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This study investigates the storage properties and sensory evaluation of palm-based chocolate spreads formulated with sunflower wax (SFW) and carnauba wax (CW) in a wide range of temperatures. Hardness, spreadability and stability assessments of chocolate spreads with 3.5% SFW and 3.5% CW were made over a 24-week storage period. The hardness, spreadability and stability of the chocolate spreads were analyzed by means of Texture Analyzer, observation and LUMiFuge Stability Analyzer, respectively. A sensory evaluation of these chocolate spreads was conducted using a 7-point hedonic scale. The hardness of both chocolate spreads was influenced by low temperatures of 5-10 °C during the storage study. Decreasing and increasing trends were observed for samples stored at 5 and 10 °C, respectively. However, both palm-based chocolate spreads remained spreadable at 5 °C even after 24 weeks of storage. Both chocolate spreads demonstrated stability at 40 °C after 24 weeks of storage. The sensory evaluation revealed that chocolate spread with 3.5% CW was the most widely accepted by sensory panelists. Therefore, chocolate spread with 3.5% CW has the potential to be utilized over a wide range of temperature applications of 5-40 °C.

This research featured the noteworthy properties of a Mozzarella cheese analogue composed of palm oil (PO) and palm olein (POo) as milk fat alternatives. The objective of this study was to examine the properties of a palm-based Mozzarella cheese analogue (P-MCA) in comparison to a fat-free Mozzarella cheese analogue (FF-MCA) and a commercial Mozzarella cheese sample (C-MC) containing 68% palm-based Mozzarella cheese analogue. Mozzarella cheese samples were analyzed for compositional properties, color, functional properties (stretchability and meltability) and sensory evaluation. The stretchability and meltability of both P-MCA and FF-MCA were desirably and significantly (p < 0.05) higher than the C-MC. Moreover, the P-MCA had the significantly highest (p < 0.05) acceptance score for all sensory attributes in both raw form and as a pizza topping. In conclusion, the P-MCA showed superior performance in terms of functionality and sensory acceptance.

Palm oil (PO) is widely utilised in the food industry and consumed in large quantities by humans. Owing to its bioactive components, such as fatty acids, carotenoids, vitamin E, and phenolic compounds, PO has been utilised for generations. However, public concern about their adverse effects on human health is growing. A literature search was conducted to identify fractionated palm oil processing techniques, proof of their health advantages, and potential food applications. Refined palm oil (RPO) is made from crude palm oil (CPO) and can be fractionated into palm olein (POl) and palm stearin (PS). Fractional crystallisation, dry fractionation, and solvent fractionation are the three basic fractionation procedures used in the PO industry. The composition of triacylglycerols and fatty acids in refined and fractionated palm oil and other vegetable oils is compared to elucidate the triacylglycerols and fatty acids that may be important in product development. It is well proven that RPO, POl, and PS extends the oil's shelf life in the food business. These oils have a more significant saturated fat content and antioxidant compounds than some vegetable oils, such as olive and coconut oils, making them more stable. Palm olein and stearin are also superior shortening agents and frying mediums for baking goods and meals. Furthermore, when ingested modestly daily, palm oils, especially RPO and POl, provide health benefits such as cardioprotective, antidiabetic, anti-inflammatory, and antithrombotic effects. Opportunities exist for fractionated palm oil to become a fat substitute; however, nutrition aspects need to be considered in further developing the market.

Background and objective: The adolescent stage is critical because of the increase in influences from peers and media and exposure to unhealthy food environments and aggressive marketing. This necessitates the need for dentists, dental and oral health therapists, hygienists, and others to engage with adolescents early for establishing good life-long oral health habits. A review of New Zealand school Year 8 children's and adolescents' dental caries experience shows improvements over recent years for Māori, Pacific, and non-Māori and non-Pacific children. However, large ethnic inequalities persist, with no sign of the gaps closing. The objective of this paper was to examine risk factors associated with dental caries in New Zealand adolescents, identify current strategies to improve caries experience, and make recommendations for further improvement. Methods: Electronic databases and electronic and hand-searches of reference lists of articles, reports, and textbooks used were identified, and findings were organised into common themes. Findings: Seven themes have updated: past caries experience and current caries activity; dietary habits; oral hygiene habits; exposure to fluoride; access to dental services; oral health literacy; and socioeconomic background of adolescents and parents/caregivers. Each of these themes is described in detail. For various reasons, adolescents are susceptible to higher dental caries experience. Conclusion: While dental practitioners and others engage with adolescents early and provide appropriate preventive practices, additional effective strategies proposed are needed to further improve the overall caries experience among New Zealand adolescents and to reduce ethnic inequalities. [ABSTRACT FROM AUTHOR]

Background: A recent review of New Zealand 5-year-old children’s oral health data reveals that minimal improvements have been made over recent years, despite considerable investment. Furthermore, unacceptably wide inequalities among different ethnic and socioeconomically disadvantaged communities have remained largely unchanged. Aims: To examine evidence-based risk factors that are associated with Early Childhood Caries (ECC) and current strategies to mitigate against them; identify preventive strategies that may further improve the overall oral health of New Zealand preschool children and reduce disparities; and make recommendations. Methods: Articles and textbooks used in this review were identified primarily using electronic databases and from electronic and hand-searches of reference lists of articles and reports. Findings were collated and then organised into common themes. Findings and Discussion: Ten themes were identified, namely: [1] high frequency of sugar consumption; [2] continuous breastfeeding at nights; [3] oral hygiene habits; [4] lack of exposure to fluoride; [5] socioeconomic, cultural and demographic background of parents/caregivers; [6] oral health literacy; [7] access to dental services; [8] oral health status of mothers and transmission of cariogenic bacteria; [9] teeth susceptible to caries due to developmental defects of enamel; and [10] role of genetics in dental caries. Based on these findings, it is recommended that prevention starts during pregnancy and continues through preschool years. Both population- and individual-based strategies aimed at modifying or eliminating aetiological factors causing caries and preventing initiation and progression of ECC appear warranted. Rather than developing oral health programmes in isolation, a common coherent risk approach integrated with other health initiatives is likely to be more efficacious. By addressing common risks and underlying social determinants, improvements in a range of chronic conditions are likely to be efficiently achieved. Conclusions: To further improve the oral health of preschool children and to reduce inequalities, recommendations are described within 10 themes. [ABSTRACT FROM AUTHOR]

The Canadian Association of Radiologists (CAR) Gastrointestinal Expert Panel consists of radiologists, a gastroenterologist, a general surgeon, a family physician, a patient advisor, and an epidemiologist/guideline methodologist. After developing a list of 20 clinical/diagnostic scenarios, a systematic rapid scoping review was undertaken to identify systematically produced referral guidelines that provide recommendations for one or more of these clinical/diagnostic scenarios. Recommendations from 58 guidelines and contextualization criteria in the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) for guidelines framework were used to develop 85 recommendation statements specific to the adult population across the 20 scenarios. This guideline presents the methods of development and the referral recommendations for dysphagia/dyspepsia, acute nonlocalized abdominal pain, chronic abdominal pain, inflammatory bowel disease, acute gastrointestinal bleeding, chronic gastrointestinal bleeding/anemia, abnormal liver biopsy, pancreatitis, anorectal diseases, diarrhea, fecal incontinence, and foreign body ingestion., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Oxysterols previously were considered intermediates of bile acid and steroid hormone biosynthetic pathways. However, recent research has emphasized the roles of oxysterols in essential physiologic processes and in various diseases. Despite these discoveries, the metabolic pathways leading to the different oxysterols are still largely unknown and the biosynthetic origin of several oxysterols remains unidentified. Earlier studies demonstrated that the glucocorticoid metabolizing enzymes, 11β-hydroxysteroid dehydrogenase (11β-HSD) types 1 and 2, interconvert 7-ketocholesterol (7kC) and 7β-hydroxycholesterol (7βOHC). We examined the role of 11β-HSDs in the enzymatic control of the intracellular availability of 7β,27-dihydroxycholesterol (7β27OHC), a retinoid-related orphan receptor γ (RORγ) ligand. We used microsomal preparations of cells expressing recombinant 11β-HSD1 and 11β-HSD2 to assess whether 7β27OHC and 7-keto,27-hydroxycholesterol (7k27OHC) are substrates of these enzymes. Binding of 7β27OHC and 7k27OHC to 11β-HSDs was studied by molecular modeling. To our knowledge, the stereospecific oxoreduction of 7k27OHC to 7β27OHC by human 11β-HSD1 and the reverse oxidation reaction of 7β27OHC to 7k27OHC by human 11β-HSD2 were demonstrated for the first time. Apparent enzyme affinities of 11β-HSDs for these novel substrates were equal to or higher than those of the glucocorticoids. This is supported by the fact that 7k27OHC and 7β27OHC are potent inhibitors of the 11β-HSD1-dependent oxoreduction of cortisone and the 11β-HSD2-dependent oxidation of cortisol, respectively. Furthermore, molecular docking calculations explained stereospecific enzyme activities. Finally, using an inducible RORγ reporter system, we showed that 11β-HSD1 and 11β-HSD2 controlled RORγ activity. These findings revealed a novel glucocorticoid-independent prereceptor regulation mechanism by 11β-HSDs that warrants further investigation., (Copyright © 2019 Beck et al. Published by The American Society for Biochemistry and Molecular Biology, Inc.)

Background: Sepsis has been associated with high morbidity and mortality. The aims were to determine predictors of mortality among patients with bloodstream infections (BSIs) and to ascertain the role of quick Sequential Organ Failure Assessment (qSOFA) in predicting poor outcomes., Methods: All internal medicine patients with BSIs at the Hospital of Jura, Switzerland during a three year period (July 2014 to June 2017) were included., Results: Among 404 BSIs, Escherichia coli represented the most common species isolated (156 episodes; 38.6%), followed by Staphylococcus aureus (68; 16.8%). The most common site of infection was urinary tract accounting for 39.6% of BSIs (160 episodes). Thirty-day mortality was 18.1%. Multivariate analysis revealed BSI due to staphylococci, malignancy (haematologic or solid organ), qSOFA≥2 points, Pitt bacteraemia score as independent predictors of mortality, while appropriate empiric antibiotic therapy and administration of antibiotic therapy within three hours from infection's recognition were identified as a predictor of good prognosis. qSOFA showed the highest sensitivity (87.7%), negative predictive value (96.6%) and accuracy (0.83) as compared to other scores. Mortality among 141 septic patients was 45.4%. Malignancy (haematologic or solid organ), primary BSI, Pitt bacteraemia score, were independently associated with mortality, while appropriate empiric antibiotic therapy and administration of antibiotic therapy within the first hour from infection's recognition were associated with better prognosis., Conclusion: qSOFA as compared to other severity scores showed an excellent negative predictive value. Better prognosis was associated with administration of appropriate empiric antibiotic therapy and its timely initiation., (Copyright © 2019 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.)

Oxysterols are cholesterol metabolites derived through either autoxidation or enzymatic processes. They consist of a large family of bioactive lipids that have been associated with the progression of multiple pathologies. In order to unravel (patho-)physiological mechanisms involving oxysterols, it is crucial to elucidate the underlying formation and degradation of oxysterols. A role of 11β-hydroxysteroid dehydrogenases (11β-HSDs) in oxysterol metabolism by catalyzing the interconversion of 7-ketocholesterol (7kC) and 7β-hydroxycholesterol (7βOHC) has already been reported. The present study addresses a function of 11β-HSD1 in the enzymatic generation of 7β,25-dihydroxycholesterol (7β25OHC) from 7-keto,25-hydroxycholesterol (7k25OHC) and tested whether 11β-HSD2 is able to catalyze the reverse reaction. For the first time, using recombinant enzymes, the formation of 7k25OHC from 7kC by cholesterol 25-hydroxylase (CH25H) and further stereospecific oxoreduction to 7β25OHC by human and mouse 11β-HSD1 could be demonstrated. Additionally, experiments using human 11β-HSD2 showed the oxidation of 7β25OHC to 7k25OHC. Molecular modeling provided an explanation for the stereospecific interconversion of 7β25OHC and 7k25OHC. Production of the Epstein-Barr virus-induced gene 2 (EBI2) ligand 7β25OHC from 7k25OHC in challenged tissue by 11β-HSD1 may be important in inflammation. In conclusion, these results demonstrate a novel glucocorticoid-independent pre-receptor regulation mediated by 11β-HSDs., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

The concept of supply and demand is well established within the health economy of the UK. However, complex health and social care needs, associated with an ageing population, pose a novel challenge to NHS resources and, in particular, its workforce. Although existing strategies adopt a more linear approach to clinical activity and workforce demands, the Workforce Repository and Planning Tool process draws upon the principles of 'realist' data evaluation to combine -empirical evidence, practical experience and clinical theory to offer transformation strategies for an NHS workforce that is fit for purpose and its patients.

Red palm oil (RPO) is a natural source of Vitamin E (70-80% tocotrienol). It is a potent natural antioxidant that can be used in skin-care products. Its antioxidant property protects skin from inflammation and aging. In our work, a tocotrienol-rich RPO-based nanoemulsion formulation was optimized using response surface methodology (RSM) and formulated using high pressure homogenizer. Effect of the concentration of three independent variables [surfactant (5-15 wt%), co-solvent (10-30 wt%) and homogenization pressure (500-700 bar)] toward two response variables (droplet size, polydispersity index) was studied using central composite design (CCD) coupled to RSM. RSM analysis showed that the experimental data could be fitted into a second-order polynomial model and the coefficients of multiple determination (R2) is 0.9115. The optimized formulation of RPO-based nanoemulsion consisted of 6.09 wt% mixed surfactant [Tween 80/Span 80 (63:37, wt)], 20 wt% glycerol as a co-solvent via homogenization pressure (500 bar). The optimized tocotrienol-rich RPO-based nanoemulsion response values for droplet size and polydispersity index were 119.49nm and 0.286, respectively. The actual values of the formulated nanoemulsion were in good agreement with the predicted values obtained from RSM, thus the optimized compositions have the potential to be used as a nanoemulsion for cosmetic formulations., Competing Interests: The authors have declared that no competing interests exist.

The annual Eastern Canadian Gastrointestinal Cancer Consensus Conference 2017 was held in St. John's, Newfoundland and Labrador, 28-30 September. Experts in radiation oncology, medical oncology, surgical oncology, and cancer genetics who are involved in the management of patients with gastrointestinal malignancies participated in presentations and discussion sessions for the purpose of developing the recommendations presented here. This consensus statement addresses multiple topics in the management of gastric, rectal, and colon cancer, including ■ identification and management of hereditary gastric and colorectal cancer (crc);■ palliative systemic therapy for metastatic gastric cancer;■ optimum duration of preoperative radiation in rectal cancer-that is, short- compared with long-course radiation;■ management options for peritoneal carcinomatosis in crc;■ implications of tumour location for treatment and prognosis in crc; and■ new molecular markers in crc.

Objectives: Immigration and acculturation are increasingly recognized as important explanatory factors for health disparities, although their impact on oral health is less well understood. This study investigates the relationship between Pacific children's cultural orientation and oral health, after adjusting for potentially moderating and confounding variables., Methods: The Pacific Islands Families (PIF) study follows a cohort of Pacific infants born in 2000. PIF study participants' data from their last dental examination were extracted from service records, and matched to the cohort. A bi-directional acculturation classification, derived from maternal reports, was related to children's oral health indices in crude and adjusted analyses., Results: 1,376 children were eligible, of whom 922 (67.0 percent) had mothers born outside New Zealand. Matching was successful for 970 (70.5 percent) children, with mean age 12.2 years (range: 6.8, 15.4 years). Significant differences were found between acculturation groups for children's tooth brushing frequency and school dental service enrollments but these differences did not moderate relationships between acculturation and oral health status. Unmet treatment need was significantly different between acculturation groups, with children of mothers having higher Pacific orientation having worse unmet needs than those with lower Pacific orientation. No other significant differences were noted., Conclusions: Pacific children carry a disproportionate oral health burden, particularly amongst those with mothers more aligned to their Pacific culture. Strategies which enable Pacific people to re-shape their oral health understanding, together with reducing barriers to accessing dental health care, are needed to prevent a legacy of poor oral health in Pacific people within New Zealand., (© 2017 American Association of Public Health Dentistry.)

Colonoscopy is the most sensitive and specific means for detection of colon cancers and polyps. To make colonoscopy more effective several problems must be overcome including: pain associated with the procedure, the risk of perforation, and incomplete intubation colonoscopy. Technically, these problems are the result of loop formation during colonoscopy. Although, several solutions such as modifying the stiffness of the colonoscope, using an overtube and developing image-guided instruments have been introduced to resolve the looping problem, the results of these systems are not completely satisfactory. A new paradigm to overcome loop formation is proposed that is doctor-assistive colonoscopy. In this approach, the endoscopists performance is enhanced by providing using a kinetic model that provides information such as the shape of the scope, direction of the colon and forces exerted within certain sections. It is expected that with the help of this model, the endoscopist would be able to adjust the manipulation to avoid loop formation. In the present studies, the kinetic model is developed and validated using an ex vivo colonoscopy test-bed with a comprehensive kinematic and kinetic data collection. The model utilizes an established colon model based on animal tissue with position tracking sensors, contact force sensors for the intraluminal portion of the scope and a Colonoscopy Force Monitor for the external insertion tube.

The colonoscope is an important tool in the diagnosis and management of diseases of the colon; yet its design has not changed appreciably since it was first introduced to clinical practice 40 years ago. One of the ongoing challenges with this device is that the natural shape of the colon predisposes to loop formation by the scope during the examination. The result of this looping is that further insertion of the scope results in a larger loop size without any advancement of the tip of the scope. Looping thus causes pain in the patient, risks perforation of the colon, and results in incomplete examinations. In this article, loop formation is analyzed in terms of frictional force state and Kirchhoff's slender rod model in order to better understand the generic principle of loop formation. Next, a mathematical model of deformation of the colon with respect to external manipulation involving a number of variables involved in loop formation is constructed. Finally, a model of the motion of the scope relative to the colon when looping occurs is presented. The model has clinical significance for prediction of advancement of the tip of the scope when looping occurs. The mathematical model was then validated and verified using data available from the literature. Our models are an important starting point in the development of a novel device to overcome loop formation and result in increased patient comfort and an improved completion rate for colonoscopy procedures.

Objectives: To report robust and contemporary estimates of permanent teeth emergence ages in children of Māori, Pasifika, Chinese, Indian and European ethnic origin in the Auckland region., Design: A stratified, two-stage cross-sectional study. Strata were defined by school decile status. Schools defined the first-stage sampling unit, and students the second stage., Setting: Invitations and consent forms were distributed to eligible participants at school for completion at home. Participants were examined at school-based clinics or in a mobile clinic. PARTICIPANTS/MATERIALS, AND METHODS: Children aged between 5 and 13 years enrolled within the Auckland Regional Dental Service. Schools were randomly selected and then all students within selected schools were invited to participate. Eligible participants completing a consent form had an additional tooth assessment that complemented their routine dental examination. A generalised gamma failure-time model was employed to estimate permanent tooth eruption ages., Main Outcome Measures: Visually based assessment of permanent tooth emergence., Results: Overall, 3,466 children participated. Differences in median permanent tooth emergence ages were seen among ethnic groups and sexes (P < or = 0.01). Pasifika children had earlier median eruption time than sex-matched Māori children, who (in turn) were more advanced than sex-matched European children. Median eruption age occurred earlier in girls than boys for all permanent teeth., Conclusions: Despite known demographic, geographic and ethnic differences, estimates of permanent teeth emergence timing widely used in New Zealand are based on historical overseas populations. The presented estimates provide new standards and may be more appropriate for dental therapists and dentists when assessing permanent teeth emergence in New Zealand children.

Although colonoscopy is a very commonly carried out procedure, it is not without its problems, including a risk of perforation and significant patient discomfort, especially associated with looping formation. Furthermore, looping formation may prevent a complete colonoscopy from being carried out in certain patients. The conventional colonoscope has not changed very much since its original introduction. We review promising technologies that are being promoted as a way to address the problems with current colonoscopy. There are some methods to prevent looping formation, including overtube, variable stiffness, computer-guided scopes, Aer-O-Scope, magnetic endoscopic imaging and the capsule endoscope. In recent years, with the progress of microelectromechanical and microelectronic technologies, many biomedical and robotic researchers are developing autonomous endoscopes with miniaturization of size and integration functionality that represent state of the art of the micro-robotic endoscope. The initial results by using aforementioned methods seem promising; however, there are some conflicting reports of clinical trials with the overtube colonoscope, the computer-guided scope and the variable stiffness colonoscope. There are also some limitations in the use of the Aer-o-scope and the capsule endoscope. The autonomous endoscope is based on a self-propelling property that is able to avoid looping completely. This novel technology could potentially become the next generation endoscope; however, there are still critical techniques to be approached in order to develop the effective and efficient novel endoscope., (© 2011 The Authors. Digestive Endoscopy © 2011 Japan Gastroenterological Endoscopy Society.)

Background and Objectives: Controversy continues over the extent of surgical resection margin required to minimize the risk of local recurrence (LR) in breast-conserving therapy (BCT) for early stage breast cancer. This study explores whether or not a narrow (≤ 2 mm) but negative resection margin affects LR., Methods: All patients registered at the Saskatoon Cancer Center between January 1, 1991 and December 31, 2000 with a diagnosis of early stage invasive duct carcinoma treated with BCT were examined. All charts and pathology reports were reviewed with a review of the pathology for all cases where the resection margin was unclear in the original report. Other factors known or thought to effect LR (age, radiation boost, grade, extensive DCIS, ER/PR receptor status) were considered in the statistical analysis., Results: Amongst the 200 narrow margin cases 19 LR were detected (19/201 = 9.5%) while 52 LR were detected in the 491 wide margin cases (52/491 =10.6%). This difference was not statistically significant., Conclusions: A narrow (≤ 2 mm) surgical resection margin does not result in an increase in LR compared to a surgical resection margin 2 mm in BCT for early stage duct carcinoma and does not warrant re-excision., (Copyright © 2011 Wiley-Liss, Inc.)

Objectives: This epidemiological study aims to investigate the developmental enamel defects and dental caries among 9-year-old children resident in fluoridated and nonfluoridated regions in Auckland, New Zealand., Methods: A stratified, two-stage random selection design where strata were defined by fluoridation status, school size, and school decile. After informed consent was obtained, parents completed oral health questionnaires and children underwent dental examinations at school clinics., Results: 612 children from 38 schools participated in the study. Overall, 175 (29%) children had lived continuously in fluoridated areas, 149 (24%) had lived continuously in nonfluoridated areas, and 288 (47%) had resided intermittently in fluoridated areas. Diffuse opacities were present in 117 (19%) children and deciduous teeth dental caries was seen in 370 (60%) children. After adjustment for covariates, a strong dose-response relationship between diffuse opacity and fluoridation status was found, with children who lived continuously in fluoridated areas being 4.17 times as likely to have diffuse opacities as children who lived continuously in nonfluoridated areas (P < 0.001). Conversely, a strong protective dose-response relationship between caries experience and fluoridation status was seen, with children who lived continuously in fluoridated areas being 0.42 times as likely to have dental caries as children who lived continuously in nonfluoridated areas (P < 0.001)., Conclusions: Reticulated water fluoridation in Auckland reduces the risk of dental caries but increases the risk of diffuse opacities in 9-year-old children. Guidelines and health-promotion strategies that enable children to minimize their risk to diffuse opacities yet reduce their risk of dental caries should be reviewed.

Objectives: To report the prevalence and severity of enamel defects and dental caries in a probability-based sample of 9-year-old children in the Auckland region, both overall and by residence in fluoridated and non-fluoridated areas., Design: A two-stage clustered design with stratification. Strata were defined by fluoridated and non-fluoridated regions, school size, and school decile status., Setting: Invitations, consent forms and questionnaires were distributed to eligible participants at school for completion at home. Participants were examined at school-based clinics or in a mobile clinic. PARTICIPANTS/MATERIALS AND METHODS: The source population was 9-year-old children attending schools in the Auckland region and enrolled with the Auckland Regional School Dental Service. Participants returned a completed consent form and questionnaire by post and then had a dental examination. Regression analyses accommodating probability sampling weights, stratification and clustering were employed., Main Outcome Measures: The modified Developmental Defects of Enamel index was used to classify enamel defects in permanent teeth. Diagnosis of dental caries on deciduous and permanent teeth was visually-based., Results: Overall, 612 children participated, 310 in fluoridated and 302 in non-fluoridated areas. Diffuse opacities are prevalent inAuckland, with 28.0 per 100 children affected. Significant regional differences by fluoridation status were apparent, with diffuse opacity rates of 29.1 per 100 and 14.7 per 100 children in fluoridated and in non-fluoridated areas respectively (P<0.001). Conversely, the prevalence of deciduous teeth dental caries was significantly lower in fluoridated areas (54.9 per 100) than in non-fluoridated areas (62.0 per 100), P=0.05., Conclusions: Diffuse opacities were the predominant tooth defect found in this study, but their prevalence appears largely unchanged from estimates reported within New Zealand over the last 25 years.

Knowledge of utilisation rates in the General Dental Benefit Scheme and caries levels among 15-year-old adolescents is important to study the dental needs of the population for planning and purchasing the necessary services. These data were collected from contracting dentists in the General Dental Benefit (GDB) Scheme in the Southern Regional Health Authority's region. The enrollment rate of 15-year-olds in the Scheme in 1995 was 89.6 percent. In 1996, 76.1 percent had experience of dental caries, and the mean DMF was 3.7 teeth. This study confirms the continued decline of dental caries among adolescents. However, nearly one-third of that group had high caries levels, and this needs further investigation. Despite some limitations, this study's data are useful as they provide the only recent information on this age group in New Zealand.