Efad newsletter december2015

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European Dietitians

French flag by Robo at Slovak Wikipedia

The Voice of

President's Message: Our newsletter comes with very warm and festive greetings from EFAD for a peaceful and restful time with family and friends. Judith and I have already spent time this year at a Christmas Market in Germany enjoying the festivities. However, all of us want to take a moment to express our heartfelt sorrow at the attacks in France and in Paris in particular. We especially need to remember all those who will be away from their homes, over the next weeks and months; the refugees, those in transit camps and those who maintain our security. In this issue we report on a meeting where EFAD discussed with dietitians from around the world, the impact that we can have to improve the provision of food and secure a nutritionally sound diet. Dietitians have so much to offer and we should not forget to step up and offer support where we can. EFAD will continue to make a commitment to this global project. I am delighted to say that the European Dietetic Action Plan 2015-­‐2020 (EuDAP) was unanimously adopted at our General Meeting and formally launched at our 9th conference in Amsterdam. Responding to EuDAP is another way of recognising and letting key stakeholders know how dietitians in Europe are responding to the health agenda. The EFAD Professional Practice Committee (PPC) report on a survey they carried out to benchmark the professional dietetic practice with a plea from a patient group for us to consider the value of ‘street dietitians’ is made in another article. An initiative in Spain to encourage dietitians to engage more in research is encouraging as are the reports of success of dietitians engaged in research across Europe. Our Newsletter continues to grow with excellent reports from dietitians around Europe and abroad. I am looking forward to 2016 particularly, our international meeting in Granada, Spain (September) and to hearing more about what dietitians are up to; exciting times! Best wishes for Christmas and the New Year,


Anne de Looy, President, EFAD Professor of Dietetics, Plymouth University, England ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 1

Three Months in the Life of the EFAD President: Promoting Dietetics and Dietitians

September-­‐ Switzerland At Bern University of Applied Sciences, I discussed the establishment of a consortium to deliver lifelong learning at Master’s level and gave a lecture to dietetics students.

October -­‐ Romania

I spoke at the 8th National Congress of Obesity in Cluj-­‐Napoca. I also celebrated with the Romanian dietitians the legal establishment of one Romanian College for Dietitians that will establish dietetic standards and manage their registration process. Following the meeting, I met with two members of the Nutrition Working Group of the European Association for the Study of Obesity to discuss a project on European standards for the treatment of obesity.

October -­‐ The Netherlands

General Meeting of EFAD, 9th EFAD conference in Amsterdam and Global Nutrition Project meeting (see report in this issue).

November -­‐ United Kingdom In Birmingham, I addressed a meeting of The British Dietetic Association Council on the work of EFAD.

November -­‐ Spain

In Barcelona, I spoke at the Third Conference of the Nutritionist-­‐Dietitians Association of Catalonia (CoDiNuCat).

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November -­‐ Austria In Vienna, I spoke to a wide range of health professionals about the value of lifelong learning and higher degrees, including professional doctorates.

November -­‐ Germany

In Berlin, I co-­‐chaired a meeting of Optimal Nutrition Care for All (ONCA). Over the past 3 years, countries in Europe have been coming together in multi-­‐ disciplinary teams (including dietitians and representatives from ministries of health) to systematically address a countrywide approach to disease-­‐related malnutrition. The progress being made is very encouraging – check out the website for news and resources at www.european-­‐nutrition.org/index.php/activities In the photo below, I am in the front row, 3rd from the right.


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What makes a 'dietitian'? Survey Results From Across Europe

Professional Practice Committee (PPC) From the PPC Desktop

In 2014, the PPC surveyed National Dietetic Associations (NDAs) in 17 countries. The aim of the survey was to map variations in the registration, regulation, professional practice and lifelong learning for dietitians in Europe. About half of our NDAs responded. Key results were: • In 12 countries, the professional title 'dietitian' is protected (by legislation or some other regulatory system). • In 7 of these countries, only a relevant first degree is needed to become a dietitian. • In 5 countries, additional postgraduate study is needed to become a dietitian and this must include approved professional practice and a written exam. • In 12 countries there is a register of dietitians, but in only 9 of these does this registration give a legal licence to practise. • Eight countries do not re-­‐evaluate competence to remain on the register. • In 3 countries, LLL/CPD of members is evaluated periodically. These results suggest that across Europe the establishment of robust national registration and regulation systems for dietitians is still far off. As the title 'dietitian' is not protected in many countries, this means that the public in these countries are also not protected from those who may not be properly qualified, trustworthy or safe. What can the NDAs do to assure the public, patients, and other health professionals that they are getting the best possible advice from a properly qualified person? EFAD have developed three recommendations necessary for ensuring safe and competent dietitians. In their individual countries, NDAs should press for: • legal protection of the title 'dietitian' and the profession of dietetics • licensing of dietitians and the creation (and maintenance) of an official register, based on recognized dietetic educational qualifications, which is searchable by anyone • mandatory continuing professional education of dietitians through a lifelong learning process EFAD will help NDAs to accomplish these aims by developing mentorship, tools, learning materials and workshops.

Acknowledgements: Anne de Looy, EFAD Honorary President, for her encouragement, support and constructive comments Pauline Douglas and the PPC members who initiated and developed the project NDA delegates who responded to the survey Members of the EFAD Education and Lifelong Learning Committee for their collaboration

Claudia Bolleurs Naomi Trostler ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 4

Nutrition in Every Policy: Putting Nutrition On The Global Agenda In October, EFAD and the US Academy of Nutrition and Dietetics (AND) hosted a group of 20+ nutrition professionals for a two-­‐day Global Nutrition Forum in Amsterdam. This forum was to determine what we could do better together to address global nutrition problems. The group included dietitians; experts from agriculture, food, health and nutrition; an economist; researchers; donors; professors and dietetic association leaders from around the world. The Chair was Kudakwashe Chimanya, a nutrition specialist from the Dietetic Association of Zimbabwe and she began the forum with the analogy that fixing malnutrition will require many tools from the collective toolbox. As an icebreaker, she asked each of us to identify what unique tool we could contribute. Lawrence Haddad is a Senior Research Fellow at the International Food Policy Research Institute (IFPRI) and he started us off with an overview of the second Global Nutrition Report (GNR): www.GlobalNutritionReport.org. This opening presentation was a wake-­‐up call to everyone in the room. The highly respected GNR (2014 and 2015) had been completed without contribution from even one dietitian or dietetic association. As the co-­‐author of the GNR, Lawrence admitted that he was unaware of the role dietitians play in malnutrition and was not familiar with the dietetics organizations present. After our meeting together he posted a blog stating that: "Dietitians are an incredible resource in the fight against global malnutrition.” He also proposed that we consider creating a World Nutrition Day, as nothing currently exists for the whole globe to come together around nutrition. His blog: www.developmenthorizons.com/2015/10/dietitians-­‐for-­‐global-­‐nutrition.html?m=1 The GNRs show that malnutrition exists in many forms, and all countries face one or more types of malnutrition. This is now considered the ‘new normal’ and was also highlighted in AND’s position paper: Nutrition Security in Developing Nations: Sustainable Food, Water and Health: www.eatrightpro.org/resource/practice/position-­‐and-­‐practice-­‐papers/position-­‐papers/nutrition-­‐ security-­‐in-­‐developing-­‐nations-­‐sustainable-­‐food-­‐water-­‐and-­‐health Many countries are investing in nutrition, but the lack of analysis and disseminated country-­‐level data continues to be challenging. Governments and donors need greater prioritization and investment in nutrition. Data is important to secure that support, as well as to see where we are doing well and where we need to improve. Opportunities for improving nutrition exist all along the food system, such as improving food environments and getting involved in connecting nutrition, agriculture and our environment. ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 5

After the presentations we concluded that the major aim of our initiative should be to work together to: 'increase nutrition on the global agenda'. Three priorities were identified: communications, mapping, and data, which are being developed in small groups. We will shortly circulate drafts along with a proceedings paper from the meeting. The group agreed that the Academy would serve as the Secretariat to follow up on issues, document and communicate. We will seek funding to support the infrastructure for the initiative, with a Fellow to be appointed to manage the initiative. We will lead session about the initiative at the International Congress of Dietetics (Granada, Spain, 7-­‐10 September, 2016). Save the date!

For more information on the Global Nutrition Forum, contact: Anne de Looy, EFAD Hon President, adelooy@plymouth.ac.uk Alison Steiber, AND Chief Science Officer, ASteiber@eatright.org Or me, Stacia Nordin, Malawi AODA Country Rep, NordinMalawi@gmail.com, www.NeverEndingFood.org

This article is based on one that originally featured in the quarterly newsletter of the American Overseas Dietetic Association (AODA), the international affiliate of the Academy of Nutrition and Dietetics.


10 Healthy Lifestyle Tips For Kids The European Food Information Council (EUFIC) in collaboration with EFAD has recently released the new edition of their popular quiz book 10 Healthy Lifestyle Tips for Kids. It is designed in the same creative and fun style as the EUFIC website www.coolfoodplanet.org, where parents and teachers can play alongside kids to help them learn about food, nutrition and physical activity. It invites children to answer questions about diet and lifestyle whilst going on a space mission, providing healthy tips as they go through each stage. The book may be of use to those dietitians and health professionals regularly working with children or schools when encouraging healthier habits. You can also download a free electronic version or order printed booklets from the EUFIC website (available in 12 languages). Raymond Gemen Nutrition & Health Manager, EUFIC ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 6


EXPO 2015 Milano: Feeding the Planet, Energy for Life

This year's Expo was hosted from May 1 to October 31 in Milan, Italy. Over this period, Milan became a global showcase where more than 140 participating countries showed the best of their technology to meet a vital need: to guarantee healthy, safe and sufficient food for everyone, while respecting the planet and its equilibrium. In addition to the exhibitor nations, the Expo also involved international organizations, and welcomed over 20 million visitors to its 1.1 million m2 of exhibition area. Expo 2015 was a platform for the exchange of ideas and shared solutions on the theme of food, stimulating each country’s creativity and promoting innovation for a sustainable future. It gave everyone the opportunity to find out about, and taste, the world’s best dishes, while discovering the best of the agri-­‐food and gastronomic traditions of each of the exhibitor countries. Alpine Lions Cooperation (ALC) led an important discussion forum involving members of Lions districts in Italy, Austria, Switzerland and Germany. Their goal is to create a common platform for the development and promotion of a European Union Lions group for joint projects with social and humanitarian ends. For many centuries the Alpine region has maintained an extraordinary ecosystem in the production of human food products and nutrition. In recent years, this ecosystem of water, pastures, wildfowl and agricultural cultivation has been affected by climate changes and the use of chemical agents in food production. The ALC invited four speakers with wide-­‐ranging topics: • Development Of Mountain Agriculture: From Subsistence Farming To Production In Regional Cycles; Matthias Gauly, Professor of Zootechnics, Free University of Bolzano, Italy • Apples In South Tyrol: A Small Alpine Region’s Contribution To A Healthy Diet For The World; Michael Oberhuber, Director, Laimburg Research Centre for Agriculture and Forestry, Italy • Use Of Drones In Food Production In The Alpine Regions For A Healthier And More Sustainable Nutrition; Claudio Canella, Electronic Engineer & Chief Executive, Cardtech, Padova, Italy • I was the 4th speaker on Lower Bavarian Cuisine Manuela Thul, Registered Dietitian, Germany Honorary Treasurer, EFAD ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 7


New Scientific Society for Dietitians

The Spanish Society for Dietetics and Nutrition (SEDYN) was founded on 13 June 2015, when 15 dietitians from Andalucía, Asturias, Catalunya, Madrid, Navarra, Basque Country and Valencia came together with a shared objective. This was to form a scientific society open to all professionals devoted to dietetics and human nutrition. SEDYN will foster the science in nutrition and dietetics with a national and international scope. It will work for the promotion of high-­‐quality www.sedyn.es/members/ continuing training and lifelong learning. It will encourage the integration of the dietitian in multidisciplinary work and research teams and will collaborate with other related scientific societies, organizations, centres or groups. The dietitians who lead SEDYN come from a wide range of scientific backgrounds at national and international level. They also have experience in different fields such as teaching, research, clinical practice, institutional catering, public health and industry. They are also members of noteworthy scientific societies, research groups or professional associations. This variety in our professional experience guarantees the pursuit of excellence. In Spain, there are already several societies related to nutrition or dietetics, but the majority of their associated members are not dietitians. Several of the founding members of SEDYN work in universities that offer degrees in nutrition and dietetics, and they will be able to provide a resource for dietitians pursuing lifelong learning goals. The photo here was taken at the 1st CoDiNuCat Congress last month in Barcelona. In the centre on my right is keynote speaker and President of EFAD -­‐ Anne de Looy. SEDYN is supported by several members of the Executive Board of the Nutritionists Dietitians Association of Catalonia and Andalucia and also the Association of Dietitians-­‐Nutritionists from Madrid, in addition to several interdisciplinary organisations in Spain. SEDYN aims to be the scientific voice of Spanish dietitians and our main objective is to improve scientific knowledge in the field of nutrition and dietetics as well as its Nutritionists-Dietitians Association of Catalonia applications by linking the scientific work of dietitians with other research and with society. SEDYN will provide scientific support to organisations that need it, based on the consensus of available scientific information related to nutrition and dietetics. This support will be useful for health professionals, public or private organisations, the general population and the media. We will launch our own research projects and programs as well as acting in collaboration with other similar societies or groups. Víctor Manuel Rodríguez Rivera, President of SEDYN Dietitian, Researcher and Lecturer at the University of the Basque Country ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 8


Bridging Nutrition Sciences For Health In The Nordic Countries This conference aims to create a bridge between public health and clinical nutrition research for better understanding of the association between food, dietary habits, health and disease. The presentations and discussions will thus include parallel tracks for public health and clinical nutrition, with common plenary sessions.On the day before the Conference (19 June), DRF will host a meeting for all our Nordic colleagues that will focus on professional development for dietitians in the Nordic countries and will be an opportunity to network with colleagues. Save the date! Elisabet Rothenberg President, Swedish Association of Clinical Dietitians (DRF)



Improvement of Education & Competences in Dietetics (IMPECD): Erasmus+ Project Gets Approval

We are extremely honored to announce that our Erasmus+ application for the project IMPECD has been approved. Our project involves four European countries and five universities of applied sciences, with the project goal to unify the dietetic care process and create a Massive Open Online Course (MOOC) for dietetic students and professionals, focusing on case studies and innovative learning material and tools. More information about the project, the project partners and other members of the Sustainability and Impact Board can be found here: www.fhstp.ac.at/de/forschung/projekte/impecd Alexandra Kolm, Dietitian, International Public Health Nutritionist Fachhochschule St. Pölten GmbH University of Applied Sciences, Austria alexandra.kolm@fhstp.ac.at ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 9

The Netherlands

Getting Nutrition Recognized as a Medical Intervention and Treatment Strategy

In 2010, the European Nutrition for Health Alliance (ENHA) approached EGAN and the EPF to enlarge the role of patient groups in the screening for undernutrition in patients and the elderly. For many disease-­‐specific patient groups nutrition plays a role, but most often it is not a priority topic for them. There are patient groups where nutritional issues do play a role, but not at the end of life, only at the beginning of life -­‐ with preconception care. By 2013, ENHA had published the book 'Patient perspectives on nutrition' (downloadable from the ENHA website). Since then in The Netherlands we have founded 'Platform Patient en Voeding' (Patient and Nutrition). Its mission: to get nutrition recognized as a medical intervention and treatment strategy. A shortcoming that struck us was the gap between advice from physicians in the consulting room ('you should eat less salt' or 'take more exercise') and the practical ability to follow this type of advice. Often, such advice is not followed by referral to a dietitian, who has the skills and training to help the patient meet their health goals. Going Where The Need Is: 'Street Dietitians' In The Netherlands there is the: 'street dentists' initiative, where dental teams from university hospitals (including students) give dental care to the housebound elderly in their own homes. Good dental care of course, makes it easier to eat and chew well. We learned of an impressive project from Third Age Ireland with the name 'Eating well into the future' where local volunteer organisations prepare meals for the elderly and support each other by doing the shopping, cooking and eating together. The quality of these meals could profit from expert advice from 'street dietitians' who would be able to advise on healthy eating. Optimal Nutritional Care for All During the last ENHA conference in Berlin in November, 12 twelve representatives of patients and the elderly attended. The stakeholders highly appreciated and valued their input. Good practice in national steering committees on undernutrition should be to ensure that included in these committees should be at least two representatives from those who represent patients or the elderly. This will be a 'win-­‐win' situation for all stakeholders involved. Cees Smit Patient advocate with experience on chronic diseases and ageing issues. Chair of the Working Party on Nutrition for the European Patients' Forum (EPF) and The Patients Network for Medical Research and Health (EGAN). For more information: info@smitvisch.nl ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 10


A Swiss Transcultural Tool For The Counselling Of Pregnant Tamil Migrants With Gestational Diabetes

Today, there are approximately 50,000 Tamil living in Switzerland, home to one of the largest Tamil diasporas worldwide. To date there are no official tools in Switzerland that measure the eating and physical activity habits and preferences of this population. Current literature suggests that approximately 18% of the pregnant women in this at-­‐risk population suffer from gestational diabetes (GD) (2). This project NutriGeD (Nutrition Gestational Diabetes, 2014-­‐2015) aims to close that gap and encourages a collaborative process, where the patients become active allies in their therapy. The project will develop a folder that contains a collection of appealingly designed information and tools that help healthcare professionals work efficiently with their migrant patients, while understanding their preferences and needs. It will be a convenient tool for use in the counselling of pregnant migrants with GD and give a simple and clear structure for health care professionals working with this population group, particularly dietitians who play a decisive role in the prevention and management of GD. This first use of this tool will be with pregnant women in the Tamil population. The folder will cover the pathophysiology of GD, transcultural competency, socio-­‐ political aspects, eating and physical activity habits and preferences of the population as well as a series of bilingual info materials to be used in consultations. Shown here are photos of food preparation approved by dietitians and the Tamil Association of Northwestern Switzerland. The aim of the folder is to enhance the cooperation between healthcare professionals and patients. This tool will alert dietitians and other healthcare professionals to the special needs of this migrant population in order to promote a culturally competent treatment. This development involves an interdisciplinary healthcare team including nutrition scientists, dietitians, doctors, nurses, midwives, as well as the Swiss Diabetes Association and the Tamil Association of Northwestern Switzerland. In a next step, we will test the developed folder for its efficacy in practice, and if proven successful, we will develop additional folders for other migrant groups.

Leila Sadeghi, Project Leader Bern University of Applied Sciences, Murtenstrasse 10 CH-­‐3008 Berne, Switzerland leila.sadeghi@bfh.ch

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New Health Perception Lab Wins Award

On 13 November 2015 the interdisciplinary team of the Health Perception Lab (HPL) at FH Joanneum University of Applied Sciences received the Annual Austrian Innovation Award for Medical-­‐Technical Professions. The award recognises the novel and interdisciplinary approach of the HPL. The newly established HPL is seeking to make a mark in the sector of obesity prevention and treatment via the interdisciplinary orientation of seven institutes within the university (including Dietetics & Nutrition). Only by combining the competences of diverse scientific disciplines can new pathways be explored and innovative solutions developed. A pilot study of 60 pregnant women started at the beginning of January 2014 with the aim of developing new methods to examine the factors that affect the metabolic programming of infants. The team were looking to: • test methods for the analysis of sensory perception parameters • examine anthropometric and biomedical markers (samples of fecal, blood and breast milk), associated with metabolic programming in children and • examine possible inter-­‐relationships between the various anthropometric, sensory and biomedical parameters involved in the metabolic programming of children. The team collected data using innovative technical aids, such as an advanced 3D Facial Analysis Coding System that determines taste preferences in babies and infants. First results of the study will be available in summer 2016. Virtual laboratory visit here: www.youtube.com/watch?v=q2drn525Eoo HPL website here: www.healthperceptionlab.at Bianca Neuhold, BSc MSc HPL Project Manager Researcher/Lecturer Institute of Dietetics & Nutrition Eggenberger Allee 11 A-­‐8020 Graz, Austria Bianca.Neuhold@fh-­‐joanneum.at / hpl@fh-­‐joanneum.at Tel.: +43 316 5453 6726 ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 12

The 9th EFAD Conference and 26th General Meeting took place in Amsterdam on 22-­‐24 October 2015. The General Meeting was the largest one ever. At the Business Meeting, 24 of the 29 full member associations who attended agreed that EFAD should: • adopt the European Dietetic Action Plan (EuDAP) • establish a charity to raise funds to support European dietetics • elect an Honorary Vice-­‐President • increase income in coming years • accept the business and work plans for 2016 • work further on the definitions of “dietitian” and “dietetics” The meeting elected Manuela Thul of the German Dietitians Association as EFAD Honorary Treasurer 2015-­‐2019. The meeting was then joined by 3 Affiliate Member Associations, 25 Education Associate Member organisations and representatives of the Student Network and each European Specialist Dietetic Network. The report by EFAD Secretary General Judith Liddell included a presentation: “EFAD -­‐ The Voice of European Dietitians”, which highlighted how EFAD promotes the profession. Three workshops enabled delegates to discuss: • recognition of professional qualifications and the importance of registration, lifelong learning and ethics • the adoption and implementation process of the European Dietetic Action Plan (EuDAP) • the EFAD Strategic Plan 2017-­‐2021 and participation in a foresight brainstorm to start the process of identifying future priorities for the profession The Conference was attended by 404 delegates from 36 countries, had over 40 lectures and 48 original research presentations. The Conference was supported by 11 different organisations. Most of the presentations are available for download here: http://efadconference.com/ A conference photo gallery is available on http://efadconference.com/photos/

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Save the Date Deadline for Submissions for the Spring Newsletter: 28 February 2015 to: editor@efad.org

See Guidelines for Authors on the next page

www.efad.org European Dietitians

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Guidelines for Submitting Articles to the EFAD Newsletter • • • • • •

Please read previous editions of the Newsletter available here: www.efad.org/everyone/3147/5/0/32 Your article should be in English and emailed to me, Terry Hyde: editor@efad.org Your article should be about 500 words (2,500 characters with spaces), but can be up to 1000 words if it is particularly important. Please send your own photographs or ones that are licensed as free-­‐to-­‐use for non-­‐ commercial purposes If your article does not include the words 'dietitian' or 'dietetics', then it is unlikely to be published. I will edit all articles to meet the needs of a very wide audience: from undergraduate students to Ministers of Health and senior figures at WHO.

The first language of most of our readers and authors will not be English. Therefore, I will also edit to ensure that the writing is concise; the meaning is clear and the language is free of bias. I will use plain English, modern English usage & open punctuation. What is plain English? Some of the principles of plain English are: • use short words rather than long words • write in short sentences rather than long ones • use the active verb rather than the passive, eg 'I edit the Newsletter” not “The Newsletter is edited by me' • use lists where possible • avoid jargon, acronyms and abbreviations In science and education, the last point is probably the most difficult to follow. All of our readers will know what EFAD and EU and UN refer to (and probably WHO), but how many will know what FNAP refers to? For more information on plain English, go to www.plainenglish.co.uk What is modern English usage? English is a living language in constant change; in particular it absorbs words from other languages and treats them as its own. New words arrive every day and others drop out of use. Existing words change their meanings or develop extra meanings. A few years ago, the only thing that could be stored in a cloud was water vapour, but now…. Spellings and constructions also change. So, in modern English usage the word ‘lifelong’ is written as one word (no space, no hyphen); similarly with the words ‘online’ and ‘website’. A date such as '24th March', is now more commonly written as '24 March'. Part of my job is to reflect these changes in usage and spelling etc. For more information on modern English usage, see Burchfield RW (2004) Fowler's Modern English Usage 3rd Ed Re-­‐revised OUP Oxford. What is Open Punctuation? Open punctuation seeks to reduce the number of keystrokes needed to type a document. It does this by removing unnecessary punctuation and capital letters. So: Ph.D. → PhD B.Sc. → BSc e.g. → eg Dr. → Dr ..Doctors, Dietitians and Physiotherapists... → ...doctors, dietitians and physiotherapists... ________________________________________________________________________________________________ EFAD Newsletter December 2015 www.efad.org 15