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The purpose of this descriptive study was to determine adaptation by family caregivers of persons with Alzheimer's disease who did not use community services. Previous research has focused on the use of services, highlighting the need for studies examining factors associated with service nonuse. Lawton and Nahemow's ecology model of adaptation and aging served as the foundation for this study; the relationship between personal competence and environmental press depicts a level of adaptation. A mail and telephone survey of 70 caregivers revealed reasons for not using services to which they had been referred, as well as patterns of adaptation to caregiving. Personal competence, measured as perception of caregiving mastery, emerged as a significant factor in service nonuse. Caregiver gender and daily hours of caregiving, an environmental press factor combined with perception of mastery to most often correctly classify respondents' high and low adaptation. Strategies for enhancing caregiver competence should be given highest priority by primary health care professionals.

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An analytical system for evaluating class II cavity preparations in primary teeth was developed and tested and then compared with the traditional global (glance and grade) evaluation method with respect to intraexaminer and interexaminer reliability. Fifteen examiners with varied experience in clinical evaluation rated 24 class II cavity preparations in ivorine inverted question mark primary teeth mounted in dentoforms inverted question mark in a simulated clinical setting. The global method of scoring was compared to an analytical system consisting of a rating scale with five operationally‐defined points for each of 10 specifically‐defined performance criteria. Interexaminer reliability was improved with the analytical system which also provides a means for facilitating student feedback and learning. The gain in reliability was not tested for statistical significance.