The effect of a nutrition education programme on pregnant women attending Khartoum model clinic

A comparative study conducted in the Sudan illustrated both the potential of a nutrition education program for pregnant women and the many obstacles to creating more optimal maternal nutrition. Included in the study were 1200 women 18-34 years of age attending the Khartoum Province Model Clinic for a minimum of 5 prenatal visits. 83.3% were Muslims and 48.2% were illiterate. The 60 women who comprised the experimental group were exposed to individual nutrition counseling and home visits. Overall, 70% of subjects were anemic, 27% had malaria, and 18% were hookworm. The average weight gain during pregnancy was 4.5 kgs; 25.0% of controls and 20.0% of those in the experimental group gained 3.5-4.0 kgs, 18.3% of controls and 33.3% of experimental subjects gained 4.5-5.0 kgs, and 23.3% of controls and 30.0% of those in the experimental groups gained 5.5 kgs or more. 53.0% of controls and 61.7% of women exposed to nutrition education breastfed for at least 6 months, and 70% of women in the former group and 95% of those in the latter had enrolled their infants in an immunization program. A baseline nutrition questionnaire revealed widespread misinformation, especially a belief that pregnant women should reduce their food intake from 3 to 1-2 meals per day to prevent the fetus from growing too large and making labor difficult. Foods such as fermented sorghum products, fresh fish, and water melon were regarded as abortifacients and avoided, while hot pepper, sour milk, and cola sodas were considered nutritious. Consumption was self-reported to be poor for milk products by 25% of mothers, for meat by 16%, and for fruits and vegetables by 40% Although the educational intervention increased women's knowledge of basic nutrition, it had only a minimal effect on actual practice. This finding is assumed to reflect the widespread belief that men and their guests should be given preference in food allocation, poverty, and avoidance, on the basis of tradition, of many healthy foods. Since 72% of women reported ownership of a television, use if this medium is recommended for nutrition education.     

Getting the most for your consulting dollars

Major changes in the health care financing and delivery system have usually been accompanied by an increase in demand within the health care field for consulting services. The passage of Medicare/Medicaid in 1965 is one example. The passage of the DRG-based prospective pricing system in 1983 is another. Both spawned a substantial amount of work, and income, for consulting firms. Now the health care field is engaged in nearly total transformation as the forces of health care reform at the national level are met with myriad adjustments at the local and regional levels. Managed care, already a byword, is being strengthened by a multitude of so-called integrated system initiatives. It is not easy to survive, and the call is out to consultants to save the day, or at least stave off disaster. In the following four articles, Marilyn Kennedy, a member of the ACPE faculty and a consultant herself, gives some advice on how to make the consulting arrangement successful; three physician executives provide a glimpse at consults that have worked, and some that did not work.     

Personal trainer, personal coach

The increasing number of fresh faces in the management ranks, many of them with highly polished credentials but little in the way of practical experience in the work-a-day management world, has increased the need for a new consulting professional--the personal coach. There simply aren't enough volunteer mentors to accommodate the growing medical management profession. Whatever the conditions under which this new professional's services are sought, both the individual to be coached and the organization for which the individual works should approach the arrangement with care and planning. The author offers some guidance for making the arrangement pay off.     

Can you communicate cross-generationally?

What is fractured cross-generational communication? When what one person heard was not what the other person said. Regardless of your age, you need to understand some of the differences in communication styles that must be overcome if people are to work well together. This is especially important in health care right now when there are other pressing issues. Interpreters are at a premium because so much misunderstanding clouds the communication process. Two management strategies are presented that will help bridge the gaps between communication styles.     

How could I have gotten it wrong?

Can you avoid ending up in a career-denting job: Are there potential pitfalls to recognize on the search for a rewarding position? Finding oneself in an impossible job, working for a boss who brings out your worst qualities and deepest insecurities, or joining an organization that is doomed are nightmare scenarios. How do these judgment errors happen? We asked physicians who've been there and, unfortunately, done just that. What they learned might help the rest of us skip the experience.     

A guide to journal articles on strategic management in nonprofit organizations, 1977 to 1992

This article is a guide to over a hundred journal articles on strategic management in nonprofit organizations, published from 1977 to 1992 in nineteen leading general management or nonprofit journals. The guide provides brief summaries of articles, organized into widely accepted strategic management topic areas and research categories. The article indicates areas where substantial foundations of knowledge exist and where such bases are lacking. It distinguishes between works on general nonprofit management and those on empirical research.     

Pakistan: innovative population planning

In Pakistan the population planning program has been "federalized." As part of the new plan, the Population Planning Division will be responsible for policy formation, preparation of plans, and program implementation. With this new organization, the program will promote close coordination with provincial governments. An effective information program has been planned to promote pro-family planning attitudes. In order to develop these attitudes among the young, population education is being integrated into the curricula of the schools and colleges. At the policy making level, development projects of the Ministries of Education, Local Government, Rural Development, Health, Labor and Manpower Production, and Agriculture will in future be prepared so as to contain a component of the population planning program. The operational structure of the program was strengthened during 1976-1977 in order to reduce the crude birthrate from an estimated level of 45 per 1000 in mid-1976 to 43.6 per 1000 in mid-1977.     

关敬吾论日本传统故事的类型与结构

本文是日本民俗学家关敬吾先生对日本传统故事的概念界定以及对之内容、结构特点的概括,作为“他山之石”,可以给中国民俗学理论研究提供参考。     

'Where are the lesbians in Chaucer?' Lack, opportunity and female homoeroticism in Medieval Studies today

This article explores the study of lesbians in the Middle Ages and proposes that the unstable construct of lesbian poses a problem for traditional Medieval Studies that can lead to the development in Medieval Studies of more nuanced and productive theorizing.