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The National Immunisation Register (NIR), which is derived from general practice management systems, is an important tool for the provision of clinical services, national immunisation programme evaluation and immunisation research in New Zealand. However, the accuracy of the NIR data has not yet been quantified. This study aimed to examine, describe and quantify the extent of discrepancy in the NIR compared to Well Child Tamariki Ora parent-held health record books (Health Books).Immunisation data for vaccinations given between birth and four years old for children born between 2006 and 2019 were compared between the Health Books and the NIR. Health Book records were used as the reference standard to calculate performance measures: sensitivity, specificity, positive and negative predictive values for the NIR.Overall, NIR performance was high: sensitivity ranged from 90% to 93%, specificity from 78% to 85%, the positive predictive value from 91% to 94% and the negative predictive value from 77% to 84%. NIR performance was higher for National Immunisation Schedule (NIS) vaccines compared with non-NIS vaccines.This study indicates the NIR data accuracy generally performs well compared with international equivalents, especially for NIS vaccine records. Further work is required to ascertain why discrepancies between the Health Books and NIR continue to occur, with particular attention to important subgroups and translating records across from migrant populations. Also, future work is required to understand the accuracy of vaccination records for groups who experience lower-quality healthcare and a higher burden of infectious diseases.

Young people are becoming more detached from nature through a number of causes, including their increased use of digital media. This detachment from nature results in a lowering in the sense of ownership of the land and its resources and subsequently results in less motivation to conserve it. In order to reverse such behaviours and attitudes, a new programme termed ‘Lifelong Learning through Nature’ (LLN) was devised. This study is an analysis of the LLN programme and its potential for making links between outdoor learning, fieldwork and education for sustainable development. These results shed light on the effectiveness of the programme in influencing knowledge and attitudes and, in turn, lead to formulate a way forward in the programme’s evolution. Outdoor education is an essential element of Education for Sustainable Development (ESD) which is key to address the current situation for a sustainable future. The data was collected through a number of focus groups with students from a number of different schools from the Maltese islands. Each group of students was researched through a pre-activity focus group and a post-activity focus group. The data was then transcribed and translated and subsequently analysed through a structured thematic analysis. The results revealed a great sense of detachment in the young students and eventually a greater sense of pointlessness in the older students. The post-focus groups indicated excellent improvement in knowledge and a perceptible change towards a more positive attitude across the ages. This study reveals that the LLN programme does have an influential role in the knowledge and attitudes of school children towards nature. This study continues to uphold the vision that outdoor education should be considered as a main activity which involves and results in ESD. In response to these findings, a model illustrating the emerging links between the LLN programme and various factors is presented. This paper directly illustrates how university research in teamwork with non-governmental organisations can impact the local community and the study will be useful to anyone interested in carrying out effective programmes and research into the links between ESD and outdoor education.

Aims This study aimed to evaluate the efficacy of a high (≥12) Finnish diabetes risk (FINDRISC) score in identifying undiagnosed prediabetes and type 2 diabetes (T2D) in an New Zealand population of overweight and obese individuals, across a variety of ethnic groups. Methods We estimated the efficacy of elevated FINDRISC scores in predicting prediabetes and T2D in 424 overweight adults with no prior diagnosis recruited for the PREVention of diabetes through lifestyle Interventions in Europe and Worldwide (PREVIEW) study. All participants who completed the FINDRISC questionnaire during a pre-screening phase with a score of ≥12 were then screened using a 2 h oral glucose tolerance test (2h-OGTT) to identify undiagnosed dysglycaemia. Results Of the 424 participants, 65% (n = 280) were pre-diabetic and 7% (n = 32) had undiagnosed T2D. A higher FINDRISC score was significantly associated with prediabetes and T2D (P = 0.02). There was a significant association between ethnicity and glycaemic status (normal vs prediabetes/T2D, P = 0.02). Increasing the FINDRISC cut-off to ≥15 resulted in a non-significant increase in the proportion of participants correctly classified with dysglycaemia. ROC-AUC = 0.6 with sensitivity = 0.6026 (95% CI: 0.5459–0.6573) and specificity = 0.5536 (95% CI: 0.4567–0.6476). Isolated impaired fasting glucose (IFG) was more efficient in predicting dysglycaemia than isolated impaired glucose tolerance (IGT). Conclusions The FINDRISC questionnaire is a useful and efficacious screening tool to identify unknown prediabetes and T2D in overweight New Zealanders, particularly in Maori individuals.