An Evaluation of an Urban Health Department's Prenatal Education Program.

This study evaluated the impact of a prenatal patient education program on the knowledge and attitudes of pregnant women receiving care from an urban health department clinic. The evaluation was undertaken to determine whether attendance at prenatal classes was related to either higher levels of pregnancy-specific knowledge or more favorable attitudes toward childbearing and child rearing. Data were collected from 139 nulliparous and primiparous women; 43 percent had not attended any classes and served as a comparison group. Analyses were performed within strata formed by stage of pregnancy and levels of parity, as well as for the sample as a whole. Despite high levels of satisfaction with the instruction, class attendance and knowledge were not related for nulliparous women or among those in the early stages of pregnancy. However, class attenders in the third trimester (p < .05) or who had already given birth (p < .02) had significantly higher knowledge scores. With the exception of an indirect relationship between classes and the intention to breastfeed, no difference in attitudes was found. It would appear that prenatal patients at different points in their pregnancy may differ in their level of knowledge, possibly as a result of variability in their motivation to learn, without differing in their attitudes toward child rearing. Multiple methods and an individualized approach to prenatal education are therefore recommended. Suggestions for program changes based on general principles of health education are presented.

Mouse pancreatic acinar cells: voltage-clamp study of acetylcholine-evoked membrane current.

1. A two-micro-electrode voltage-clamp technique was applied to a study of the resting properties of mouse pancreatic acinar cell membranes and the action of acetylcholine (ACh). 2. The resting voltage-current relation was linear. The specific membrane resistance was calculated to be about 10 k omega cm2. This value was doubled after removal of Cl from the tissue bath superfusion solution. 3. At a holding potential equal to the spontaneous resting potential (about -35 mV) micro-ionophoretic ACh application evoked inward current. Reversal of the polarity of the ACh-evoked current occurred at about - 15 mV. 4. The voltage dependence of the ACh-evoked current displayed inward rectification. This inward rectification could not be accounted for by the constant field equation. 5. The dose-response curves for ACh-evoked inward current were compared in the same units with dose-response curves for ACh-evoked depolarization. Half-maximal depolarization was consistently obtained at a lower dose of ACh than half-maximal inward current. 6. During steady-state exposure of the pancreatic tissue segments to Cl-free sulphate solution the ACh reversal potential was about + 10 mV and the voltage-current relationship for the ACh-controlled channels showed inward rectification. Removal of external Na from the Cl-free solution virtually abolished ACh-evoked inward current. 7. The resting pancreatic acinar cell membrane is electrically inexcitable. The relative permeabilities of the major monovalent ions appears to be PC1/PNa/PK = 2/0.23/1. The ACh-evoked inward current is largely carried by Na. Dose-response curves for ACh-evoked depolarization and inward current in the same acinar units are different, in such a way that the depolarization response saturates at lower ACh concentrations than the current response.