako went to Tarrlok's gala as a couple. They also went on several more dates. Korra tried to make a move on Mako and although he did have feelings for her, he still remained with Asami. After the pro-bending arena was shut down, Asami allowed Mako and his brother Bolin to go live with her. However, it was later discovered that Asami's father was an Equalist. Mako comforted her after realizing this.
Asami eventually began to learn of the feelings between Mako and Korra. She found out from Ikki that Korra liked Mako and noticed that he began to act obsessive once Korra was kidnapped. Asami asked Bolin if Mako liked Korra and found out that they kissed at one point. Asami later confronted Mako about the situation. Mako refused to admit anything and complained that it was not the right to discuss their relationship, but Asami remarked that they might not have a relationship to discuss. Before the final battle for Republic City, Mako apologized to Asami for letting their relationship go the way it did. They admitted that they cared for each other and kissed one final time before they broke up.
Mako ended up dating Korra for over six months but they broke up. Asami was worried that things were not going well between them and asked Mako if everything was alright. Mako and Asami decided to work together to figure out who was bombing the ships. Asami eventually overheard Mako saying that her and Korra broke up and asked why he did not tell her. Later, all of Asami's supplies were stolen. She was about to give up but Mako refused to give up on her. Asami kissed Mako but quickly apologized.
Mako eventually found out that Varrick was behind the bombings but was too late to stop Asami from signing an agreement with him so he did not tell her. Varrick could tell that Mako was catching on and threatened to harm Asami and Bolin if he did not cooperate but he still refused. Asami later came over and tried to convince Mako to go on a date with her. He refused until she mentioned Kwong's Cuisine and then he agreed and kissed her. However, Mako was arrested shortly after. When he was finally released, Korra kissed him in front of Asami because she forgot about the break-up. Mako refused to remind Korra and although nothing was said, he and Asami were done for good after that.
Mako and Asami still remained on good terms although Mako was awkward around both Asami and Korra at first. Asami realized that Mako was never really on to be in touch with his feelings. Three years later, the two still seemed to be very good friends. When Prince Wu was hitting on Asami, Mako came over to interrupt them. They talked about how their jobs were going. When Korra finally returned, the two joined her for lunch and worked with her to save Wu when he was captured. They eventually joined for a group hug at the end.
Masami became popular as soon as Asami was introduced as a love interest for Mako. Many fans did not trust Asami and speculated that she was an Equalist. However, it turned out that only Asami's father, Hiroshi, was an Equalist. Many fans began to hate Mako in general because of the way he behaved around Korra while he was dating Asami. In fact, only a few die-hard fans of Masami were still around by the end of Book One. However, with the brief rekindling of their romance in Book Two, fans resurfaced again. Masami primarily rivals the Makorra, Bosami, and Korrasami ships.
- Mako/Asami tag on AO3
- Mako/Asami tag on FanFiction.net
- Masami posts on Tumblr
- MasamiEdit posts on Tumblr
- Although it was not clear at first, the final kiss and apology in Book One was supposed to be a break up.
|Amorra • Baavira • Baayin • Boleska • Bolinger • Bopal • Borra • Bosami • Kainora • Korroh • Linzin • Makorra • Masami • Mingko • Mingzan • Pemzin • Pheer • Raavaatu • Senraq • Tahnorra • Varrisami • Waava • Zhurrick
|Borrick • Lieumon • Unavaatu • Wuko
|Korrasami • Korralin • Korpal • Kovira • Opalvira
|Korra • Toph • Zuko


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18 Dec 2018 19:43

Contemplating A Hobby? Listed here are Don't know What kind of Hobby To Take Up? Read These tips! !

Have you ever been given up on your hobbies currently because they do not seem like fun? Possibly you just need a hobby to do in your spare time that is enjoyable for the whole family? No matter the case, it is at all times nice to learn fascinating recommendations on hobbies that anybody can use. Read on for these great ideas!

A terrific interest to have is to paint. You don't need formal artwork coaching to take on painting as a passion. You cannot expect to be as good as Velasquez, however you possibly can nonetheless get plenty of enjoyment out of painting. You can impress all the folks that come over to your own home too.

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Check the waters to your product earlier than you determine to turn your pastime right into a enterprise. Strive Hobby Advice For Anyone From Learners To Superior out as an element-time business at first to see if there is an efficient market in your product. You'll be able to do this whereas you continue to maintain a day job. Keep in mind that regardless that it is an element-time, customers will count on full service if you'd like what you are promoting to develop.

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Speak with others who take pleasure in your interest. Not everyone enjoys what you do. When your pals and household get uninterested in hearing about your hobby, meet new people! Be part of forums online or help teams in your space.

 Advice About Hobbies That will Help Anyone among the benefits of some hobbies is spending time with others who share related interests as yours. Discover teams around you, or online that share your hobby. This is a superb technique to make buddies, socialize, and you may even get tips on no matter your interest may be.

Consider beading as your new passion. It is the proper manner to specific your internal girly aspect and do something creative that pays off in an afternoon. What's extra is which you can create jewellery that matches your wardrobe, so your interest just isn't only enjoyable and stress-free; it truly lets you present individuals what you can do.

Assume about how you can progress with any hobby you undertake. After you've gotten been doing all of your interest for some time, it might begin to really feel boring except you look for methods to get higher. Whether Hobbies Complicated You? This text Will Clear It Up For You might be knitting or sailing, there may be always a brand new degree you may attain, so intention for it.

If studying is Interest Ideas And Ideas For Anybody To use of choice, you'll know the way expensive books will be to buy. Why not considering investing in an e-reader system? The tips You Need With reference To Hobbies are much cheaper to purchase that the paper varieties. Additionally, numerous libraries now lend digital books too. You'll be able to keep up with the latest releases at a fraction of the associated fee.

 Helpful Recommendation You should Find out about Hobbies see how a lot fun there is with all these attention-grabbing hobbies that you probably never even considered. Anybody can partake in these hobbies, including all the family. Show them the tips right here, and perhaps it'll spark extra idea. You by no means know what you and your loved ones are capable of doing at home.


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ISLAMABAD; Pakistan's finance minister estimated GDP growth for this fiscal year ending in June at 3.7 percent on Thursday, falling short of the government's forecast after floods damaged the agricultural sector and due to a weak global economy.The government had forecast 4.2 percent growth for 2011/12. Finance minister Abdul Hafeez Shaikh said a 3.7 percent expansion would still be the best performance since 2007/08."If we compare it to the 3 percent last year, then this is the highest economic growth in the last three years," he said.Shaikh said the economy would have grown at a higher rate but was hampered by extensive flood damage to crops and infrastructure in the Sindh and Baluchistan provinces, and threats to the global economic recovery."Is (the GDP growth rate) rising in the way we want? No," he said, while unveiling Pakistan's economic survey for 2011/12.According to the survey, the government's fiscal deficit in the first 10 months (July-April) of 2011/12 stood at 5 percent of GDP, compared to 5.5 percent in the same period the previous year.The agriculture sector grew by an estimated 3.1 percent in 2011/12, the survey showed, compared to 2.4 percent growth the previous year. The sector accounts for 21 percent of GDP, 45 percent of employment and 60 percent of exports, according to the survey.The manufacturing sector grew by an estimated 1.1 percent expansion, against 1 percent growth the previous year, while the services sector expanded 4 percent, compared to 4.4 percent in 2010/11. AGENCIES
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text: Sections View Full Chapter Figures Tables Videos Full Chapter Figures Tables Videos Supplementary Content ++ A 1-year-old Asian American girl is brought to her family physician for a new rash on her face and legs (Figures 145-1 and 145-2). The child is scratching both areas but is otherwise healthy. There is a family history of asthma, allergic rhinitis, and atopic dermatitis (AD) on the father's side. The child responded well to low-dose topical corticosteroids and emollients. ++Figure 145-1Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)Atopic dermatitis on the cheeks of an infant. (With permission from Milgrom EC, Usatine RP, Tan RA, Spector SL. Practical Allergy. Philadelphia, PA: Elsevier; 2004.) ++Figure 145-2Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)Atopic dermatitis on the leg of the infant in Figure 145-1. The coin-like pattern is that of nummular eczema. (With permission from Milgrom EC, Usatine RP, Tan RA, Spector SL. Practical Allergy. Philadelphia, PA: Elsevier; 2004.) ++ AD is a chronic and relapsing inflammatory skin disorder characterized by itching and inflamed skin that is triggered by the interplay of genetic, immunologic, and environmental factors. ++ Eczema, atopic eczema. ++ AD is the most frequent inflammatory skin disorder in the United States and the most common skin condition in children.1Worldwide prevalence in children is 15% to 20% and is increasing in industrialized nations.2Sixty percent of cases begin during the first year of life and 90% by 5 years of age.1 One third will persist into adulthood.2Sixty percent of adults with AD have children with AD (Figure 145-3).1 ++Figure 145-3Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)The child and his mother both have atopic dermatitis but not in the most typical distribution. (Courtesy of Richard P. Usatine, MD.) ++ Strong familial tendency, especially if atopy is inherited from the maternal side.Associated with elevated T-helper (Th) 2 cytokine response, elevated serum immunoglobulin (Ig) E, hyperstimulatory Langerhans cells, defective cell-mediated immunity, and loss of function mutation in filaggrin, an epidermal barrier protein.Exotoxins of Staphylococcus aureus act as superantigens and stimulate activation of T-cells and macrophages, worsening AD without actually showing signs of superinfection.Patients may have a primary T-cell defect. This may be why they can get more severe skin infections caused by herpes simplex virus (eczema herpeticum as seen in Figure 145-4) or bacteria (widespread impetigo). They are also at risk of a bad reaction to the smallpox vaccine with dissemination of the attenuated virus beyond the vaccination site. Eczema vaccinatum is a potentially deadly complication of smallpox vaccination (Figure 145-5). ++Figure 145-4Graphic Jump LocationView Full Size|Favorite Figure|Download Slide (.ppt)An 18-year-old woman with atopic dermatitis superinfected by herpes (eczema herpeticum). (From Buccolo LS. Severe rash after dermatitis. J Fam ... GET ACCESS TO THIS RESOURCE Sign In Username Error: Please enter User Name Password Error: Please enter Password Forgot Username? Forgot Password? Sign in via OpenAthens Sign in via Shibboleth Get Free Access Through Your Institution Contact your institution's library to ask if they subscribe to McGraw-Hill Medical Products. What is MyAccess? Create a FREE MyAccess profile to: Use this site remotely Bookmark your favorite content Track your self-assessment progress and more! GET ACCESS TO THIS RESOURCE Subscription Options Pay Per View Timed Access to all of AccessMedicine 24 Hour $34.95 (USD) Buy Now 48 Hour $54.95 (USD) Buy Now Best Value AccessMedicine Full Site: One-Year Individual Subscription $995 USD Buy Now View All Subscription Options