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Importance: Testing the long-term usefulness of a childhood intervention and determining the best age of implementation are important for translation and policy change., Objectives: To investigate among children aged 3 years the long-term effectiveness an intervention that aimed to reduce dental caries among South Australian Aboriginal children and to assess if children in the delayed intervention (DI) group had any benefit from the intervention from ages 2 to 3 years and if the intervention usefulness was greater when delivered between pregnancy and age 2 years (immediate intervention [II] vs ages 2 to 3 years [DI])., Design, Setting, and Participants: Secondary analysis of a randomized clinical trial. The study enrolled 448 pregnant women across South Australia, Australia, at baseline (February 1, 2011, to May 30, 2012), with 223 randomly allocated to the II group and 225 to the DI group. Three-year follow-up data were collected November 2014 to February 2016., Interventions: The intervention comprised dental treatment to mothers, fluoride varnish application to children, and motivational interviewing delivered together with anticipatory guidance. This was delivered during pregnancy and at child ages 6, 12, and 18 months for the II group and at child ages 24, 30, and 36 months for the DI group., Main Outcomes and Measures: The mean number of decayed teeth measured at child age 3 years., Results: There were 324 children at age 3 years (52.3% male). The mean number of decayed teeth at age 3 years was 1.44 (95% CI, 1.38-1.50) for the II group and 1.86 (95% CI, 1.89-2.03) for the DI group (mean difference, -0.41; 95% CI, -0.52 to -0.10). The predicted mean number of decayed teeth at age 3 years for the DI group was 2.15. Between ages 2 and 3 years, the caries increment for the II group was 0.82 (95% CI, 0.75-0.89), compared with 0.97 (95% CI, 0.87-1.17) for the DI group (P = .05)., Conclusions and Relevance: At the 3-year follow-up, II children had less dental caries than DI children, DI children developed dental caries at a lower trajectory than predicted had the intervention not been received at ages 2 to 3 years, and the caries increment was less between ages 2 to 3 years among II children compared with DI children. This study suggests that the best time to implement the intervention is earlier rather than later infancy., Trial Registration: Australian and New Zealand Clinical Trial Registry Ideintifier: ACTRN12611000111976.

Background: Dental disease has far-reaching impacts on child health and wellbeing. We worked with Aboriginal Australian communities to develop a multifaceted oral health promotion initiative to reduce children's experience of dental disease at age 2 years., Methods: This was a single-blind, parallel-arm, randomised controlled trial. Participants were recruited from health service providers across South Australia. Women pregnant with an Aboriginal child were eligible. The intervention comprised: (1) provision of dental care to mothers during pregnancy; (2) application of fluoride varnish to teeth of children at ages 6, 12 and 18 months; (3) motivational interviewing delivered in conjunction with; (4) anticipatory guidance. The primary outcome was untreated dental decay as assessed by the number of teeth with cavitated and non-cavitated carious lesions (mean dt) at child age 24 months. Analyses followed intention-to-treat principles. The RCT was registered with the Australian and New Zealand Clinical Trial Registry, ACTRN12611000111976., Findings: Women (n = 448) were recruited from February 2011 to May 2012, resulting in 223 children in the treatment group and 225 in the control. Mean dt at age two years was 0.62 (95% CI 0.59 to 0.65) for the intervention group and 0.89 (95% CI 0.85 to 0.92) for the control group (mean difference - 0.27 (95% CI - 0.31, - 0.22))., Interpretation: A culturally-appropriate intervention at four time-points from pregnancy through to 18-months resulted in improvements in the oral health of Aboriginal children. Further consultation with Aboriginal communities is essential for understanding how to best sustain these oral health improvements for young Aboriginal children.

The Baby Teeth Talk Study (BTT) is a partnership-based research project looking at interventions to prevent early childhood caries (ECC) in First Nations populations in Canada. Community-based researchers (CBRs) conducted preventive and behavioral interventions that targeted expectant mothers and their newborns, over a 3-year period. The work of the CBRs requires a great deal of training and skills to administer the interventions. It also requires a broad set of strategies to meaningfully engage participants to make health-promoting changes in their behavior to prevent ECC in their children. After implementing the intervention, BTT CBRs participated in interviews to explore the strategies they employed to engage participants in the prevention of ECC. CBRs perceived two key strategies as essential for meaningful engagement with BTT participants. First, CBRs indicated that their shared experiences through motherhood, First Nations identity, age, and childhood experience provided a positive foundation for dialog with participants that lead to build trust and rapport. Second, supportive interpersonal and culturally based communication skills of the CBR provided further foundation to engage with participants from a strength-based approach. For example, the CBRs knew how to effectively communicate in ways such as being gentle, non-intrusive, and avoiding any perception of judgment when discussing oral health behavior. In First Nations health research, CBRs can provide an essential link in engaging participants and the community for improvements in health. Researchers should carefully consider characteristics such as shared experience and ability to understand cultural communication styles when hiring CBRs in order to build a solid foundation of trust with research participants.

Reducing the exposure of children and young people to the marketing of unhealthy foods is a core strategy for reducing the high overweight and obesity prevalence in this population. The Advertising Standards Authority (ASA) has recently reviewed its self-regulatory codes and proposed a revised single code on advertising to children. This article evaluates the proposed code against eight criteria for an effective code, which were included in a submission to the ASA review process from over 70 New Zealand health professors. The evaluation found that the proposed code largely represents no change or uncertain change from the existing codes, and cannot be expected to provide substantial protection for children and young people from the marketing of unhealthy foods. Government regulations will be needed to achieve this important outcome., Competing Interests: Nil.

This study assessed links between racism and oral health outcomes among pregnant Canadian Aboriginal women. Baseline data were analyzed for 541 First Nations (94.6%) and Métis (5.4%) women in an early childhood caries preventive trial conducted in urban and on-reserve communities in Ontario and Manitoba. One-third of participants experienced racism in the past year determined by the Measure of Indigenous Racism Experience. In logistic regressions, outcomes significantly associated with incidents of racism included: wearing dentures, off-reserve dental care, asked to pay for dental services, perceived need for preventive care, flossing more than once daily, having fewer than 21 natural teeth, fear of going to dentist, never received orthodontic treatment and perceived impact of oral conditions on quality of life. In the context of dental care, racism experienced by Aboriginal women can be a barrier to accessing services. Programs and policies should address racism's insidious effects on both mothers' and children's oral health outcomes.

Unlabelled: Early childhood caries is a global health issue for Indigenous populations. The study, "Reducing disease burden and health inequalities arising from chronic dental disease among Indigenous children: an early childhood caries intervention," is being conducted in Australia, Canada, and Aotearoa/New Zealand., Objective: To conduct the research in New Zealand using a kaupapa Māori (Māori philosophy) approach., Methods: This is a mixed-method study incorporating quantitative and qualitative data whilst acknowledging Māori cultural practices by the utilization of Te Whare Tapa Whā, a model for Māori health and well-being., Results: This paper describes the application of the four dimensions of this model, (spiritual, mental, physical and family dimensions) within the research activity., Conclusion: Health research projects that are undertaken with Indigenous populations must ensure that the research process embraces Indigenous cultural practices. In Aotearoa/New Zealand Māori leadership over the research process ensures meaningful and beneficial outcomes for the Māori Indigenous population.

Objectives: This paper assessed the fidelity of an early childhood caries MI intervention among Aboriginal mothers in South Australia., Methods: Four MI-trained staff delivered the intervention and all interviews were recorded. A randomly selected subset (n = 164, 41.2%) were tested for MI fidelity using the Motivational Interviewing Treatment Integrity (MITI) code 3.1.1. A further randomly selected 20 taped sessions were additionally scored by an external expert to assess external reliability., Results: Mean scores for evocation, collaboration, autonomy/support, direction and empathy ranged from 3.5 (95% CI 3.4-3.7) to 4.1 (95% CI 4.0-4.2). The mean global score was 3.8 (95% 3.7-3.9). The Reflection:Question ratio was 0.9 (95% CI 0.8-1.0), % Open-ended Questions was 54.9 (95% CI 50.0-59.8), % Complex Reflections was 54.0 (95% CI 50.5-57.5) and % MI-adherent statements was 95.0 (95% CI 92.0-98.0). Inter-assessor reliability was high., Conclusions: Beginner to expert competency in fidelity to the MI model was observed.

Objectives: To inform the provision of support to veterans by analysing hospital discharge data, thereby identifying which conditions show an excess risk, require specific management strategies and deserve further investigation., Setting: Tertiary level care, including all public and private New Zealand hospitals., Participants: All New Zealand Vietnam veterans with service between 1964 and 1972., Primary Outcome Measures: Standardised hospitalisation ratios (SHRs) were calculated based on the number of first observed hospital admissions for a condition, those expected being based on New Zealand national hospitalisation rates., Results: The SHR for all causes of hospitalisation was 1.18, 95% CI 1.15 to 1.21, with modest increases for the major common causes, cardio and cerebrovascular disease. Admission rates for chronic renal failure and chronic obstructive pulmonary disease were highest in the 2006-2009 time period. The highest statistically significant hospitalisation risk was for alcohol-related mental disorder, SHR 1.91, 99% CI 1.39 to 2.43., Conclusions: Chronic renal failure has limited attribution to veteran service but along with chronic obstructive pulmonary disease has the potential to have high costs both to the individual and the health system. We suggest that routine surveillance of veterans by way of a 'flag' in national and primary care databases would facilitate the recognition of service-related conditions and the appropriate provision of healthcare., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Objectives: Oral health personnel are limited in their ability to assess the readiness of patients to make changes to improve oral health. We aimed to develop and test the Stages of Change in Oral Health (SOCOH) model, a scaled index of the stages of change - pre-contemplative, contemplative or active - with particular emphasis on pregnancy., Materials and Methods: Items were collected in a self-report questionnaire conducted among a convenience sample of 446 mothers (age range: 14-43 years) pregnant with Aboriginal children in South Australia, Australia. Scales representing openness (four items; Cronbach's alpha = 0.73), value (four items; Cronbach's alpha = 0.71), inconvenience (six items; Cronbach's alpha = 0.79) and permissiveness (four items; Cronbach's alpha = 0.66) were developed. Participants were categorised according to the Stages of Change model and were evaluated against key self-reported oral health outcomes., Results: Some 11.9% of participants were classified as pre-contemplators, 46.4% as contemplators and 41.7% as active. A higher proportion of active participants had a higher education, last visited a dentist less than a year previously, had no dental fear, owned a toothbrush, brushed the previous day, used toothpaste, had no difficulties paying a $100 dental bill, self-reported their dental health as 'excellent' and in the previous 12 months did not experience dental pain, embarrassment related to their dental appearance or difficulties eating food., Conclusions: The SOCOH model offers an internally consistent and valid instrument for detailed assessment of the readiness for change in regarding oral health behaviours in pregnancy and has potential benefits for clinical decision making and research., (© 2014 FDI World Dental Federation.)

Objectives: We hypothesized that the psychosocial factors perceived stress and sense of personal control mediated the relationship between self-reported racism and experience of toothache. We hypothesized that social support moderated this relationship., Methods: Data from 365 pregnant Aboriginal Australian women were used to evaluate experience of toothache, socio-demographic factors, psychosocial factors, general health, risk behaviors, and self-reported racism exposure. Hierarchical logistic regression models estimated odds ratios (ORs) and 95 percent confidence intervals (CIs) for experience of toothache. Perceived stress and sense of personal control were examined as mediators of the association between self-reported racism and experience of toothache. Social support was examined as a moderator., Results: Self-reported racism persisted as a risk indicator for experience of toothache (OR 1.99, 95 percent CI 1.07-3.72) after controlling for age, level of education, and difficulty paying a $100 dental bill. The relationship between self-reported racism and experience of toothache was mediated by sense of control. The direct effect of self-reported racism on experience of toothache became only marginally significant, and the indirect effect was significant (β coefficient=0.04, bias-corrected 95 percent CI 0.004-0.105, 21.2 percent of effect mediated). Stress was insignificant as a mediator. Social support was insignificant as a moderator., Conclusions: The findings indicate that high levels of self-reported racism were associated with experience of toothache and that sense of control, but not perceived stress, mediated the association between self-reported racism and experience of toothache among this sample of pregnant Aboriginal Australian women. Social support did not moderate the association between self-reported racism and experience of toothache., (© 2014 American Association of Public Health Dentistry.)

Background: Self-efficacy plays an important role in oral health-related behaviours. There is little known about associations between self-efficacy and subjective oral health among populations at heightened risk of dental disease. This study aimed to determine if low self-efficacy was associated with poor self-rated oral health after adjusting for confounding among a convenience sample of pregnant women., Methods: We used self-reported data from 446 Australian women pregnant with an Aboriginal child (age range 14-43 years) to evaluate self-rated oral health, self-efficacy and socio-demographic, psychosocial, social cognitive and risk factors. Hierarchical entry of explanatory variables into logistic regression models estimated prevalence odds ratios (POR) and 95% confidence intervals (95% CI) for fair or poor self-rated oral health., Results: In an unadjusted model, those with low self-efficacy had 2.40 times the odds of rating their oral health as 'fair' or 'poor' (95% CI 1.54-3.74). Addition of socio-demographic factors attenuated the effect of low self-efficacy on poor self-rated oral health by 10 percent (POR 2.19, 95% CI 1.37-3.51). Addition of the psychosocial factors attenuated the odds by 17 percent (POR 2.07, 95% CI 1.28-3.36), while addition of the social cognitive variable fatalism increased the odds by 1 percent (POR 2.42, 95% CI 1.55-3.78). Inclusion of the behavioural risk factor 'not brushing previous day' attenuated the odds by 15 percent (POR 2.11, 95%CI 1.32-3.36). In the final model, which included all covariates, the odds were attenuated by 32 percent (POR 1.80, 95% CI 1.05, 3.08)., Conclusions: Low self-efficacy persisted as a risk indicator for poor self-rated oral health after adjusting for confounding among this vulnerable population.

Background: Maaori are the Indigenous people of New Zealand and do not enjoy the same oral health status as the non-Indigenous majority. To overcome oral health disparities, the life course approach affords a valid foundation on which to develop a process that will contribute to the protection of the oral health of young infants. The key to this process is the support that could be provided to the parents or care givers of Maaori infants during the pregnancy of the mother and the early years of the child. This study seeks to determine whether implementing a kaupapa Maaori (Maaori philosophical viewpoint) in an early childhood caries (ECC) intervention reduces dental disease burden among Maaori children. The intervention consists of four approaches to prevent early childhood caries: dental care provided during pregnancy, fluoride varnish application to the teeth of children, motivational interviewing, and anticipatory guidance., Methods/design: The participants are Maaori women who are expecting a child and who reside within the Maaori tribal area of Waikato-Tainui.This randomised-control trial will be undertaken utilising the principles of kaupapa Maaori research, which encompasses Maaori leadership, Maaori relationships, Maaori customary practices, etiquette and protocol. Participants will be monitored through clinical and self-reported information collected throughout the ECC intervention. Self-report information will be collected in a baseline questionnaire during pregnancy and when children are aged 24 and 36 months. Clinical oral health data will be collected during standardised examinations at ages 24 and 36 months by calibrated dental professionals. All participants receive the ECC intervention benefits, with the intervention delayed by 24 months for participants who are randomised to the control-delayed arm., Discussion: The development and evaluation of oral health interventions may produce evidence that supports the application of the principles of kaupapa Maaori research in the research processes. This study will assess an ECC intervention which could provide a meaningful approach for Maaori for the protection and maintenance of oral health for Maaori children and their family, thus reducing oral health disparities., Trial Registration: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12611000111976.

Objectives: The aim was to observe the patterns of mortality and cancer incidence in New Zealand Vietnam veterans. The objectives were to assess whether the patterns of disease observed were consistent with those associated with military service in Vietnam, and similar to the patterns identified in other groups of Vietnam veterans., Design: A historical cohort study., Setting: Veterans, identified from service records, with Vietnam service between 1964 and 1972., Participants: Of the 3322 survivors of Vietnam service, we followed up 2783 (84%)., Outcome Measures: Standardised mortality and incidence ratios (SMRs and SIRs, respectively) were calculated based on the number of deaths and cancer registrations observed, those expected being based on New Zealand national rates., Results: All cause mortality was significantly reduced (SMR 0.85, 95% CI 0.77 to 0.94) and cancer incidence non-significantly increased (SIR 1.06, 95% CI 0.97 to 1.16). The risk of mortality from cancers of the head and neck (SMR 2.20, 95% CI 1.09 to 3.93); oral cavity pharynx and larynx (SMR 2.13, 95% CI 1.06 to 3.81) and the incidence of chronic lymphatic leukaemia (CLL) (SIR 1.91, 95% CI 1.04 to 3.20) were, however, significantly increased. Other lymphohaematopoietic disorders, specifically multiple myeloma and Hodgkin disease, showed non-significant mortality excesses, reflected by a similar increase in incidence., Conclusions: Service in the Vietnam war was associated with defoliant herbicide exposure, including 2,4,5-trichlorophenoxyacetic acid, 2,4-dichlorophenoxyacetic acid, picloram and cacodylic acid. Subsequent reviews of mechanistic, animal and epidemiological evidence led to certain conditions being deemed compensable. The pattern of mortality and cancer incidence is not at odds with the list of compensable conditions and consistent with that found in Australian veterans serving in the same area of Vietnam, but also consistent with smoking and the healthy soldier effect. In common with the Australian experience, this is the only veterans group to show a significant excess of CLL.

Aim: Despite a significant improvement since graduated licensing was introduced, traffic related injury remains the leading cause of death and hospitalisation among young New Zealanders. The New Zealand Drivers Study (NZDS) was established with a view to providing information that would lead to an improvement in this situation. The NZDS is a prospective cohort study designed to explore the relationship between a comprehensive range of driving and traffic safety related factors and subsequent traffic crashes and convictions among newly licensed drivers. We describe key process objectives in establishing the cohort, and our success in meeting them and the implications arising thereof., Methods: We compare what occurred with what was proposed in the research protocol., Results: We successfully established a cohort of 3992 newly licensed car drivers with substantial heterogenity in sociodemographic, behavioural, and driving experiences. We have 825 Maori that will allow us to undertake a separate Maori analyses. Response rates to interviews at the restricted and full licence stages have been very high at 87% and 93%, respectively. We have been successful via linkage in following them through the stages of licensure and via linkage obtaining national data on the outcomes of interest., Conclusions: The NZDS is well placed to make a significant contribution to our knowledge of young driver road safety behaviour. This process has already commenced.

Background:  Most research on older people's oral health has been quantitative. A need for more in-depth understanding of the oral health of that age group has pointed to a need for more qualitative investigations., Objective: To explore experiences and perceptions of oral health and oral health care among an ethnically-mixed sample of older New Zealanders., Methods: In-depth interviews were conducted with 24 older people in two communities in New Zealand's South Island. Thematic analysis of transcribed data was undertaken., Results: Three main themes that emerged were: (1) the processes of negotiating a tension between cost and convenience of access; (2) the experiential constraining of oral health maintenance; and (3) trusting in dental professionals. These serve to organise processes such as normalising, justifying and social comparisons that create an equilibrium or tolerance and acceptance of what might otherwise be considered to be relatively poor oral health., Conclusions: We identified a number of shared experiences which affect older people's ability to maintain their oral health in the face of material and social barriers to oral health care. Because expectations were generally lower, there was greater concordance between experience and expectation, and people tended to be fairly satisfied with their oral health and the care they had received., (© 2010 The Gerodontology Society and John Wiley & Sons A/S.)

This review of the oral health of children in Australia, New Zealand, Canada and the USA demonstrates that significant oral health inequalities exist in each nation. Despite traditionally low levels of disease in Indigenous communities, dental caries is now highly prevalent and of increased severity among Indigenous children in comparison to their non-Indigenous counterparts. Early childhood caries is particularly prevalent. The high level of dental disease experience at an early age is associated with increased rates of general anaesthesia and greater risk of dental caries in later life. The rates and severity of dental caries experienced by young Indigenous children are even more alarming when we consider that dental caries is essentially a preventable disease. The success of specific preventive programmes is encouraging; these approaches should be further evaluated and implemented as part of broader health promotion programmes for Indigenous children and families in order to decrease current oral health disparities., (© 2010 The Authors. Journal of Paediatrics and Child Health © 2010 Paediatrics and Child Health Division (Royal Australasian College of Physicians).)

Māori are the Indigenous people of New Zealand having migrated across the Pacific from Hawaiki over a 500 year period from 800AD to 1300AD establishing a society based on whānau (family), hapū (subtribe) and iwi (tribe). Today, like other Indigenous populations throughout the world, New Zealand Māori do not enjoy the same oral health status as non-Māori across all age groups. An intervention strategy to improve Māori oral health and to reduce disparities is to develop a dental health workforce that has an understanding of contemporary Māori society and Māori oral health. The Faculty of Dentistry (Te Kaupeka Pūniho) of the University of Otago has a well developed undergraduate programme in Māori culture and Māori oral health. This programme has been reinforced by the adoption of a new Māori Strategic Framework (MSF) which has been designed to be "a vibrant contributor to Māori development and the realisation of Māori aspirations." Goal 5 of the MSF, Ngā Whakahaerenga Pai (Quality Programmes) has the objective to develop and integrate Māori content in the undergraduate course. This paper will discuss the oranga niho Māori (Māori oral health) component of the undergraduate dental curriculum.

Objective: To determine the extent and type of self-reported unlicensed car driving and reasons given for driving before getting a license among Maori drivers in urban and rural areas of New Zealand., Method: Participants included 824 people of self-identified Maori ethnicity. The ages ranged from 15 to 65 years, with the majority of participants aged 15 (37%), 16 (21%), or 17 (14%) years at the time of recruitment. Participants were recruited after passing the car driver's learner license theory test at a driver licensing agency or a learner license course or by the participant responding to a postcard placed at licensing agencies nationwide. All participants completed a self-administered questionnaire that included items for a wide range of personal, driving, and licensing-related variables. The cohort was not randomly selected but included as many eligible participants as possible, with recruitment taking place in urban and rural areas of both the North and South Islands of New Zealand., Results: Unlicensed car driving experience was common, especially among rural participants (urban: 65%, rural: 83%). The nature and extent of driving experience and reasons for driving unlicensed were remarkably similar for urban and rural drivers, Females (47%) were more likely than males (37%) to report previous experience of a serious traffic crash. Being stopped by the police for driving unlicensed was not common (24% urban, 17% rural), but for those who had been stopped, the consequences varied by residential location., Conclusions: Driving before obtaining a driver's license was common practice and the amount of driving extensive, for both rural and urban drivers. Furthermore, contrary to common perceptions in New Zealand, the need and opportunities for driving were similar, irrespective of place of residence. This suggests that similar issues may need to be addressed by both urban and rural Maori community road safety providers.

Aim: To investigate the opinions of newly licensed drivers towards the minimum age of car driver licensing, and reasons for getting a licence., Method: The New Zealand Drivers Study (NZDS) is a prospective cohort study of 3992 newly licensed car drivers in New Zealand, recruited between 1 February 2006 and 31 January 2008 from driver licensing agencies and licensing courses throughout New Zealand. The cohort comprises 51% females and 49% males, 49% were aged 15 years and 28% 16-17 years, 55% self-identified as New Zealand European, 21% Maori, 13% Pacific, 11% Asian, and 15% as "other". After passing the learner licence theory test all participants completed a questionnaire that included a range of questions on driver licensing topics, including minimum driver licence age and reasons for getting a car driver's licence., Results: Overall, 51% of newly licensed drivers supported 15 years as the minimum age to start licensing but this varied significantly by the age, gender, and residential location of the learner driver. The most frequently reported reason for getting a licence related to independence and freedom. This applied equally to males and females, rural and urban drivers, and across all ages, although for learner drivers aged 18+ years, to drive to work was also a very important reason for having a licence., Conclusion: Contrary to what many may believe to be the case, the evidence presented here showed that there was not universal opposition by young people to raising the driver licensing age. Also those in rural and urban areas had much in common with respect to the reasons for obtaining a licence. With respect to the latter it is worth noting that travel for work was of most relevance to the learner drivers aged 18 years or older. Overall, these findings suggest that increasing the minimum age for licensing would have relatively little impact on essential travel among young people in New Zealand.

Objective: To determine whether home-based and clinic-based dental examinations of older people are comparable., Background: Despite a number of studies which have examined the concordance between different examiners or examination circumstances, none has directly compared an oral examination conducted at home with one conducted in an appropriate clinical setting., Materials and Methods: Dentate participants (n = 61) aged between 65 and 74 years underwent two clinical examinations, one in a conventional dental clinic and the other in the person's home. Kappa statistics, intra-class correlation coefficients and 'Difference against mean' plots were used to determine the nature and extent of any bias., Results: The summary estimates for missing teeth and dental caries were close, although the home-based examinations resulted in a lower estimate of the mean number of decayed teeth and of untreated coronal decay. The lowest reliability statistics were observed with respect to the prevalence of untreated coronal caries, filled root surfaces and root surface (Decayed or Filled Surfaces) DFS. The periodontitis prevalence estimates were closer, but the reliability statistics were relatively low. The extent of bleeding on probing was relatively under-estimated in the home-based examinations. 'Difference against mean' plots indicated that, overall, the clinic-based examinations detected more disease (although this was not observed for all clinical parameters which were measured)., Conclusion: While clinic-based examinations will remain the preferred option, the potential loss of information associated with home-based examinations is unlikely to be great enough to preclude using them where required, although surveys with larger samples (and therefore more accurate estimates) should restrict their proportion of home-based examinations to no more than 10%. As they are less precise, surveys with samples of 300 or fewer can safely accommodate up to about one-third of their examinations being conducted in participants' homes.

Aims: To provide a descriptive epidemiology of fatal and non-fatal motor vehicle traffic (MVT) crashes involving Maori (1980-1994 inclusive) and to describe factors associated with those crashes., Methods: A data set for 1980-1994 was created by linking: (1) the New Zealand Police traffic crash reports (providing crash details), and (2) the New Zealand Health Information Services (NZHIS) hospital inpatient and mortality files (providing ethnicity, other demographic and injury details)., Results: The linked data set contained 8178 MVT crash events involving 8273 vehicles/drivers in which there were 9288 Maori casualties. Findings showed 82% of Maori casualties were aged less than 34 years and 70% were male. Nearly 30% were car drivers, 32% passengers, 15% motorcyclists and 12% pedestrians. Most crashes occurred in fine weather (82%), on a sealed (98%), two-way (97%) road, in or near an urban area (62%). The largest proportion (44%) of crashes occurred between 5 pm and midnight and the most common days of the week on which they occurred were Saturday (21%) and Friday (19%). The most common type of crash was 'loss of control' on a corner (27%) or a straight road (13%)., Conclusions: Motor vehicle traffic crashes are a major cause of mortality and morbidity for Maori. Future research, and the development of strategies to prevent traffic-related injury among Maori, would be facilitated by the inclusion of an ethnicity indicator on the traffic crash reports, and the collection of more comprehensive crash data on safety measures, such as occupant protection and driver-licence status.

Cross-linked hydroxypropylmethylcellulose (HPMC) cast films with citric acid as polycarboxylic cross-linker were elaborated to study the effect of cross-linking level on various properties. Increased amounts of cross-linking agent were not connected to statistically different tensile strength and Young's modulus. Whatever the cross-linking level of the film was, the ultimate elongation parameter decreased by approximately 60% compared to the HMPC control film. Moisture sorption isotherms and water contact angle meter showed that the effect of cross-linking degree tends to reduce the hygroscopic and hydrophilic characteristics of films. In addition, to control bacteria growth on food surfaces, the antimicrobial activity of both 98% cross-linked HPMC-nisin and control HPMC-nisin films was tested on Micrococcus luteus. Despite the incorporation of a significant content of nisin, cross-linked HPMC-nisin films were completely inactive on the microbial strain compared to the HPMC-nisin control films. Cross-linking conditions likely either denatured the nisin or irreversibly bound nisin to the cross-linked HPMC. However, nisin adsorbed into films made from previously cross-linked HPMC maintained its activity.