Arsenic is a known carcinogen found globally in groundwater supplies due to natural geological occurrence. Levels exceeding the internationally recognized safe drinking water standard of 10 μg/L have been found in private drinking water supplies in many parts of Canada and the United States. Emerging epidemiological evidence confirms groundwater arsenic to be a significant health concern, even at the low to moderate levels typically found in this region. These findings, coupled with survey data reporting limited public adherence to testing and treatment guidelines, have prompted calls for improved protective measures for private well users. The purpose of this review is to assess current jurisdictional provisions for private well water protection in areas where arsenic is known to naturally occur in groundwater at elevated levels. Significant limitations in risk management approaches are identified, including inconsistent and uncoordinated risk communication approaches, lack of support mechanisms for routine water testing and limited government resources to check that testing and treatment guidelines are followed. Key action areas are discussed that can help to build regulatory, community and individual capacity for improved protection of private well water supplies and enhancement of public health.
Background: The Midwifery First Year of Practice programme (MFYP) is a fully governmentfunded programme aimed at supporting newly qualified midwives in their first year of practice. This formalised programme provides mentor support, professional continuing education and quality assessment and reflection. Aim: This research was designed to assess and explore the MFYP programme and identify which components New Zealand midwifery graduates considered important and supported them to develop confidence as a midwifery practitioner in their first year of practice. Method: A survey of graduate midwives who participated in the MFYP programme from 2007 to 2010 was undertaken. A survey tool was developed which was designed to explore each element of the programme. Likert scales were provided for the majority of questions with comment boxes also provided so that answers could be contextualised. Quantitative data were analysed using SPSS 21 with descriptive statistics provided to demonstrate responses. Findings: Between the years 2007 and 2010, there were 415 new graduate midwives who participated in the MFYP programme, of which 180 responded to the survey (43.4% response rate). The demographics of the respondents were reflective of the total cohort of MFYP programme participants. In their first year of practice, respondents were almost evenly split between self-employed midwives in case loading practice (47.5%) and midwives employed by a maternity facility (45.5%). Support from the mentor and the financial support for education were considered important contributors to developing professional confidence for these new graduates. The majority of respondents reported feeling supported when attending women during labour and birth (92.2%), and at other times during clinical practice (93.9%). Main sources of support were midwives employed within the facility, midwifery practice partners, and midwife mentors from the MFYP programme. Conclusion: Each element of the programme was considered important by new graduates and this was regardless of their practice setting. The MFYP programme is flexible, meets the needs of New Zealand graduates and helps them to increase confidence in their first year of practice as a registered midwife.
This research explored the midwifery graduate's perspective of the MFYP programme to identify which elements were important and supported them in their transition to confident practitioner. Method: Survey methodology was used to explore the views of the MFYP programme participants for the years 2007 to 2010. This paper provides the qualitative analysis of the open text responses in the survey and explores the support needs of graduate midwives during their first year of practice. Findings: A total of 180 midwives responded to the survey, with the majority also providing text responses to enable more in-depth understanding of their views. Graduate midwife participants were supported to consolidate practice skills and decision making, and to develop networks within the midwifery and wider health communities. An unexpected finding was that this support was provided by the whole midwifery community for all graduates, whether they were employed or self-employed. The mentoring relationship was also considered an important source of support. Conclusion: Graduate midwives are gaining wrap-around support from the whole midwifery community. This research, unlike any previous international or national research, demonstrates that midwives in New Zealand have taken on collective responsibility for supporting graduates. This suggests that this national programme has successfully fostered a culture of nurturing midwife graduates into their professional role.
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