Periodontitis and systemic diseases:A record of discussions of working group 4 of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases

Background There has been an explosion in research into possible associations between periodontitis and various systemic diseases and conditions. Aim To review the evidence for associations between periodontitis and various systemic diseases and conditions, including chronic obstructive pulmonary disease (COPD), pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer, and to document headline discussions of the state of each field. Periodontal associations with diabetes, cardiovascular disease and adverse pregnancy outcomes were not discussed by working group 4. Results Working group 4 recognized that the studies performed to date were largely cross-sectional or case-control with few prospective cohort studies and no randomized clinical trials. The best current evidence suggests that periodontitis is characterized by both infection and pro-inflammatory events, which variously manifest within the systemic diseases and disorders discussed. Diseases with at least minimal evidence of an association with periodontitis include COPD, pneumonia, chronic kidney disease, rheumatoid arthritis, cognitive impairment, obesity, metabolic syndrome and cancer. The working group agreed that there is insufficient evidence to date to infer causal relationships with the exception that organisms originating in the oral microbiome can cause lung infections. Conclusions The group was unanimous in their opinion that the reported associations do not imply causality, and establishment of causality will require new studies that fulfil the Bradford Hill or equivalent criteria. Precise and community-agreed case definitions of periodontal disease states must be implemented systematically to enable consistent and clearer interpretations of studies of the relationship to systemic diseases. The members of the working group were unanimous in their opinion that to develop data that best inform clinicians, investigators and the public, studies should focus on robust disease outcomes and avoid surrogate endpoints. It was concluded that because of the relative immaturity of the body of evidence for each of the purported relationships, the field is wide open and the gaps in knowledge are large. © 2013 European Federation of Periodontology and American Academy of Periodontology.

Report of the workshop for life detection in samples from Mars

The question of whether there is or was life on Mars has been one of the most pivotal since Schiaparellis' telescopic observations of the red planet. With the advent of the space age, this question can be addressed directly by exploring the surface of Mars and by bringing samples to Earth for analysis. The latter, however, is not free of problems. Life can be found virtually everywhere on Earth. Hence the potential for contaminating the Mars samples and compromising their scientific integrity is not negligible. Conversely, if life is present in samples from Mars, this may represent a potential source of extraterrestrial biological contamination for Earth. A range of measures and policies, collectively termed ‘planetary protection’, are employed to minimise risks and thereby prevent undesirable consequences for the terrestrial biosphere. This report documents discussions and conclusions from a workshop held in 2012, which followed a public conference focused on current capabilities for performing life-detection studies on Mars samples. The workshop focused on the evaluation of Mars samples that would maximise scientific productivity and inform decision making in the context of planetary protection. Workshop participants developed a strong consensus that the same measurements could be employed to effectively inform both science and planetary protection, when applied in the context of two competing hypotheses: 1) that there is no detectable life in the samples; or 2) that there is martian life in the samples. Participants then outlined a sequence for sample processing and defined analytical methods that would test these hypotheses. They also identified critical developments to enable the analysis of samples from Mars.

State of the art in research into the risk of low dose radiation exposure-findings of the fourth MELODI workshop

The fourth workshop of the Multidisciplinary European Low Dose Initiative (MELODI) was organised by STUK-Radiation and Nuclear Safety Authority of Finland. It took place from 12 to 14 September 2012 in Helsinki, Finland. The meeting was attended by 179 scientists and professionals engaged in radiation research and radiation protection. We summarise the major scientific findings of the workshop and the recommendations for updating the MELODI Strategic Research Agenda and Road Map for future low dose research activities.

Free Improvisation in Europe:Lecture and Hands-on Workshop, given at 5 different universities in Brazil during February - June 2014

The lecture traces the beginnings of the free improvisation scene in Europe, commencing in the 1960. I present a multitude of video and audio examples of some of the most prominent improvisers of the time.
I focus specifically on the scene that developed around John Stevens and his SME (Spontaneous Music Ensemble). The work of Derek Bailey, specifically his writings in “Improvisation: its nature and practice in music” (1980), will feature.

The practical workshop invites improvisers (beginners to advanced with any instruments) to work with me on several listening and improvisation exercises.
Many of the exercises will be based on the innovative methods as developed by John Stevens in his work “Search and Reflect”. Participants will be able to experiment with a few essential ‘sound/listening’ exercises, guided by myself.
It is envisaged that a small ensemble is formed which will explore several improvisatory strategies. This part is open to all skill levels, all ages and any instrumental groupings.

Preparing medical students for normal birth: an interactive workshop by pre-registration midwifery students.

There is an increasing recognition of the need to improve inter professional relationships within clinical practice (DoH, 2001). Evidence supports the assertion that health care professionals who are able to communicate and work effectively together and who have a mutual respect and understanding for one another’s roles will provide a higher standard of care (McPherson et al, 2001; Begley, 2008). Providing inter professional education within a University setting offers an opportunity for a non-threatening learning environment where students can develop confidence and build collaborative working relationships with one another (Saxell et al, 2009).
An inter-professional education initiative was developed in Queen’s University Belfast within the Schools of Nursing and Midwifery and Medicine and piloted in 2014. The aim of the collaboration was to introduce concepts of normal labour and birth to fourth year medical students prior to their obstetric and gynaecological placement in hospital. The teaching staff felt this would be an excellent opportunity for final year pre-registration midwifery students to demonstrate their knowledge and understanding on normality in labour and birth by preparing interactive workshops with the medical students. The midwifery students were provided with an outline agenda in relation to content for the workshop, but then were allowed creative licence with regard to delivery of the workshop. The workshops consisted of approximately 4 midwifery students to 12 medical students. Resources such as birthing balls, birth mannequins, dolls and pelvises were available to the students to increase interactivity. Significant emphasis was placed upon the importance of relationship building with women in labour and the concept of being ‘with woman’ was core to all elements of teaching. Midwifery students undertook acting roles such as the labouring woman, partner or a midwife role and acted out mini scenarios such as contacting for advice about early labour; positions for labour or positions for birth. Medical students were prompted to vocalise about their feelings towards labour and birth and encouraged to think about their role within the birth setting.
Preliminary evaluations of the workshops have been extremely positive from both the midwifery students and the medical students. The midwifery students have commented on the enjoyable aspects of team working for preparing for the workshop and also the confidence gained from teaching the medical students. The medical students have evaluated the teaching by the midwifery students positively and felt that it lowered their anxiety going into the labour setting. A number of midwifery and medical students have subsequently worked with one another within the practice setting which has been recognised as beneficial. Both Schools have recognised the benefits of this form of inter professional education and have subsequently made a commitment to embed it within each curriculum.