Adolescents and oral health service utilization in Canterbury, New Zealand: A geospatial cross-sectional study

OBJECTIVE

Non-utilization of dental care during adolescence can result in poorer oral health and subsequently higher expenditures on dental services. This study examined the geospatial and epidemiological factors associated with utilization of the publicly funded Adolescent Oral Health Services (AOHS) in Canterbury, Aotearoa New Zealand (NZ).

METHODS

A secondary analysis of prospectively collected routine data from AOHS visits of adolescents in school Year 9 (13-14 years) for the financial year 2019-2020. Geographic information systems examined distance from home to dental practices. Multilevel mixed-effects Poisson regression models investigated associations between geospatial, demographic and clinical factors and non-utilization of dental services. Models were adjusted for sex, ethnicity, area-level deprivation, rural/urban classification, previous caries experience and the distance from home address to dental practice referred.

RESULTS

Dental practices were concentrated in large urban areas and in the least deprived neighbourhoods, with several service area gaps identified. Rural areas and the most deprived areas of Christchurch City had the highest non-utilization rates. After adjustment, adolescents residing in the most deprived areas had a higher risk of non-utilization (adjusted risk ratio [aRR] = 1.38; 95% CI 1.26-1.51) compared to adolescents in the least deprived areas. Adolescents in remote areas also had an increased risk of non-utilization (aRR = 1.36; 95% CI 1.20-1.54) compared to adolescents in urban core areas. Finally, Māori (aRR = 1.37; 95% CI 1.29-1.46) and Pasifika (aRR = 1.46; 95% CI 1.35-1.59) adolescents had significantly higher risks of non-utilization compared to their NZ European counterparts.

CONCLUSION

Inequitable utilization of dental services exists among adolescents in Canterbury, NZ, and is associated with Māori, Pasifika and those living in rural and most deprived areas. Adolescents at the greatest oral health risk are geographically underserved by current oral health services. The current health system should also explore the possibility of partnering with Māori and Pasifika communities to provide services within culturally appropriate settings.

Comparative Evaluation of Genome Assemblers from Long-Read Sequencing for Plants and Crops

The availability of recent state-of-the-art long-read sequencing technologies has significantly increased the ease and speed of producing high-quality plant genome assemblies. A wide variety of genome-related software tools are now available and they are typically benchmarked using microbial or model eukaryotic genomes such as Arabidopsis and rice. However, many plant species have much larger and more complex genomes than these, and the choice of tools, parameters, and/or strategies that can be used is not always obvious. Thus, we have compared the metrics of assemblies generated by various pipelines to discuss how assembly quality can be affected by two different assembly strategies. First, we focused on optimizing read preprocessing and assembler variables using eight different de novo assemblers on five different Pacific Biosciences long-read datasets of diploid and tetraploid species. Then, we examined a single scaffolding tool (quickmerge) that has been employed for the postprocessing step. We then merged the outputs from multiple assemblies to produce a higher quality consensus assembly. Then, we benchmarked the assemblies for completeness and accuracy (assembly metrics and BUSCO), computer memory, and CPU times. Two lightweight assemblers, Miniasm/Minimap/Racon and WTDBG, were deemed good for novice users because they involved smaller required learning curves and light computational resources. However, two heavyweight tools, CANU and Flye, should be the first choice when the goal is to achieve accurate and complete assemblies. Our results will provide valuable guidance in future plant genome projects and beyond.