Evaluation of Sheffield City Council's Community Justice Panels Project

This report is the output of an evaluation commissioned by Sheffield City Council and undertaken by the Hallam Centre for Community Justice at Sheffield Hallam University. The evaluation was undertaken during October and November 2009 with the objectives of assessing the effectiveness of the Community Justice Panels project so far and providing recommendations for future development. The evaluation used an action research methodology and included documentary analysis, semi-structured interviews with strategic partners and stakeholders, wrongdoers and harmed persons, facilitator focus group and observation of the Panels

Process evaluation of five integrated offender management pioneer areas

A qualitative process evaluation of five Integrated Offender Management (IOM) pioneer areas was undertaken to assess implementation of IOM, identify approaches to implementation and capture the lessons learnt. The findings indicated that IOM enabled structural changes, transforming the delivery of offender management. There was considerable commitment and enthusiasm for IOM at the sites, whilst acknowledging barriers to development such as definition, resourcing, governance and clarity of agency roles. Since the evaluation took place, the political and criminal justice landscape has changed somewhat, supporting a more locally driven approach which can draw on the learning directly from the pioneers which were shaped and delivered locally

Revealing microbial recognition by specific antibodies

Background: Recognition of microorganisms by antibodies is a vital component of the human immune response. However, there is currently very limited understanding of immune recognition of 50 % of the human microbiome which is made up of as yet un-culturable bacteria. We have combined the use of flow cytometry and pyrosequencing to describe the microbial composition of human samples, and its interaction with the immune system. Results: We show the power of the technique in human faecal, saliva, oral biofilm and breast milk samples, labeled with fluorescent anti-IgG or anti-IgA antibodies. Using Fluorescence-Activated Cell Sorting (FACS), bacterial cells were separated depending on whether they are coated with IgA or IgG antibodies. Each bacterial population was PCR-amplified and pyrosequenced, characterizing the microorganisms which evade the immune system and those which were recognized by each immunoglobulin. Conclusions: The application of the technique to healthy and diseased individuals may unravel the contribution of the immune response to microbial infections and polymicrobial diseases

Periodontal treatment causes a longitudinal increase in nitrite-producing bacteria

BackgroundThe oral microbiome-dependent nitrate (NO3−)–nitrite (NO2−)–nitric oxide (NO) pathway may help regulate blood pressure. NO2−-producing bacteria in subgingival plaque are reduced in relative abundance in patients with untreated periodontitis compared with periodontally healthy patients. In periodontitis patients, the NO2−-producing bacteria increase several months after periodontal treatment. The early effects of periodontal treatment on NO2−-producing bacteria and the NO3−–NO2−-NO pathway remain unknown. The aim of this study was to determine how periodontal treatment affects the oral NO2−-producing microbiome and salivary NO3− and NO2− levels over time.MethodsThe subgingival microbiota of 38 periodontitis patients was analysed before (baseline [BL]) and 1, 7 and 90 days after periodontal treatment. Changes in NO2−producing bacteria and periodontitis-associated bacteria were determined by 16s rRNA Illumina sequencing. Saliva samples were collected at all-time points to determine NO3− and NO2− levels using gas-phase chemiluminescence.ResultsA significant increase was observed in the relative abundance of NO2−-producing species between BL and all subsequent timepoints (all p &lt; 0.001). Periodontitis-associated species decreased at all timepoints, relative to BL (all p &lt; 0.02). NO2−-producing species negatively correlated with periodontitis-associated species at all timepoints, with this relationship strongest 90 days post-treatment (ρ = −0.792, p &lt; 0.001). Despite these findings, no significant changes were found in salivary NO3− and NO2− over time (all p &gt; 0.05).ConclusionsPeriodontal treatment induced an immediate increase in the relative abundance of health-associated NO2−-producing bacteria. This increase persisted throughout periodontal healing. Future studies should test the effect of periodontal treatment combined with NO3− intake on periodontal and cardiovascular health.</p

The subgingival plaque microbiome, systemic antibodies against bacteria and citrullinated proteins following periodontal therapy

Periodontitis (PD) shows an association with rheumatoid arthritis (RA) and systemic inflammation. Periodontal pathogens, namely Porphyromonas gingivalis and Aggregatibacter actinomycetemcomitans, are proposed to be capable of inducing citrullination of peptides in the gingiva, inducing the formation of anti-citrullinated protein antibodies (ACPAs) within susceptible hosts. Here, we sought to investigate whether periodontal treatment influenced systemic inflammation and antibody titres to P. gingivalis, A. actinomycetemcomitans, Prevotella intermedia and ACPA in 42 systemically health patients with periodontal disease. Subgingival plaque and serum samples were collected from study participants before (baseline) and 90 days after treatment to analyse the abundance of specific bacteria and evaluate anti-bacterial antibodies, C-reactive protein (CRP), tumour necrosis factor α (TNF-α), interleukin 6 (IL-6) and ACPA in serum. Following treatment, all patients showed reduced periodontal inflammation. Despite observing a weak positive correlation between CRP and IL-6 with periodontal inflammation at baseline, we observed no significant reductions in any indicators of systemic inflammation 90 days after treatment. In contrast, anti-P. gingivalis IgG significantly reduced post-treatment (p &lt; 0.001, Wilcoxon signed rank test), although no changes were observed for other antibody titres. Patients who had detectable P. gingivalis in subgingival plaques had significantly higher anti-P. gingivalis IgG and ACPA titres, suggesting a potential association between P. gingivalis colonisation and systemic antibody titres

Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability

The reduction of nitrate to nitrite by the oral microbiota has been proposed to be important for oral health and results in nitric oxide formation that can improve cardiometabolic conditions. Studies of bacterial composition in subgingival plaque suggest that nitrate-reducing bacteria are associated with periodontal health, but the impact of periodontitis on nitrate-reducing capacity (NRC) and, therefore, nitric oxide availability has not been evaluated. The current study aimed to evaluate how periodontitis affects the NRC of the oral microbiota. First, 16S rRNA sequencing data from five different countries were analyzed, revealing that nitrate-reducing bacteria were significantly lower in subgingival plaque of periodontitis patients compared with healthy individuals (P &lt; 0.05 in all five datasets with n = 20–82 samples per dataset). Secondly, subgingival plaque, saliva, and plasma samples were obtained from 42 periodontitis patients before and after periodontal treatment. The oral NRC was determined in vitro by incubating saliva with 8 mmol/L nitrate (a concentration found in saliva after nitrate-rich vegetable intake) and compared with the NRC of 15 healthy individuals. Salivary NRC was found to be diminished in periodontal patients before treatment (P &lt; 0.05) but recovered to healthy levels 90 days post-treatment. Additionally, the subgingival levels of nitrate-reducing bacteria increased after treatment and correlated negatively with periodontitis-associated bacteria (P &lt; 0.01). No significant effect of periodontal treatment on the baseline saliva and plasma nitrate and nitrite levels was found, indicating that differences in the NRC may only be revealed after nitrate intake. Our results suggest that an impaired NRC in periodontitis could limit dietary nitrate-derived nitric oxide levels, and the effect on systemic health should be explored in future studies

Nitrate and a nitrate-reducing Rothia aeria strain as potential prebiotic or synbiotic treatments for periodontitis

A few studies indicate that nitrate can reduce dysbiosis from a periodontitis point of view. However, these experiments were performed on samples from healthy individuals, and it is unknown if nitrate will be effective in periodontal patients, where the presence of nitrate-reducing bacteria is clearly reduced. The aim of this study was to test the effect of nitrate and a nitrate-reducing R. aeria (Ra9) on subgingival biofilms of patients with periodontitis. For this, subgingival plaque was incubated with 5 mM nitrate for 7 h (n = 20) or 50 mM nitrate for 12 h (n = 10), achieving a ~50% of nitrate reduction in each case. Additionally, Ra9 was combined with 5 mM nitrate (n = 11), increasing the nitrate reduced and nitrite produced (both p &lt; 0.05). The addition of nitrate to periodontitis communities decreased biofilm mass (50 mM &gt; 5 mM, both p &lt; 0.05). Five millimolar nitrate, 50 mM nitrate and 5 mM nitrate + Ra9 led to 3, 28 and 20 significant changes in species abundance, respectively, which were mostly decreases in periodontitis-associated species. These changes led to a respective 15%, 63% (both p &lt; 0.05) and 6% (not significant) decrease in the dysbiosis index. Using a 10-species biofilm model, decreases in periodontitis-associated species in the presence of nitrate were confirmed by qPCR (all p &lt; 0.05). In conclusion, nitrate metabolism can reduce dysbiosis and biofilm growth of periodontitis communities. Five millimolar nitrate (which can be found in saliva after vegetable intake) was sufficient, while increasing this concentration to 50 mM (which could be achieved by topical applications such as a periodontal gel) increased the positive effects. Ra9 increased the nitrate metabolism of periodontitis communities and should be tested in vivo.</p

Publisher Correction: Nitrate reduction capacity of the oral microbiota is impaired in periodontitis: potential implications for systemic nitric oxide availability

No abstract available

Longitudinal changes in subgingival biofilm composition following periodontal treatment

Background: Current periodontal treatment involves instrumentation using hand and/or ultrasonic instruments, which are used either alone or in combination based on patient and clinician preference, with comparable clinical outcomes. This study sought to investigate early and later changes in the subgingival biofilm following periodontal treatment; to identify whether these changes were associated with treatment outcomes; and to investigate whether the biofilm responded differently to hand compared with ultrasonic instruments. Methods: This was a secondary-outcome analysis of a randomised controlled trial. Thirty-eight periodontitis patients received full-mouth subgingival instrumentation using hand (n = 20) or ultrasonic instrumentation (n = 18). Subgingival plaque was sampled at baseline and 1, 7 and 90 days following treatment. Bacterial DNA was analysed using 16S rRNA sequencing. Periodontal clinical parameters were evaluated before and after treatment. Results: Biofilm composition was comparable in both (hand and ultrasonics) treatment groups at all timepoints (all genus and species; p[adjusted]&gt;0.05). Large-scale changes were observed within-groups across timepoints. At days 1 and 7, taxonomic diversity and dysbiosis were reduced, with an increase in health-associated genera including Streptococcus and Rothia equating to 30-40% of the relative abundance. When reassessed at day 90 a subset of samples reformed a microbiome more comparable with baseline, which was independent of instrumentation choice and residual disease. Conclusions: Hand and ultrasonic instruments induced comparable impacts on the subgingival plaque microbiome. There were marked early changes in the subgingival biofilm composition, although there was limited evidence that community shifts associated with treatment outcomes