Translating evidence into practice in childbirth: A case from the Occupied Palestinian Territory

ObjectiveTo investigate possible changes in practices during normal childbirth by implementing interventions which reduce the frequency of: intravenous fluids; bladder catheterization; analgesia; artificial rupture of membranes; oxytocin use for augmentation; vaginal examination; episiotomy, and increase: mobility; oral intake of fluids; and initiation of immediate breastfeeding.DesignAn operational research design.SettingA referral governmental hospital in the Occupied Palestinian Territory (oPt) between 2006 and 2010.Participants2345 women (baseline: 134 women, intervention: 1860 women, post-intervention: 351 women) and 17 providers (10 midwives and 7 physicians).InterventionsMultifaceted interventions; a combination of on-the-job training, audit, and feedback, supported by a core team and informal meetings.Main outcome measuresChange of practices during normal childbirth according to best evidence and the WHO recommendations.FindingsSignificant sustained improvements in practices during childbirth from baseline to post-intervention including artificial rupture of membranes, liberal use of oxytocin to augment normal labour, intravenous fluids, frequency of vaginal examinations, oral intake, immediate breastfeeding and routine episiotomy (P < 0.005). There was positive change in the mobility during labour, but this change was not sustained after 9 months from intervention to post-intervention. The usage of analgesia did not change.Key conclusionsCertain changes in practices during normal childbirth were possible in this hospital. A combination of on-the-job training with other interactive approaches increased midwives’ awareness, capacities and self-confidence to implement fewer interventions during normal labour.     

EDLP versus Hi–Lo pricing strategies in retailing—a state of the art article

The pricing strategy is seen as one of the five most important priorities in retail management. Over the past years, price wars have emerged and price has become an even more focal point of retailers’ agendas. Especially grocery retailers operate on very low margins and have fallen into a price-promotion trap, pressured both by competition and consumers. In times of intensive competition it is getting even more important for retailers to focus on profitable and successful pricing strategies. Furthermore, retailers act under complex circumstances, especially because of broad assortments, and should therefore define a clear framework for their pricing strategy. There are several studies which have been published on pricing strategy in retailing during the last years, but no comprehensive literature review of this topic with its determinants and outcomes exists. Based on the theoretical and conceptual foundations of pricing strategy in retailing, all relevant conceptual and empirical studies are analyzed. First, the different definitions of pricing strategy in retailing are examined and systemized. Furthermore, a division into studies on determinants and outcomes of pricing strategy in retailing is included followed by a discussion of main and further results. Based on this analysis of the existing literature, avenues for further research are identified and prioritized.     

Promoting women entrepreneurs in Lebanon: the experience of UNIFEM

The work of the United Nations Development Fund for Women (UNIFEM) in West Asia began in 1994 with a regional program to strengthen women-owned enterprises in Jordan, Syria, and Lebanon. In Lebanon, a survey of 100 women entrepreneurs, as well as nontraditional credit programs and banks, was conducted prior to program design. A second survey assessed micro-entrepreneurs' demands for financial and other services. Since gender analysis was a new concept in Lebanon, UNIFEM organized a gender awareness workshop for representatives of government, nongovernmental organizations, and the banking sector, followed by a strategic planning workshop. The surveys confirmed that women were concentrated mainly in the less profitable economic sectors, producing handicrafts and food products or running small service or trading companies. Women were less likely than men to get bank loans or to register their businesses. Women's problems accessing credit--the main obstacle limiting their ability to develop their businesses--were compounded by their lack of information, male-oriented collateral requirements, and discriminatory banking regulations. UNIFEM decided to channel counseling of women entrepreneurs on legal matters, marketing, and credit sources through the Ministry of Social Affairs. It is expected that knowledge of gender-related employment issues and the use of gender-specific analysis will become integral to the Ministry's program as a result.