Safe Deliveries?: a Review of New Zealand's Midwifery Regulation through the Lens of the Health and Disability Commissioner

Although birth is a fundamental part of the life process, competing factions within the health profession struggle to agree on the best way to deliver maternity services. Despite this long-standing tension, the midwifery-led model has dominated New Zealand’s maternity system for more than two decades with the majority of consumers expressing satisfaction with the care provided. Unfortunately for a small number of mothers and babies the pregnancy and birth experience is not a positive one and families are left suffering life-long, and often tragic, consequences. As one of the main consumer watchdogs in New Zealand, the Health and Disability Commissioner is charged with investigating claims of poor quality healthcare. This paper examines the central themes in the Commissioner’s reports on substandard midwifery practice and proposes a number of regulatory solutions to the issues involved. Working in unison, these amendments have the potential to ease the pressure placed on midwives; enhance interprofessional relationships; improve practitioner competence; and increase overall compliance with the Code of Health and Disability Services Consumers’ Rights. By implementing these changes, the New Zealand Government could safeguard valuable midwifery-based principles whilst still ensuring that high quality maternity care is provided to all of the country’s mothers and babies

Soft drinks and 'desire to drink' in preschoolers

Interest in soft drink consumption has increased following a dramatic rise in intake over recent years. Research to date has focused primarily on general trends in consumption or on understanding the mechanism by which soft drink consumption may be linked to weight gain. It is clear however that there is considerable individual variability in the extent to which soft drinks are consumed and factors potentially influencing intake have received little attention. This study examines how the Child Eating Behaviour Questionnaire (CEBQ) construct 'Desire to Drink' (DD) relates to drink consumption, preferences and BMI-SDS

When adoption disrupts: Views & experiences of adoptive mothers

An increasing number of looked-after children are being placed for adoption in accordance with the government drive to increase permanency for children in local authority care. Unfortunately it is estimated that approximately one fifth of all adoptive placements end in disruption. Previous studies attempting to identify factors associated with disruption have tended to focus on demographic details and assessment data to predict increased risk. Few attempts have been made to explore the phenomenon in more depth by considering the views and accounts of the individuals involved. This study explores the experience of adoption disruption from the perspective of the adoptive mothers. It considers their understanding of the main contributing factors and their views on how services could be improved.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Safe Deliveries?: a Review of New Zealand's Midwifery Regulation through the Lens of the Health and Disability Commissioner

Although birth is a fundamental part of the life process, competing factions within the health profession struggle to agree on the best way to deliver maternity services. Despite this long-standing tension, the midwifery-led model has dominated New Zealand’s maternity system for more than two decades with the majority of consumers expressing satisfaction with the care provided. Unfortunately for a small number of mothers and babies the pregnancy and birth experience is not a positive one and families are left suffering life-long, and often tragic, consequences. As one of the main consumer watchdogs in New Zealand, the Health and Disability Commissioner is charged with investigating claims of poor quality healthcare. This paper examines the central themes in the Commissioner’s reports on substandard midwifery practice and proposes a number of regulatory solutions to the issues involved. Working in unison, these amendments have the potential to ease the pressure placed on midwives; enhance interprofessional relationships; improve practitioner competence; and increase overall compliance with the Code of Health and Disability Services Consumers’ Rights. By implementing these changes, the New Zealand Government could safeguard valuable midwifery-based principles whilst still ensuring that high quality maternity care is provided to all of the country’s mothers and babies

Safe Deliveries?: a Review of New Zealand's Midwifery Regulation through the Lens of the Health and Disability Commissioner

Although birth is a fundamental part of the life process, competing factions within the health profession struggle to agree on the best way to deliver maternity services. Despite this long-standing tension, the midwifery-led model has dominated New Zealand’s maternity system for more than two decades with the majority of consumers expressing satisfaction with the care provided. Unfortunately for a small number of mothers and babies the pregnancy and birth experience is not a positive one and families are left suffering life-long, and often tragic, consequences. As one of the main consumer watchdogs in New Zealand, the Health and Disability Commissioner is charged with investigating claims of poor quality healthcare. This paper examines the central themes in the Commissioner’s reports on substandard midwifery practice and proposes a number of regulatory solutions to the issues involved. Working in unison, these amendments have the potential to ease the pressure placed on midwives; enhance interprofessional relationships; improve practitioner competence; and increase overall compliance with the Code of Health and Disability Services Consumers’ Rights. By implementing these changes, the New Zealand Government could safeguard valuable midwifery-based principles whilst still ensuring that high quality maternity care is provided to all of the country’s mothers and babies.</p

Defining “serious harm” to the marine environment in the context of deep-seabed mining

Increasing interest in deep-seabed mining has raised many questions surrounding its potential environmental impacts and how to assess the impacts’ significance. Under the United Nations Convention on the Law of the Sea (UNCLOS), the International Seabed Authority (ISA) is charged with ensuring effective protection of the marine environment as part of its responsibilities for managing mining in seabed areas beyond national jurisdiction (the Area) on behalf of humankind. This paper examines the international legal context for protection of the marine environment and defining the significant adverse change that can cause “serious harm”, a term used in the ISA Mining Code to indicate a level of harm that strong actions must be taken to avoid. It examines the thresholds and indicators that can reflect significant adverse change and considers the specific vulnerability of the four ecosystems associated with the minerals targeted for mining: (1) manganese (polymetallic) nodules, (2) seafloor massive (polymetallic) sulphides, (3) cobalt-rich (polymetallic) crusts and (4) phosphorites. The distributions and ecological setting, probable mining approaches and the potential environmental impacts of mining are examined for abyssal polymetallic nodule provinces, hydrothermal vents, seamounts and phosphorite-rich continental margins. Discussion focuses on the special features of the marine environment that affect the significance of the predicted environmental impacts and suggests actions that will advance understanding of these impacts

Evidence of dark oxygen production at the abyssal seafloor

Deep-seafloor organisms consume oxygen, which can be measured by in situ benthic chamber experiments. Here we report such experiments at the polymetallic nodule-covered abyssal seafloor in the Pacific Ocean in which oxygen increased over two days to more than three times the background concentration, which from ex situ incubations we attribute to the polymetallic nodules. Given high voltage potentials (up to 0.95 V) on nodule surfaces, we hypothesize that seawater electrolysis may contribute to this dark oxygen production.</p