OBAMACARE: BEFORE AND AFTER: On March 23, 2010, President Barack Obama signed into law the Patient Protection & Affordable Care Act (ACA)—commonly referred to. Average birth weight, how much weight should your baby gain (breastfed vs formula fed), weight gain chart by month, baby not gaining weight and how to help. TODAY Parents is the premiere destination for parenting news, advice & community. Find the latest parenting trends and tips for your kids and family on TODAY.com. United Nations News Centre with breaking news from the UN News Service. To access the pdfs & translations of individual guidelines, please log in as EAU member. Non-EAU members can view the web versions. To become an EAU member, click here. PHYSICAL CHARACTERISTICS (Bodmer & Rabb 1992) (Colbert,1938) (Dagg & Foster 1982) (Grzimek 1990) (Hart 2013) (Lindsey et al 1999) Weight (Hart 2013). Exercise and Vitamin D Better Together for Heart Health. Exercisers more likely to have adequate vitamin D. Antidepressant May Enhance Drug Delivery to the. Okapi Fact Sheet. Okapi, Okapia johnstoni. October 2. 00. 9TAXONOMY & NOMENCLATURE(Benirschke & Hagey 2. Colbert 1. 93. 8) (Daag & Forster 1. Spinage 1. 96. 8). Describer (Date): P. L. Sclater (1. 90. Proceedings of the Zoological. Society of London, 1. Kingdom: Animal Phylum: Chordata Class: Mammalia Order. Artiodactyla* (nearly 2. Suborder: Ruminantia (cud- chewing cattle, goats, sheep, bison, giraffes and more). ![]() Family: Giraffidae (only two species - giraffes and okapis). Genus: Giraffa camelopardalis (giraffe). Genus: Okapi (okapi). Species: Okapia johnstoni*New anatomical and DNA evidence on the relationship between Artiodactyla (even- toed ungulates) and Cetacea (whales and dolphins) recently led to a merging of the two orders into a new group, Cetartiodactyla (Montgelard, 1. Kulemzina, 2. 00. As of October 2. 01. Cetartiodactyla as an official taxonomic order that would replace Artiodactyla and Cetacea. The AXS Cookie Policy. This website, like most others, uses cookies in order to give you a great online experience. By continuing to use our website you accept to our. Read the latest Cardiology news, opinion, conference coverage, thought leader perspectives, medical journal articles and more from theheart.org and Medscape. RACE, EVOLUTION AND BEHAVIOR: A Life History Perspective. 2nd Special Abridged Edition. University of Western Ontario. Some continue to list okapi in the order Artiodactyla (Franklin, 2. Cetartiodactyla without defining it as an order (IUCN, 2. Nomenclature. Common Names: okapi. Local Names: Atti (from Wambuti pygmy tribe). Okapi derived from the pygmy word O'Api which, when. Other Scientific Nomenclature: Okapia liebrecht originated when, in the late 1. Forsyth Major concluded that a specimen of skin and. Okapia erikssoni was named in 1. Lord. Rothschild who found the skin of a female okapi to be. Species name is in Johnson's honor. Giraffe family (giraffes and okapi) dates to about 1. Miocene) (Dagg & Foster 1. At the same time in the same place, now extinct relatives of the giraffes existed. Okapi don't range into gallery forests or into forest islands on the savanna and they don't stay in the disturbed habitats surrounding human settlements. Adapted from www. IUCN fact sheet. Click here for detailed distribution (IUCN)PHYSICAL CHARACTERISTICS(Bodmer & Rabb 1. Colbert,1. 93. 8) (Dagg & Foster 1. Grzimek 1. 99. 0) (Hart 2. Lindsey et al 1. 99. Weight (Hart 2. 01. Males: 1. 80- 2. 60 kg. Females: 2. 40- 3. Shoulder Height (Hart 2. Males: 1. 4. 0- 1. Females: 1. 4. 2- 1. Length: 2. 5 m (8 ft) average for both sexes General. Okapi are a medium sized, extremely shy, even- toed ruminants related to giraffes; adapted for dense forest living. Smaller than giraffes, with shorter necks (but necks still longer than most ruminants)Okapi backs are nearly level, while giraffe backs slope markedly towards the rear. Have long skulls, large black eyes, large ears. Teeth show giraffe- like pattern with large gap between incisors and premolars. Large bony capsule enclosing the middle ear bones (auditory bullae), common to many forest- dwelling ruminants. Colbert 1. 93. 8). These ear bones enhance hearing (plains- dwelling giraffes have much smaller auditory bullae). Can hear and transmit low- frequency sounds below audible range for humans, according to studies in 1. San Diego Zoo and White Oak Conservation Center, Florida. Can be extended 2. Skin- covered horns are permanent (not shed annually). Poor eyesight Cervical vertebrae not as elongated as in the giraffe. Five sacral (lower back) vertebrae (3- 4 in giraffe) Only three tarsal (ankle area) bones; giraffes have four tarsal bones. Unlike giraffe, okapi has glands between toes on all 4 feet. Tapered white or creamy white horizontal stripes on rear and. Anklets and stockings of white on lower legs. Cheeks, throat and rear- most belly are whitish to gray or tan. Newborns have similar color and pelage; mane is conspicuous and is largely lost by adulthood. Hairs of white stripes are longer than hairs in dark stripes. Sexual Dimorphism. Males have skin- covered horns. Females have no horns but do have . Serval cat and golden cats prey on young okapi. Males and females flehmen, and males then go through a series. The. receptive female responds by a head- low posture, often with the tail. However, mothers may respond aggressively to the newborn. Common in many large zoos; currently being bred to maintain numbers. Captive okapi population in North American zoos has 2. Europe there are 2. In 2. 00. 8 camera trap images of okapi obtained for first time; cameras set up in Virunga by Zoological Society of London and the Congolese Institute for Nature Conservation (ICCN). Okapi protection begins officially in Congo/Zaire. Okapi Wildlife Reserve designated as a United Nation World Heritage Site. Within the reserve, some 5,0. This reserve encompasses the cultural center for two tribes of forest pygmy people - the Mubuti and Efe; okapi are not a significant part of their traditional diet,Strengthening protection of this reserve and Maiko National Park is the single most important means to ensure long- term survival of Okapi (IUCN 2. Okapi Wildlife Reserve placed on list of World Heritage in Danger because of devastation by civil war, invasion by miners and militants and destruction of wildlife by hunting for bushmeat and ivory. Disclaimer: Although San Diego Zoo Global makes every attempt to provide accurate information, some of the facts may become outdated or replaced by new research findings. Student Projects. Evidence Based Clinical Practice Guideline. Premature rupture of membranes at term: An evidenced- based clinical practice guideline for home birth midwives. Susan. Karimi. Susan Karimi, CNMMW2. Critical Inquiry II, Completion of Final Project. Abstract. Premature rupture of membranes (PROM) is defined as the rupturing of the fetal membranes at term, prior to the onset of uterine contractions (Duff, 1. King, 1. 99. 4). PROM is a relatively common occurrence, affecting 5% to 1. Duff, 1. 99. 6; King, 1. Risks associated with PROM include maternal and neonatal infection, cord compression, cord prolapse, and malpresentation (King, 1. As time passes with no ensuing labor, the risks of problems, particularly of infection, rises. Numerous options for treatment include an immediate induction of labor, the induction of labor after a set number of hours, expectant management while hospitalized, or out- patient expectant management. The best option for the management of PROM remains controversial due to inconsistencies within the literature (Duff, 1. King 1. 99. 4; Hannah, Hodnett, Willan, Foster, Di Cesso, & Helewa, 2. Furthermore, the research to date has been primarily conducted on hospitalized populations. Women who have planned a home birth are often reluctant to initiate the more aggressive treatment options for PROM because of the need for hospitalization. The home environment may offer protective advantages for these women, as common hospital interventions that may increase certain risks, such as vaginal examinations and internal fetal monitoring, are not performed or are not as frequent. The literature review revealed that the risk of infection is low for up to 7. PROM. Existing research also shows that most women will enter spontaneous labor within 7. PROM, and that women planning home birth prefer home care with minimal use of intervention. The exact duration for expectant management of PROM remains the primary area of debate. The conceptual framework - environment affects health - guides this inquiry. An evidenced- based clinical practice guideline is offered out of this inquiry for use in the midwifery management of PROM in home birth. CHAPTER 1: Introduction to the problem. Premature rupture of membranes (PROM) is commonly defined as the rupturing of the amniotic sac before the onset of uterine contractions and occurring after 3. Duff, 1. 99. 6; King, 1. The time between membrane rupture and onset of contractions is known as the latency period. Prior to rupture, the amniotic sac serves as a barrier to infectious organisms (King, 1. The intact amniotic sac also provides a cushion for both the fetal head and maternal tissues, so that pressure from uterine contractions is distributed more evenly and gently (King, 1. The umbilical cord is cushioned as well, protecting the cord from undue force. When the membranes rupture, these protections are lost. The management of PROM, therefore, is designed to minimize the risk of injury, particularly of infection, for both the woman and the fetus. There are several possible contributing factors to PROM. Existing infection is one possible cause, with N. According to this theory, one or more of these organisms may ascend through the cervix. An inflammatory reaction within the fetal membranes and/or uterus is initiated. As a result, injury to the fetal membranes may occur by the direct production of protease and other enzymes, or indirectly through cytokine production from the maternal immune response. Smoking, inadequate nutritional intake, and coitus within 9 days of delivery may also contribute to PROM. Finally, women with PROM, especially greater than 7. Enkin et al., 2. 00. Inadequate prostaglandin production may contribute to delayed labor and result in poor progress of cervical dilation. Current community standards of care call for medical intervention to begin immediately or within 1. PROM despite research evidence that longer waiting periods may be safe (Duff, 1. Monzurkewich & Walk, 1. Such interventions include pharmacological induction of labor and/or the use of intravenous antibiotics. Risks associated with these medications include failed induction, cesarean delivery, antibiotic resistance, and allergic reaction (Keirse, Ottervanger & Smit, 1. The research to date has been conducted primarily on women treated in hospital environments (Mozurkewich & Walf, 1. However, this data may not be applicable to women in the home setting due to the absence of virulent hospital microorganisms and the use of fewer medical interventions (Rooks, 1. Women who choose home birth, and the midwives who serve them, are philosophically unique (Anderson & Murphy, 1. Rooks, 1. 99. 7). Pregnancy and birth are viewed as normal, healthy life processes. The process is believed to develop best when unhindered by artificial rules, medications, and foreign environments. Women consider their social, spiritual, cultural, and economical needs to be as important as the physiological birth process. Freedom of self- expression, control over who will share this most personal experience with them, and cost- effectiveness are sought. Home birth midwives meet these unique needs through provision of individualized care. Hours of time are invested in getting to know women and their significant relationships with others. An intimate relationship develops between the woman and her midwife, thus enabling the midwife to intuitively recognize subtle changes in a woman's biopsychosocial health status. When labor ensues, the midwife stays with the woman, closely monitoring for signs of health or pathology while offering individualized comfort care. Interventions are only used when clearly indicated by medical need. The more naturalistic practices used in the home setting offer a very different, and sometimes controversial, option for birth than is commonly found in hospitals (Rooks, 1. This article reviews the controversies surrounding PROM management and suggests an evidenced- based clinical practice guideline (EB- CPG) for the midwifery management of PROM in planned home birth. Scope of the problem. PROM occurs in approximately 5% to 1. Duff, 1. 99. 6; King, 1. Approximately 4 million births occurred in the United States in 2. National Center for Health Statistics, 2. Therefore, an estimated 2. PROM in planned home birth will occur annually. In the 1. 95. 0s, the primary concern related to PROM was the risk of maternal and/or neonatal infection (Enkin et al, 2. Such episodes of infection were associated with a high risk of mortality. Therefore, immediate induction of labor was recommended. Today, however, current obstetrical knowledge has evolved. We now know that elimination of vaginal examinations after PROM significantly lowers the incidence of infection (Keirse et al, 1. Monitoring for clinical signs of infection is also more advanced, with cultures that detect DNA fragments. Monitoring for fetal well- being is also better through fetal surveillance testing such as non- stress testing (NST) and auscultated acceleration testing (Paine et al, 2. Deaths noted in earlier years primarily occurred after prolonged periods of severe infection, where antibiotic therapy was inadequate by today's standards (Enkin et al, 1. Such deaths are a rarity today (Keirse et al, 1. Enkin et al, 1. 99. Significance to women's health. Women seeking home birth desire a midwifery model of care that promotes nonintervention, except when clear medical need is demonstrated (Rooks, 1. Womenchoosing home birth expect to deliver their babies without medication while in the privacy of their own environments. An otherwise healthy pregnant woman who experiences PROM would suddenly find herself thrust into the world of hospital care and pharmacological intervention by those authors and care providers who promote immediate labor induction or antibiotic prophylaxis, often without listening to and acknowledging women's concerns. Without clear evidence of medical need, such women would potentially feel robbed of their home birth plans. In the event of iatrogenic complication from the recommended interventions, women would also experience avoidable threats to their health and that of their babies. For every woman planning a home birth, provider support for these plans is critical. Recommendations for transfer to the hospital should only be made under clear condition of need so that the woman and her growing family may have the best start possible. Significance to midwifery. Midwives provide evidenced- based health care that is individualized for each woman served (ACNM, 1. Clients who utilize midwives thus benefit from safe, cost- effective care (ACNM). An important component of midwifery care includes measures to reduce the use of expensive medications and cesarean surgeries. Specifically, care provided by skilled midwives in the home setting has been shown to be a safe and cost- effective option (ACNM, 2. The expectant home management of PROM has the potential to dramatically reduce overall health expenses for society. Furthermore, cutting back on the need for induction of labor, along with associated cesarean sections for failures, may help to achieve the Healthy People 2. Keirse et al., 1. Healthy People 2. Establishment of a clear practice guideline for the midwifery management of PROM in home birth is essential. Gaps between current practice and evidence based practice. The most effective management strategy for term pregnancies experiencing PROM remains uncertain. Some authors recommend immediate induction of labor for all women (Duff, 1. Garite, 2. 00. 1). Others have suggested expectant management lasting up to 7. King, 1. 99. 4; Keirse et al., 1. Shalev, Peleg, Eliyahu, & Nahum, 1. Due to these inconsistencies in the literature, no definitive clinical guideline has yet been determined. Current trends, therefore, have been towards immediate induction as a means to decrease the perceived risk of infection (Gabbe et al, 1.
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