Educational relationships : a study in midwifery

At its inception in 1902, formal midwifery training developed within hospital midwifery services. With the development of a theoretical base, training became education during the 1980s. During a period of economic and societal changes in the 1990s, midwifery education was incorporated into higher education, separating education from health service practice. There were consequences for midwifery education especially the structure of pedagogical relationships. This thesis looks at key sets of relationships in midwifery education between the three main groups of actors: academics, clinicians and students. In so doing, the inquiry utilises a grounded theory approach and embraces disciplines of education, social sciences, social psychology, management and philosophy. The study confirms the importance of relationships between the key actors as part of a student's learning experiences. However, these relationships have become more problematic as a result of the organisational separation between the academic and professional components. A framework is proposed to describe educational relationships in midwifery. The framework has six dimensions; (i) a core component of personal traits, (ii) a secondary component of social and communication abilities and four subsidiary components of (iii) professional expertise, (iv) personal knowledge, (v) education knowledge and skills and (vi) a vision for practice. Realisation of the components by one person of another within the three groups aids mutuality in understanding. General principles are offered that include notions of encounter, exchange, rules, boundaries, reciprocity and reinforcement that aid in constructions of relationships. Though these conditions, in themselves, aid the formation of learning relationships, two processes occur in these relationships through encounters, that is, complementation (a unity of meanings between actors) and complementarity (a matching of understandings). These require a forum for encounters. A model of education is proposed that offers just such a forum aiding positive encounters to promote learning between the three groups of actors. Features of this model are the development of teachers within clinical practice, accreditation of practitioners as educators and the education of students primarily in clinical situations with interactive learning

Nut Consumption and Cardiovascular Risk in Older Chinese: The Guangzhou Biobank Cohort Study

<div><p>Objectives</p><p>In Western contexts nut consumption is associated with better health. We examined the associations of nut consumption with cardiovascular disease risk in the non-Western setting of Southern China.</p><p>Methods</p><p>In the Guangzhou Biobank Cohort Study we used multivariable linear regression to examine the associations of baseline nut (mainly peanuts) consumption (none (n = 6688), <3 portions/week (n = 2596) and ≥3 portions/week (n = 2444)) with follow-up assessment of Framingham cardiovascular disease score (excluding smoking) and its components in older Chinese (≥50 years) (follow-up 57.8%).</p><p>Results</p><p>Nut consumption was not associated with Framingham score (≥3 portions/week compared to none: 0.02 95% confidence interval (CI) -0.11 to 0.15), systolic blood pressure (-0.66 mmHg 95% CI -1.94, 0.62), diastolic blood pressure (-0.69 mmHg 95% CI -1.44, 0.07), HDL-cholesterol (-0.01 mmol/L 95% CI -0.02, 0.005), LDL-cholesterol (-0.01 mmol/L 95% CI -0.05, 0.02) or fasting glucose (0.04 mmol/L 95% CI -0.02, 0.09), adjusted for baseline values, energy intake, age, sex, phase of recruitment, socio-economic position, lifestyle and baseline health status.</p><p>Conclusions</p><p>Observations concerning the benefits of nut consumption may be contextually specific, perhaps depending on the type of nut consumed.</p></div

Characteristics by Nut Consumption in Older Chinese (3329 men and 8399 women) in Phases 1 and 2 of the Guangzhou Biobank Cohort Study.

<p>^a<i>P</i> value from chi-square test for categorical variables and from one-way analysis of variants (ANOVA) for continuous variables, 2 sided; bold values indicate <i>P</i><0.05.</p><p>Abbreviations: IPAQ, International Physical Activity Questionnaire; HEPA, health-enhancing physical activity, i.e., vigorous activity at least 3 days a week that corresponds to a minimum of 1500 metabolic equivalent (MET) minutes per week, or activity 7 days of the week that corresponds to at least 3000 MET minutes per week.</p

Fruit and Vegetable Consumption and Cardiovascular Risk Factors in Older Chinese: The Guangzhou Biobank Cohort Study

<div><p>Objective</p><p>To examine the adjusted associations of fruit consumption and vegetable consumption with the Framingham score and its components in the non-Western setting of Southern China, considering health status.</p><p>Method</p><p>Linear regression was used to assess the cross-sectional associations of fruit and vegetable consumption with the Framingham score and its components, among 19,518 older Chinese (≥50 years) from the Guangzhou Biobank Cohort Study in Southern China (2003–2006), and whether these differed by health status.</p><p>Results</p><p>The association of fruit consumption with the Framingham score varied by health status (<i>P</i>-value<0.001), but not vegetable consumption (<i>P</i>-value 0.51). Fruit consumption was associated with a lower Framingham score (-0.04 per portions/day, 95% confidence interval (CI) -0.08 to -0.004) among participants in poor health, adjusted for age, sex, recruitment phase, socio-economic position and lifestyle. However, similarly adjusted, fruit consumption was associated with a higher Framingham score (0.05, 95% CI 0.02 to 0.09) among participants in good health, perhaps due to a positive association of fruit consumption with fasting glucose. Similarly adjusted, vegetable consumption was associated with a higher Framingham score (0.03, 95% CI 0.01 to 0.05) among all participants, with no difference by health status.</p><p>Conclusion</p><p>This large study from a non-western setting found that fruit and vegetable consumption was barely associated with the Framingham score, or major CVD risk factors.</p></div

Associations of alcohol (per 10g ethanol per day) with gamma-glutamyltransferase (GGT, U/L) using a Mendelian randomization design and an observational multivariable linear regression analysis among participants from the Phase 3 of Guangzhou Biobank Cohort Study (2006–2008).

<p>^† Adjusted for age, education, physical activity and smoking.</p><p>Associations of alcohol (per 10g ethanol per day) with gamma-glutamyltransferase (GGT, U/L) using a Mendelian randomization design and an observational multivariable linear regression analysis among participants from the Phase 3 of Guangzhou Biobank Cohort Study (2006–2008).</p

Characteristics by Fruit and Vegetable Consumption in Older Chinese (5602 men and 13,916 women) in Phases 1 and 2 of the Guangzhou Biobank Cohort Study, 2003–2006.

<p>Abbreviations: IPAQ, International Physical Activity Questionnaire; HEPA, health-enhancing physical activity, i.e., vigorous activity at least 3 days a week that corresponds to a minimum of 1500 metabolic equivalent (MET) minutes per week, or activity 7 days of the week that corresponds to at least 3000 MET minutes per week.</p><p>^a<i>P</i> value from chi-square test for categorical variables and from one-way analysis of variants (ANOVA) for continuous variables, 2 sided; bold values indicate <i>P</i><0.05.</p><p>Characteristics by Fruit and Vegetable Consumption in Older Chinese (5602 men and 13,916 women) in Phases 1 and 2 of the Guangzhou Biobank Cohort Study, 2003–2006.</p

Two-sample Mendelian randomization of alcohol use and gamma-glutamyltransferase (GGT) in the Guangzhou Biobank Cohort Study.

<p>Two-sample Mendelian randomization of alcohol use and gamma-glutamyltransferase (GGT) in the Guangzhou Biobank Cohort Study.</p

Alcohol consumption and socio-demographic characteristics by <i>ALDH2</i> polymorphism rs671 in men and women from the Phase 3 of Guangzhou Biobank Cohort Study (2006–8).

<p>†P-value from analysis of variance (ANOVA) for continuous variables and from a χ² test for categorical variables, 2 sided; Alcohol unit and GGT were log-transformed before the ANOVA analysis.</p><p>Alcohol consumption and socio-demographic characteristics by <i>ALDH2</i> polymorphism rs671 in men and women from the Phase 3 of Guangzhou Biobank Cohort Study (2006–8).</p

Baseline characteristics of 21,658 women and 8,284 men aged 50+ in the Guangzhou Biobank Cohort Study first examined in 2003 to 2008 and followed up until January 2016.

<p>Baseline characteristics of 21,658 women and 8,284 men aged 50+ in the Guangzhou Biobank Cohort Study first examined in 2003 to 2008 and followed up until January 2016.</p