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We present the requirements, design, and evaluation of the cryogenic continuously rotating half-wave plate (CHWP) for the Simons Observatory (SO). SO is a cosmic microwave background polarization experiment at Parque Astronómico de Atacama in northern Chile that covers a wide range of angular scales using both small (⌀0.42 m) and large (⌀6 m) aperture telescopes. In particular, the small aperture telescopes (SATs) focus on large angular scales for primordial B-mode polarization. To this end, the SATs employ a CHWP to modulate the polarization of the incident light at 8 Hz, suppressing atmospheric 1/f noise and mitigating systematic uncertainties that would otherwise arise due to the differential response of detectors sensitive to orthogonal polarizations. The CHWP consists of a 505 mm diameter achromatic sapphire HWP and a cryogenic rotation mechanism, both of which are cooled down to ∼50 K to reduce detector thermal loading. Under normal operation, the HWP is suspended by a superconducting magnetic bearing and rotates with a constant 2 Hz frequency, controlled by an electromagnetic synchronous motor. We find that the number of superconductors and the number of magnets that make up the superconducting magnetic bearing are important design parameters, especially for the rotation mechanism's vibration performance. The rotation angle is detected through an angular encoder with a noise level of 0.07 μrad s. During a cooldown process, the rotor is held in place by a grip-and-release mechanism that serves as both an alignment device and a thermal path. In this paper, we provide an overview of the SO SAT CHWP: its requirements, hardware design, and laboratory performance.

We measure the projected number density profiles of galaxies and the splashback feature in clusters selected by the Sunyaev-Zel'dovich effect from the Advanced Atacama Cosmology Telescope (AdvACT) survey using galaxies observed by the Dark Energy Survey (DES). The splashback radius is consistent with CDM-only simulations and is located at 2.4-0.4+0.3 Mpc h-1. We split the galaxies on color and find significant differences in their profile shapes. Red and green-valley galaxies show a splashback-like minimum in their slope profile consistent with theory, while the bluest galaxies show a weak feature at a smaller radius. We develop a mapping of galaxies to subhalos in simulations and assign colors based on infall time onto their hosts. We find that the shift in location of the steepest slope and different profile shapes can be mapped to the average time of infall of galaxies of different colors. The steepest slope traces a discontinuity in the phase space of dark matter halos. By relating spatial profiles to infall time, we can use splashback as a clock to understand galaxy quenching. We find that red galaxies have on average been in clusters over 3.2 Gyr, green galaxies about 2.2 Gyr, while blue galaxies have been accreted most recently and have not reached apocenter. Using the full radial profiles, we fit a simple quenching model and find that the onset of galaxy quenching occurs after a delay of about a gigayear and that galaxies quench rapidly thereafter with an exponential timescale of 0.6 Gyr.

We present measurements of the radial profiles of the mass and galaxy number density around Sunyaev–Zel’dovich (SZ)-selected clusters using both weak lensing and galaxy counts. The clusters are selected from the Atacama Cosmology Telescope Data Release 5 and the galaxies from the Dark Energy Survey Year 3 data set. With signal-to-noise ratio of 62 (45) for galaxy (weak lensing) profiles over scales of about 0.2–20 h-1 Mpc, these are the highest precision measurements for SZ-selected clusters to date. Because SZ selection closely approximates mass selection, these measurements enable several tests of theoretical models of the mass and light distribution around clusters. Our main findings are: (1) The splashback feature is detected at a consistent location in both the mass and galaxy profiles and its location is consistent with predictions of cold dark matter N-body simulations. (2) The full mass profile is also consistent with the simulations. (3) The shapes of the galaxy and lensing profiles are remarkably similar for our sample over the entire range of scales, from well inside the cluster halo to the quasilinear regime. We measure the dependence of the profile shapes on the galaxy sample, redshift, and cluster mass. We extend the Diemer & Kravtsov model for the cluster profiles to the linear regime using perturbation theory and show that it provides a good match to the measured profiles. We also compare the measured profiles to predictions of the standard halo model and simulations that include hydrodynamics. Applications of these results to cluster mass estimation, cosmology, and astrophysics are discussed.

We present measurements of the average thermal Sunyaev Zel’dovich (tSZ) effect from optically selected galaxy groups and clusters at high signal-to-noise (up to ) and estimate their baryon content within a radius aperture. Sources from the Sloan Digital Sky Survey Baryon Oscillation Spectroscopic Survey DR15 catalog overlap with 3,700 sq deg of sky observed by the Atacama Cosmology Telescope (ACT) from 2008 to 2018 at 150 and 98 GHz (ACT DR5), and 2,089 sq deg of internal linear combination component-separated maps combining ACT and Planck data (ACT DR4). The corresponding optical depths , which depend on the baryon content of the halos, are estimated using results from cosmological hydrodynamic simulations assuming an active galactic nuclei feedback radiative cooling model. We estimate the mean mass of the halos in multiple luminosity bins, and compare the tSZ-based estimates to theoretical predictions of the baryon content for a Navarro-Frenk-White profile. We do the same for estimates extracted from fits to pairwise baryon momentum measurements of the kinematic Sunyaev-Zel’dovich effect (kSZ) for the same dataset obtained in a companion paper. We find that the estimates from the tSZ measurements in this work and the kSZ measurements in the companion paper agree within for two out of the three disjoint luminosity bins studied, while they differ by in the highest luminosity bin. The optical depth estimates account for one-third to all of the theoretically predicted baryon content in the halos across luminosity bins. Potential systematic uncertainties are discussed. The tSZ and kSZ measurements provide a step toward empirical Compton- relationships to provide new tests of cluster formation and evolution models.

We present a detection of the pairwise kinematic Sunyaev-Zeldovich (kSZ) effect using Atacama Cosmology Telescope (ACT) and Planck CMB observations in combination with Luminous Red Galaxy samples from the Sloan Digital Sky Survey (SDSS) DR15 catalog. Results are obtained using three ACT CMB maps: co-added 150 and 98 GHz maps, combining observations from 2008-2018 (ACT DR5), which overlap with SDSS DR15 over 3,700 sq. deg., and a component-separated map using night-time only observations from 2014-2015 (ACT DR4), overlapping with SDSS DR15 over 2,089 sq. deg. Comparisons of the results from these three maps provide consistency checks in relation to potential frequency-dependent foreground contamination. A total of 343,647 galaxies are used as tracers to identify and locate galaxy groups and clusters from which the kSZ signal is extracted using aperture photometry. We consider the impact of various aperture photometry assumptions and covariance estimation methods on the signal extraction. Theoretical predictions of the pairwise velocities are used to obtain best-fit, mass-averaged, optical depth estimates for each of five luminosity-selected tracer samples. A comparison of the kSZ-derived optical depth measurements obtained here to those derived from the thermal SZ effect for the same sample is presented in a companion paper.

Two recent large data releases for the Atacama Cosmology Telescope (ACT), called DR4 and DR5, are available for public access. These data include temperature and polarization maps that cover nearly half the sky at arcminute resolution in three frequency bands; lensing maps and component-separated maps covering ~2100 deg2 of sky; derived power spectra and cosmological likelihoods; a catalog of over 4000 galaxy clusters; and supporting ancillary products including beam functions and masks. The data and products are described in a suite of ACT papers; here we provide a summary. In order to facilitate ease of access to these data, we present a set of Jupyter IPython notebooks developed to introduce users to DR4, DR5, and the tools needed to analyze these data. The data products (excluding simulations) and the set of notebooks are publicly available on the NASA Legacy Archive for Microwave Background Data Analysis; simulation products are available on the National Energy Research Scientific Computing Center.

We quantify the calibration requirements for systematic uncertainties for next-generation ground-based observatories targeting the large-angle B-mode polarization of the Cosmic Microwave Background, with a focus on the Simons Observatory (SO). We explore uncertainties on gain calibration, bandpass center frequencies, and polarization angles, including the frequency variation of the latter across the bandpass. We find that gain calibration and bandpass center frequencies must be known to percent levels or less to avoid biases on the tensor-to-scalar ratio r on the order of Δ r∼10-3, in line with previous findings. Polarization angles must be calibrated to the level of a few tenths of a degree, while their frequency variation between the edges of the band must be known to O(10) degrees. Given the tightness of these calibration requirements, we explore the level to which residual uncertainties on these systematics would affect the final constraints on r if included in the data model and marginalized over. We find that the additional parameter freedom does not degrade the final constraints on r significantly, broadening the error bar by O(10%) at most. We validate these results by reanalyzing the latest publicly available data from the collaboration within an extended parameter space covering both cosmological, foreground and systematic parameters. Finally, our results are discussed in light of the instrument design and calibration studies carried out within SO.

The thermal and kinematic Sunyaev-Zel'dovich effects (tSZ, kSZ) probe the thermodynamic properties of the circumgalactic and intracluster medium (CGM and ICM) of galaxies, groups, and clusters, since they are proportional, respectively, to the integrated electron pressure and momentum along the line of sight. We present constraints on the gas thermodynamics of CMASS (constant stellar mass) galaxies in the Baryon Oscillation Spectroscopic Survey using new measurements of the kSZ and tSZ signals obtained in a companion paper [Schaan et al.]. Combining kSZ and tSZ measurements, we measure within our model the amplitude of energy injection ϵM⋆c2, where M⋆ is the stellar mass, to be ϵ=(40±9)×10-6, and the amplitude of the nonthermal pressure profile to be αNth

The scattering of cosmic microwave background (CMB) photons off the free-electron gas in galaxies and clusters leaves detectable imprints on high resolution CMB maps: the thermal and kinematic Sunyaev-Zel'dovich effects (tSZ and kSZ respectively). We use combined microwave maps from the Atacama Cosmology Telescope DR5 and Planck in combination with the CMASS (mean redshift ⟨z

We present ΛCDM cosmological parameter constraints obtained from delensed microwave background power spectra. Lensing maps from a subset of DR4 data from the Atacama Cosmology Telescope (ACT) are used to undo the lensing effect in ACT spectra observed at 150 and 98 GHz. At 150 GHz, we remove the lensing distortion with an effective efficiency of 30% (TT), 30% (EE), 26% (TE) and 20% (BB); this results in detections of the delensing effect at 8.7σ (TT), 5.1σ (EE), 2.6σ (TE), and 2.4σ (BB) significance. The combination of 150 and 98 GHz TT, EE, and TE delensed spectra is well fit by a standard ΛCDM model. We also measure the shift in best-fit parameters when fitting delensed versus lensed spectra; while this shift does not inform our ability to measure cosmological parameters, it does provide a three-way consistency check among the lensing inferred from the best-fit parameters, the lensing in the CMB power spectrum, and the reconstructed lensing map. This shift is predicted to be zero when fitting with the correct model since both lensed and delensed spectra originate from the same region of sky. Fitting with a ΛCDM model and marginalizing over foregrounds, we find that the shift in cosmological parameters is consistent with zero. Our results show that gravitational lensing of the microwave background is internally consistent within the framework of the standard cosmological model.

We construct cosmic microwave background lensing mass maps using data from the 2014 and 2015 seasons of observations with the Atacama Cosmology Telescope (ACT). These maps cover 2100 square degrees of sky and overlap with a wide variety of optical surveys. The maps are signal dominated on large scales and have fidelity such that their correlation with the cosmic infrared background is clearly visible by eye. We also create lensing maps with thermal Sunyaev-Zel'dovich contamination removed using a novel cleaning procedure that only slightly degrades the lensing signal-to-noise ratio. The cross-spectrum between the cleaned lensing map and the BOSS CMASS galaxy sample is detected at 10σ significance, with an amplitude of A = 1.02 ± 0.10 relative to the Planck best-fitting Lambda cold dark matter cosmological model with fiducial linear galaxy bias. Our measurement lays the foundation for lensing cross-correlation science with current ACT data and beyond.

We present new arcminute-resolution maps of the Cosmic Microwave Background temperature and polarization anisotropy from the Atacama Cosmology Telescope, using data taken from 2013–2016 at 98 and 150 GHz. The maps cover more than 17,000 deg2, the deepest 600 deg2 with noise levels below 10µK-arcmin. We use the power spectrum derived from almost 6,000 deg2 of these maps to constrain cosmology. The ACT data enable a measurement of the angular scale of features in both the divergence-like polarization and the temperature anisotropy, tracing both the velocity and density at last-scattering. From these one can derive the distance to the last-scattering surface and thus infer the local expansion rate, H0. By combining ACT data with large-scale information from WMAP we measure H0 = 67.6±1.1 km/s/Mpc, at 68% confidence, in excellent agreement with the independently-measured Planck satellite estimate (from ACT alone we find H0 = 67.9 ± 1.5 km/s/Mpc). The ΛCDM model provides a good fit to the ACT data, and we find no evidence for deviations: both the spatial curvature, and the departure from the standard lensing signal in the spectrum, are zero to within 1σ; the number of relativistic species, the primordial Helium fraction, and the running of the spectral index are consistent with ΛCDM predictions to within 1.5–2.2σ. We compare ACT, WMAP, and Planck at the parameter level and find good consistency; we investigate how the constraints on the correlated spectral index and baryon density parameters readjust when adding CMB large-scale information that ACT does not measure. The DR4 products presented here will be publicly released on the NASA Legacy Archive for Microwave Background Data Analysis.

We present the temperature and polarization angular power spectra of the CMB measured by the Atacama Cosmology Telescope (ACT) from 5400 deg2 of the 2013–2016 survey, which covers >15000 deg2 at 98 and 150 GHz. For this analysis we adopt a blinding strategy to help avoid confirmation bias and, related to this, show numerous checks for systematic error done before unblinding. Using the likelihood for the cosmological analysis we constrain secondary sources of anisotropy and foreground emission, and derive a “CMB-only” spectrum that extends to ` = 4000. At large angular scales, foreground emission at 150 GHz is ∼1% of TT and EE within our selected regions and consistent with that found by Planck. Using the same likelihood, we obtain the cosmological parameters for ΛCDM for the ACT data alone with a prior on the optical depth of τ = 0.065 ± 0.015. ΛCDM is a good fit. The best-fit model has a reduced χ2 of 1.07 (PTE = 0.07) with H0 = 67.9 ± 1.5 km/s/Mpc. We show that the lensing BB signal is consistent with ΛCDM and limit the celestial EB polarization angle to ψP = −0.07◦ ±0.09◦. We directly cross correlate ACT with Planck and observe generally good agreement but with some discrepancies in TE. All data on which this analysis is based will be publicly released.

We use gravitational lensing of the cosmic microwave background (CMB) to measure the mass of the most distant blindly selected sample of galaxy clusters on which a lensing measurement has been performed to date. In CMB data from the the Atacama Cosmology Telescope and the Planck satellite, we detect the stacked lensing effect from 677 near-infrared-selected galaxy clusters from the Massive and Distant Clusters of WISE Survey (MaDCoWS), which have a mean redshift of zñ = 1.08. There are currently no representative optical weak lensing measurements of clusters that match the distance and average mass of this sample. We detect the lensing signal with a significance of 4.2s. We model the signal with a halo model framework to find the mean mass of the population from which these clusters are drawn. Assuming that the clusters follow Navarro–Frenk–White (NFW) density profiles, we infer a mean mass of M500cñ = (1.7 + 0.4) ´ 1014 M*. We consider systematic uncertainties from cluster redshift errors, centering errors, and the shape of the NFW profile. These are all smaller than 30% of our reported uncertainty. This work highlights the potential of CMB lensing to enable cosmological constraints from the abundance of distant clusters populating ever larger volumes of the observable universe, beyond the capabilities of optical weak lensing measurements.

Optimal analyses of many signals in the cosmic microwave background (CMB) require map-level extraction of individual components in the microwave sky, rather than measurements at the power spectrum level alone. To date, nearly all map-level component separation in CMB analyses has been performed exclusively using satellite data. In this paper, we implement a component separation method based on the internal linear combination (ILC) approach which we have designed to optimally account for the anisotropic noise (in the 2D Fourier domain) often found in ground-based CMB experiments. Using this method, we combine multifrequency data from the Planck satellite and the Atacama Cosmology Telescope Polarimeter (ACTPol) to construct the first wide-area (≈2100 sq. deg.), arcminute-resolution component-separated maps of the CMB temperature anisotropy and the thermal Sunyaev-Zel'dovich (tSZ) effect sourced by the inverse-Compton scattering of CMB photons off hot, ionized gas. Our ILC pipeline allows for explicit deprojection of various contaminating signals, including a modified blackbody approximation of the cosmic infrared background (CIB) spectral energy distribution. The cleaned CMB maps will be a useful resource for CMB lensing reconstruction, kinematic SZ cross-correlations, and primordial non-Gaussianity studies. The tSZ maps will be used to study the pressure profiles of galaxies, groups, and clusters through cross-correlations with halo catalogs, with dust contamination controlled via CIB deprojection. The data products described in this paper are available on LAMBDA.

We present a detection of the splashback feature around galaxy clusters selected using the Sunyaev-Zel'dovich (SZ) signal. Recent measurements of the splashback feature around optically selected galaxy clusters have found that the splashback radius, rsp, is smaller than predicted by N-body simulations.Apossible explanation for this discrepancy is that rsp inferred from the observed radial distribution of galaxies is affected by selection effects related to the optical cluster-finding algorithms.We test this possibility by measuring the splashback feature in clusters selected via the SZ effect in data from the South Pole Telescope SZ survey and the Atacama Cosmology Telescope Polarimeter survey. The measurement is accomplished by correlating these cluster samples with galaxies detected in the Dark Energy Survey Year 3 data. The SZ observable used to select clusters in this analysis is expected to have a tighter correlation with halo mass and to be more immune to projection effects and aperture-induced biases, potentially ameliorating causes of systematic error for optically selected clusters. We find that the measured rsp for SZ-selected clusters is consistent with the expectations from simulations, although the small number of SZ-selected clusters makes a precise comparison difficult. In agreement with previous work, when using optically selected redMaPPer clusters with similar mass and redshift distributions, rsp is ~2σ smaller than in the simulations. These results motivate detailed investigations of selection biases in optically selected cluster catalogues and exploration of the splashback feature around larger samples of SZ-selected clusters. Additionally, we investigate trends in the galaxy profile and splashback feature as a function of galaxy colour, finding that blue galaxies have profiles close to a power law with no discernible splashback feature, which is consistent with them being on their first infall into the cluster.

We present the temperature and polarization angular power spectra measured by the Atacama Cosmology Telescope Polarimeter (ACTPol). We analyze night-time data collected during 2013-14 using two detector arrays at 149 GHz, from 548 deg2 of sky on the celestial equator. We use these spectra, and the spectra measured with the MBAC camera on ACT from 2008-10, in combination with planck and wmap data to estimate cosmological parameters from the temperature, polarization, and temperature-polarization cross-correlations. We find the new ACTPol data to be consistent with the ΛCDM model. The ACTPol temperature-polarization cross-spectrum now provides stronger constraints on multiple parameters than the ACTPol temperature spectrum, including the baryon density, the acoustic peak angular scale, and the derived Hubble constant. The new ACTPol data provide information on damping tail parameters. The joint uncertainty on the number of neutrino species and the primordial helium fraction is reduced by 20% when adding ACTPol to Planck temperature data alone.

We present a new measurement of the kinematic Sunyaev-Zel'dovich effect using data from the Atacama Cosmology Telescope (ACT) and the Baryon Oscillation Spectroscopic Survey (BOSS). Using 600 square degrees of overlapping sky area, we evaluate the mean pairwise baryon momentum associated with the positions of 50,000 bright galaxies in the BOSS DR11 Large Scale Structure catalog. A non-zero signal arises from the large-scale motions of halos containing the sample galaxies. The data fits an analytical signal model well, with the optical depth to microwave photon scattering as a free parameter determining the overall signal amplitude. We estimate the covariance matrix of the mean pairwise momentum as a function of galaxy separation, using microwave sky simulations, jackknife evaluation, and bootstrap estimates. The most conservative simulation-based errors give signal-to-noise estimates between 3.6 and 4.1 for varying galaxy luminosity cuts. We discuss how the other error determinations can lead to higher signal-to-noise values, and consider the impact of several possible systematic errors. Estimates of the optical depth from the average thermal Sunyaev-Zel'dovich signal at the sample galaxy positions are broadly consistent with those obtained from the mean pairwise momentum signal.

We present a new measurement of the kinematic Sunyaev-Zel'dovich effect using data from the Atacama Cosmology Telescope (ACT) and the Baryon Oscillation Spectroscopic Survey (BOSS). Using 600 square degrees of overlapping sky area, we evaluate the mean pairwise baryon momentum associated with the positions of 50,000 bright galaxies in the BOSS DR11 Large Scale Structure catalog. A non-zero signal arises from the large-scale motions of halos containing the sample galaxies. The data fits an analytical signal model well, with the optical depth to microwave photon scattering as a free parameter determining the overall signal amplitude. We estimate the covariance matrix of the mean pairwise momentum as a function of galaxy separation, using microwave sky simulations, jackknife evaluation, and bootstrap estimates. The most conservative simulation-based errors give signal-to-noise estimates between 3.6 and 4.1 for varying galaxy luminosity cuts. We discuss how the other error determinations can lead to higher signal-to-noise values, and consider the impact of several possible systematic errors. Estimates of the optical depth from the average thermal Sunyaev-Zel'dovich signal at the sample galaxy positions are broadly consistent with those obtained from the mean pairwise momentum signal.

We use microwave temperature maps from two seasons of data from the Atacama Cosmology Telescope at 146 GHz, together with the "Constant Mass" CMASS galaxy sample from the Baryon Oscillation Spectroscopic Survey to measure the kinematic Sunyaev-Zel'dovich (kSZ) effect over the redshift range z=0.4-0.7. We use galaxy positions and the continuity equation to obtain a reconstruction of the line-of-sight velocity field. We stack the microwave temperature at the location of each halo, weighted by the corresponding reconstructed velocity. We vary the size of the aperture photometry filter used, thus probing the free electron profile of these halos from within the virial radius out to three virial radii, on the scales relevant for investigating the missing baryons problem. The resulting best fit kSZ model is preferred over the no-kSZ hypothesis at 3.3 and 2.9σ for two independent velocity reconstruction methods, using 25,537 galaxies over 660 square degrees. The data suggest that the baryon profile is shallower than the dark matter in the inner regions of the halos probed here, potentially due to energy injection from active galactic nucleus or supernovae. Thus, by constraining the gas profile on a wide range of scales, this technique will be useful for understanding the role of feedback in galaxy groups and clusters. The effect of foregrounds that are uncorrelated with the galaxy velocities is expected to be well below our signal, and residual thermal Sunyaev-Zel'dovich contamination is controlled by masking the most massive clusters. Finally, we discuss the systematics involved in converting our measurement of the kSZ amplitude into the mean free electron fraction of the halos in our sample.

AIM: The primary aim was to describe New Zealand secondary school students' use of dental services and determine the nature and extent of any inequities by deprivation status and ethnicity. A secondary aim was to to describe their toothbrushing practices and self-reported dental pain experience, past restorative treatment and tooth loss. METHOD: Secondary analysis of data from the cross-sectional Youth 07: National Survey of the Health and Wellbeing of New Zealand Secondary School Students. A representative sample of 9,098 secondary school students aged 13-17 years from 96 secondary schools across New Zealand took part, with a response rate of 73%. Self-report information about oral health care behaviour, past dental experiences and dental visiting pattern was collected. Data analysis took the complex survey design into account, and multivariate analysis was undertaken to examine the associations of dental service-use. RESULTS: A dental visit in the previous 12 months was reported by 72% of participants. The odds of having done so were higher among females, those who brushed at least twice daily, and those who had been kept awake at night by dental pain. Lower odds were seen among students identifying with Maori, Pacific or Asian people (and those in the 'Other' ethnic category) than among European students, and among those residing in medium- or high-deprivation areas than those in lo-deprivation areas. One in seven participants reported having lost a tooth due to oral disease. Having had a tooth filled was reported by almost three-quarters of the sample, and having been kept awake by dental pain at night was reported by just over one in five. Almost two-thirds reported brushing their teeth twice or more in the previous 24 hours, and a small minority had not brushed at all. CONCLUSION: Ethnic and socio-economic inequities in the use of dental services are apparent among New Zealand adolescents. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To document changes in disease experience among Taranaki adolescents in order to enhance understanding of the natural history of dental caries in a key developmental period. METHOD: A random sample of 430 adolescents first examined in 2003 at age 13 were re-examined at age 16, when 255 (59.3%) took part. Dental caries status (in the permanent dentition) was recorded at each age by a single calibrated examiner following World Health Organization guidelines. The age-13 and 16 data-sets were merged once clinical data collection was completed. Caries increment was determined by comparing the baseline and follow-up status of each surface. RESULTS: Caries prevalence (1+ DMFS) rose from 68% to 79%; mean DMFS rose from 2.9 (SD 4.7) to 3.6 (SD 4.8), and the prevalence of high caries experience (5+ DMFS) rose from 20% to 41%. The 3-year mean net caries increment of 0.5 surfaces (SD 2.6) was dominated by occlusal surfaces and the overall incidence of caries was approximately 46%. Over one-third of the cohort (37%) presented with decayed surfaces at follow-up, and this was significantly higher among Maori and males. CONCLUSION: New Zealand adolescents still appear to be experiencing caries at a considerable rate, with social and ethnic inequalities plainly apparent (and appearing to widen). [ABSTRACT FROM AUTHOR]

Climate change will shortly be assuming centre stage when Copenhagen hosts the United Nations Climate Change Conference in early December 2009. In Copenhagen, delegates will discuss the international response to climate change (i.e. the ongoing increase in the Earth's average surface temperature) and the meeting is widely viewed as the most important of its kind ever held (http://en.cop15.dk/). International agreement will be sought on a treaty to replace the 1997 Kyoto Protocol. At the time of writing it is not known whether agreement will be reached on the main issues of reducing greenhouse gas emissions and financing the impacts of climate change, and it appears that the impact of climate change on mental health is unlikely to be on the agenda. We discuss here how climate change could have consequences for global mental health and consider the implications for future research and policy. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe the prevalence, severity and intra-oral distribution of dental caries among children from four Northland communities. DESIGN: Cross-sectional epidemiological survey of a Census sample. METHODS: Dental examinations were systematically conducted on all children aged 5 or 6 and all children 12 or 13 (and for whom parental consent was obtained) in Kaitaia, Kaikohe, Kawakawa/Moerewa and Dargaville. Bitewing radiography was used to aid caries diagnosis in the older age group. Data are reported for the deciduous dentition in the 5-6-year-olds, and the permanent dentition in the 12-13-year-olds. RESULTS: There were 369 5-6-year-olds and 171 12-13-year-olds, approximately two-thirds of whom were Maori. Almost 88% of 5-6-year-olds had experienced dental caries, and this was lower among the Pakeha/Other group, those attending higher-decile schools, and those from Dargaville. Overall caries experience (represented by a mean dmft score of 5.6; sd 3.9) was higher among Maori children, those attending lower-decile schools, and those from Kaikohe, Kawakawa/ Moerewa or Kaitaia, as was the number of untreated decayed surfaces. Almost one in four children had lost at least one tooth due to caries, and this was higher among Maori children and those from schools in more deprived areas, and lower among children from Dargaville. Caries experience was greatest among the second molars in either arch, and lowest among the mandibular incisors. Among the 12-13-year-olds, 85% had experienced dental caries (mean DMFT = 3.7; sd 3.1). The number of untreated surfaces with decay (more than 3, on average) was considerably lower among children from Dargaville. Caries experience was greatest among the first molars in either arch (followed by the second premolars), and absent among the mandibular incisors. CONCLUSIONS: The prevalence and severity of dental caries in Northland is very high in comparison to the rest of New Zealand. The problem is particularly acute among northern communities and Maori. Dealing with the problem will require a combination of population health and personal health interventions. [ABSTRACT FROM AUTHOR]

Background: Studies of planned home births attended by registered midwives have been limited by incomplete data, nonrepresentative sampling, inadequate statistical power and the inability to exclude unplanned home births. We compared the outcomes of planned home births attended by midwives with those of planned hospital births attended by midwives or physicians.Methods: We included all planned home births attended by registered midwives from Jan. 1, 2000, to Dec. 31, 2004, in British Columbia, Canada (n = 2889), and all planned hospital births meeting the eligibility requirements for home birth that were attended by the same cohort of midwives (n = 4752). We also included a matched sample of physician-attended planned hospital births (n = 5331). The primary outcome measure was perinatal mortality; secondary outcomes were obstetric interventions and adverse maternal and neonatal outcomes.Results: The rate of perinatal death per 1000 births was 0.35 (95% confidence interval [CI] 0.00-1.03) in the group of planned home births; the rate in the group of planned hospital births was 0.57 (95% CI 0.00-1.43) among women attended by a midwife and 0.64 (95% CI 0.00-1.56) among those attended by a physician. Women in the planned home-birth group were significantly less likely than those who planned a midwife-attended hospital birth to have obstetric interventions (e.g., electronic fetal monitoring, relative risk [RR] 0.32, 95% CI 0.29-0.36; assisted vaginal delivery, RR 0.41, 95% 0.33-0.52) or adverse maternal outcomes (e.g., third- or fourth-degree perineal tear, RR 0.41, 95% CI 0.28-0.59; postpartum hemorrhage, RR 0.62, 95% CI 0.49-0.77). The findings were similar in the comparison with physician-assisted hospital births. Newborns in the home-birth group were less likely than those in the midwife-attended hospital-birth group to require resuscitation at birth (RR 0.23, 95% CI 0.14-0.37) or oxygen therapy beyond 24 hours (RR 0.37, 95% CI 0.24-0.59). The findings were similar in the comparison with newborns in the physician-assisted hospital births; in addition, newborns in the home-birth group were less likely to have meconium aspiration (RR 0.45, 95% CI 0.21-0.93) and more likely to be admitted to hospital or readmitted if born in hospital (RR 1.39, 95% CI 1.09-1.85).Interpretation: Planned home birth attended by a registered midwife was associated with very low and comparable rates of perinatal death and reduced rates of obstetric interventions and other adverse perinatal outcomes compared with planned hospital birth attended by a midwife or physician. [ABSTRACT FROM AUTHOR]

A retrospective audit of trends in day-stay treatment for dental caries at a New Zealand hospital dental unit showed that demand for treatment has risen. The annual number of children undergoing a GA increased by over 13%, although the average waiting time after the initial consultation decreased. The cost of treatment also dramatically increased with time, as the numbers and complexity of cases increased. The type of treatment under GA changed over the five years, with more extractions occurring over the course of the audit. Restorations were still the most common treatment item provided, although the use of SSC trebled in 2004 and 2005. Socio-economic status, sex and ethnic differences were observed, with more boys and Mori receiving GA care and having a higher number of extractions. These children were identified as being high users of other hospital services (such as the Emergency Department). [ABSTRACT FROM AUTHOR]

OBJECTIVE: to explore health-care professionals' views about safety in maternity services. This paper identifies aspects of care that are less safe than they should be, possible ways to improve safety, and potential obstacles to achieving these improvements. This study was part of the King's Fund inquiry into the safety of maternity services in England. DESIGN: qualitative study with a sample of health-care professionals who work in maternity services and who responded to the call for evidence. Data were collected by questionnaire and analysed using thematic content analysis. SETTING: maternity professionals throughout England were invited to take part. PARTICIPANTS: midwives, obstetricians, student midwives, nurses, neonatal nurses, general practitioners, managers, hospital doctors and paediatricians. In total, there were 591 respondents. MEASUREMENTS AND FINDINGS: participants were asked to respond to open-ended questions identifying aspects of maternity care that were less safe than they should be, potential solutions to improve safety of care, and any barriers to implementing these improvements. Problems described included the increasing social and medical complexity of the pregnant population, low staffing levels, inappropriate skill mix, low staff morale, inadequate training and education, medicalisation of birth, poor management, lack of resources and reconfiguration. Proposed solutions included more staff, better teamwork and skill mix, improved training, more one-to-one care, caseloading, better management, more resources, better guidelines and learning from incidents. Barriers to implementing improvements included stressed staff who were resistant to change, inadequate management/poor staff management relationships and financial restraints. KEY CONCLUSIONS: the responses of maternity professionals convey a deep sense of staff anxiety regarding how the problems they face pose a threat to safety. IMPLICATIONS FOR PRACTICE: policy makers and professional bodies need to take the concerns expressed by staff seriously. Concerted efforts are required to improve maternity services and support maternity professionals. [ABSTRACT FROM AUTHOR]

Objective: The neural basis for autistic spectrum disorders is unclear, but abnormalities in the development of limbic areas and of glutamate have been suggested. Proton magnetic resonance spectroscopy ((1)H-MRS) can be used to measure the concentration of brain metabolites. However, the concentration of glutamate/glutamine in brain regions implicated in autistic spectrum disorders has not yet been examined in vivo.Method: The authors used (1)H-MRS to investigate the neuronal integrity of the amygdala-hippocampal complex and a parietal control region in adults with autistic spectrum disorders and healthy subjects.Results: People with autistic spectrum disorders had a significantly higher concentration of glutamate/glutamine and creatine/phosphocreatine in the amygdala-hippocampal region but not in the parietal region.Conclusions: Abnormalities in glutamate/glutamine may partially underpin the pathophysiology of autistic spectrum disorders, and the authors confirm earlier reports that limbic areas are metabolically aberrant in these disorders. [ABSTRACT FROM AUTHOR]

The Palaeoproterozoic Rinkian fold belt in West Greenland consists of reworked Archaean basement,mainly orthogneiss, and the unconformably overlying Palaeoproterozoic Karrat Group. Both parts were intensely deformed and metamorphosed at around 1.87 Ga, at which time the crustal anatecticPrøven igneous complex was emplaced into the northern part of the belt. Seven new hornblende and muscovite 40Ar/39Ar cooling ages are presented from the central–northern parts of the Rinkian foldbelt. Four 40Ar/39Ar hornblende ages ranging from 1795 ± 3 to 1782 ± 3 Ma were obtained from amphibolite and hornblendite enclaves in the Archaean orthogneiss, and two from relict dyke fragments in the latter that may be of Palaeoproterozoic age. Three 40Ar/39Ar muscovite ages of 1681 ± 6Ma, 1686 ± 3 Ma and 1676 ± 3 Ma were obtained from samples of Karrat Group metagreywacke,andalusite schist and metasiltstone. The new 40Ar/39Ar ages, from hornblende and muscovite respectively,are very uniform and probably unrelated to local metamorphic grade and structural history,and are interpreted as regional late orogenic cooling ages. The new hornblende ages are significantly older than those previously obtained from the central and northern parts of the adjacent Nagssugtoqidianorogen to the south, and point to different uplift histories, which may suggest that the orogeny was not synchronous in the two regions.

Background: Children's pain in dentistry has undesirable short- and long-term consequences; therefore, less invasive treatments merit consideration., Aim: To investigate procedural pain scores for two treatments for carious primary molars in New Zealand primary care., Design: This study was a split-mouth randomised control trial, with secondary outcome analysis. Children (4-8 years) with proximal carious lesions on matched primary molars had one tooth treated with the Hall technique (HT) and one treated with a conventional stainless steel crown (CT); treatment type and order of treatment were randomly allocated (allocation concealment). The Wong-Baker self-report pain scale measured pretreatment dental pain, procedural pain at each treatment and post-operative pain., Results: Data were analysed for 103 children: 49 children had the HT first and 54 children had the CT first. Procedural pain scores did not differ by treatment type, with 71.8% and 76.7% of children reporting low pain for the HT and the CT, respectively. Fewer children reported low procedural pain for the second treatment than the first (p = .047). Most children reported low procedural pain for both treatments (58.3%), although 41.7% experienced moderate-high procedural pain with at least one treatment., Conclusions: The HT caused pain for as many children as the CT. There is an opportunity for better dental pain management in this setting., (© 2023 The Authors. International Journal of Paediatric Dentistry published by BSPD, IAPD and John Wiley & Sons Ltd.)

Introduction: The demands of operational deployment mean that defense force personnel must be dentally fit. Although medical evacuation for dental causes should be avoided, dental emergencies are a major non-combat-related contributor to withdrawal from deployment. Information on the oral health status of recruits and officer cadets entering the New Zealand Defence Force (NZDF) is scarce, yet it is useful for service and workforce planning. We investigated oral health status and its associations in new recruits and officer cadets entering the NZDF over a 13-month period., Materials and Methods: This study used data from recruits' initial dental examination (including baseline forensic charting), posterior bitewing radiographs, orthopantomograph radiograph, and a socio-dental questionnaire. The impaction status of third molar teeth was evaluated. Ethical approval was obtained from the University of Otago Ethics Committee (reference number D18/200) and the NZDF Organisational Research Committee., Results: Of the 874 (83%) of the 1,053 recruits (age range 17-59 years) who participated, one in five were Māori. Nearly two-thirds were Army recruits. Caries prevalence was almost 70%. Mean Decayed, Missing, and Filled Teeth (DMFT) (3.0 overall) was higher among females and Māori. Few teeth were missing due to caries. Third molars were common, seen in 745 (88.3%). One in four maxillary third molars (but only one in six mandibular ones) had fully erupted. The most common type of impaction among mandibular third molars was the mesioangular type, followed by vertical, horizontal, and distoangular. Almost 60% of recruits had one or more potentially problematic third molars. The prevalence was highest in the youngest age groups, those of medium or low socioeconomic status and in Army or Navy recruits., Conclusions: Recruits' oral health was acceptable, but potentially problematic third molars were common, indicating a need for careful assessment (and their possible removal) before operational deployment., (© The Association of Military Surgeons of the United States 2021. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: US data on the validity and reliability of the short-form Family Impact Scale (FIS-8; a scale for measuring the impact of a child's oral condition on his/her family) are lacking., Methods: Cross-sectional analysis of data on four-year-old US children taking part in a multi-center cohort study. For child-caregiver dyads recruited at child age 12 months, the impact of the child's oral condition on the family was assessed at age 48 months using the FIS-8, with a subsample of 422 caregivers (from 686 who were approached). Internal consistency reliability was assessed using Cronbach's α, with concurrent validity assessed against a global family impact item ("How much are your family's daily lives affected by your child's teeth, lips, jaws or mouth?") and a global oral health item ("How would you describe the health of your child's teeth and mouth?")., Results: Cronbach's alpha was 0.83. Although gradients in mean scores across ordinal response categories of the global family impact item were inconsistent, there were marked, consistent gradients across the ordinal categories of the global item on the child's oral health, with scores highest for those rating their child's oral health as 'Poor'., Conclusions: While the findings provide some evidence for the utility of the FIS in a US child sample, the study's replication in samples of preschoolers with greater disease experience would be useful., (© 2022. The Author(s).)

Aotearoa New Zealand (NZ) has a long tradition of providing publicly funded oral health care for children and young people; however, substantial inequities in child oral health remain. Dental caries is the most prevalent non-communicable childhood disease in NZ, with Māori and Pasifika, those from low socio-economic backgrounds, and those without access to community water fluoridation most affected. Children and whānau with dental caries suffer consequences that seriously affect their day-to-day lives; it is critical not to underestimate the disease or fail to include it when considering children's overall health. Dental caries is a complex disease, as is its prevention. This is particularly so in the current social context of child poverty, our food environment, the exploitation of children in advertising of non-healthy foods and drinks, and the immense challenges of meeting demand for oral health care in primary, secondary and tertiary care within current constraints. We review children's oral health in NZ and make recommendations for change among oral health professionals, all health professionals, health services and society. Further research in oral health services will be an essential part of improving oral health, recognising that there is an urgent need for a shift towards much greater prevention of caries. Glossary of Māori terms: Aotearoa: New Zealand; He Korowai Oranga: New Zealand Māori Health Strategy; Hui: meeting; Manaakitanga: hospitality, kindness, generosity and support; Mana Motuhake: self-determination; Māori: the indigenous people of Aotearoa New Zealand; Mātauranga Māori: Māori knowledge; Rangatahi: adolescents; Tamariki: children; Te Ao Māori: the Māori worldview; Te Kauae Parāoa: Division of Health Sciences Policy on Admissions; Te reo Māori: the indigenous Māori language; Te Tiriti o Waitangi: Māori language version of the Treaty of Waitangi; Tikanga: customs; Whānau: family; Whakamaua: Māori Health Action Plan 2020-2025; Whakawhanaungatanga: the process of establishing relationships and relating well to others., Competing Interests: No potential conflict of interest was reported by the author(s)., (© 2022 The Royal Society of New Zealand.)

Introduction: Psychedelic-assisted psychotherapy is a promising approach in psychiatry; evidence is growing and it may not be long before mainstream services are expected to offer it to selected patients. This pilot study examined the attitudes and knowledge of NHS psychiatrists of all levels towards psychedelic-assisted psychotherapy and explored potential barriers and facilitators to its implementation. Methods: A mixed-methods approach was adopted, using a cross-sectional survey and focus groups. All psychiatrists in one NHS mental health trust were approached by email to participate. The survey was analysed using a simple descriptive approach and thematic analysis was used for the focus groups. Results: Eighty-three (25.7%) psychiatrists participated in the survey. All psychiatrists were familiar with one or more psychedelic substances. Although 77.2% felt that there should be a role for controlled or therapeutic use of psychedelics, trainees appeared better informed than non-training grade psychiatrists. Psychiatrists of all grades did not feel prepared to participate in the delivery of psychedelic-assisted psychotherapy. Thematic analysis of the focus groups identified three main themes in relation to psychedelic-assisted psychotherapy: " need for knowledge ," " openness to change ," and " uncertainty ." Discussion: NHS psychiatrists are positive about the potential for psychedelic-assisted therapy to advance psychiatric practise. However, psychiatrists are lacking in confidence or preparedness to implement this treatment should it become a mainstream option and significant training needs were identified. Thematic analysis highlighted the need for societal shifts as well as professional ones., Competing Interests: GC is employed by Small Pharma Inc. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The authors declare that this study received no funding from Small Pharma Inc or any other external organisation., (Copyright © 2021 Page, Rehman, Syed, Forcer and Campbell.)