Bulimia nervosa during pregnancy: a review.

Pregnant women with bulimia nervosa present interesting practice challenges for dietitians and healthcare professionals due to potential complications of bulimia nervosa for both mothers and fetuses. This review summarizes case study reports, case series reports, and retrospective studies of women with bulimia nervosa during pregnancy, and focuses on relationships among bulimic behaviors, pregnancy results, and birth outcomes. Pregnancy and birth outcomes of women with bulimia nervosa varied among individuals and studies. Material outcomes of concern included miscarriages, inappropriate weight gains (excessive or inadequate), complicated deliveries, and resumed and/or continued bulimic behaviors shortly after parturition. Fetal complications included low birth weights, prematurity, malformations, and low Apgar scores. Screening to detect bulimic behaviors is recommended, as is multidisciplinary treatment of pregnant women with bulimia nervosa to emphasize adequate dietary intakes, promote appropriate weight gains, and help achieve healthy infant outcomes in addition to long-term, healthy eating habits for these women. Future research regarding maternal and fetal outcomes of women with bulimia nervosa during pregnancy, conducted by registered dietitians, is needed to provide greater clarity and understanding of the impact of bulimic behaviors, dietary intakes, and nutritional status during pregnancy on maternal and fetal health.

Field anesthesia of free-living mountain gorillas (Gorilla gorilla beringei) from the Virunga Volcano region, Central Africa.

Twenty-six anesthetic procedures involving 24 free-living mountain gorillas (Gorilla gorilla beringei) from Rwanda or the Democratic Republic of Congo were performed between February 1987 and October 1997. Sixteen procedures were performed to remove snares or to treat snare-related wounds, and four of the animals died without recovering consciousness because of their severe medical conditions. Ketamine was used for induction 19 times, tiletamine/zolazepam was used five times, and the agent was not recorded for two procedures. The mean (+/- SD) ketamine dosage for four animals of known weight was 7.1 +/- 0.9 mg/kg. All induction agents were delivered i.m. by remote injection, and mean induction times for ketamine and tiletamine/zolazepam were 5.5 +/- 2.6 min (n = 12) and 5.4 +/- 3.7 min (n = 5), respectively. Mean recovery times were significantly shorter with ketamine compared with tiletamine/zolazepam (42.0 +/- 24.9 min, n = 9 vs. 75.25 +/- 22.1 min, n = 4). Low hemoglobin oxygen saturation (mean = 86.7%) was recorded in three cases under ketamine anesthesia, and oxygen insufflation is therefore recommended to prevent hypoxemia. Gorillas induced with tiletamine/zolazepam had significantly higher respiratory rates compared with animals given ketamine. Successful anesthesia and recovery, in particular, depended on the assistance of local personnel.

The perceptions of Canadian young adults with asthma of their health teaching/learning needs.

Nurses maintain that they can assist individuals with chronic illness to cope with their health problems experienced in daily living through health (patient) teaching. However, several authors claim that in planning health teaching, nurses tend to rely on their perceptions of the learning needs of persons, as opposed to drawing upon the individual's understanding of their needs. Few research studies have investigated the health teaching needs of persons with chronic illness from their unique point of view. This study examined the perceived learning needs to manage the associated health problems of young adults with asthma. The University of British Columbia Model for Nursing provided an innovative and holistic means to attain perceptions in the health teaching assessment process and facilitated the development of a learning needs assessment tool. Survey methodology was used. A convenience sample of 40 young adults between the ages of 20 and 45 years was interviewed. Twenty of the sample resided in British Columbia, Canada, and 20 in Ontario, Canada. Implications of findings are discussed with regard to nursing practice.