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Comprehensive and compassionate treatment of vulnerable patients is an important service to the community, although dental treatment of special populations can represent a challenge. The dental provider must be able to recognize the issues surrounding substance use and abuse, coordinate care with medical providers, and build a trusting provider-patient relationship to achieve success. Open conversations regarding expectations of pain, and the risks, benefits, and alternatives to opioids are important aspects of the best care of these patients.

The study of Consideration of Future Consequences (CFC) construct has increased substantively in recent years. Underlying these developments is the presumption that consideration of the future is uniform across all domains, and not a domain-specific construct. Building on work undertaken previously, the present study used 30 researcher-derived items to assess the domain specificity of consideration of the future in three large samples of adolescents in the United Kingdom. A psychometrically valid and reliable 18-item scale measuring consideration of the future in four domains emerged. Domain specificity was supported on two levels: a good fitting multidimensional model of CFC; and low to moderate factor correlations for the four domains measured by the 18-item scale. The study suggests that adolescents are considerate of future outcomes to different degrees, depending on the domain, and the implications of this with regard to future research are discussed.

Transitional type-1 (T1) cells are peripheral immature B cells known to populate the spleen (spl) after completing their BCR assembly in the bone marrow (BM). To advance the understanding of splenic T1 (CD19posCD24hiCD21neg) B cells, we addressed the heterogeneity and biology of these cells using flow cytometry combined with genetically modified mice. Most recent emigrant T1 cells were selected by excluding CD23pos and including CD93high (AA4.1) B cells termed T12123DN. Transcriptomic analysis identified RAG1 and 2 as signature genes for this B cell population. Further separation of T12123DN cells based on surface IgM expression revealed a previously undescribed cell subset with undetectable cell surface IgM (-IgMneg). The spl-IgMneg subsets expresses RAG1/2 and actively undergoes Igk gene rearrangement at levels comparable to BM pre-B cells. Upon in vitro exposure to BAFF or transplantation into immunodeficient hosts, spl-IgMneg cells can give rise to fully mature IgMposIgDpos B cells. Furthermore, BAFF-R and NF-kB pathways are required for their efficient maturation. Our findings suggest that the spl-T1 population encompasses a subset of B cells that resemble but are distinct from the developing B cells in the BM. These spl-IgMneg B cells may represent receptor editing B cells, and/or precursor B cells undergoing BCR assembly and selection in the periphery, possibly providing an opportunity for tolerance induction to tissue restricted self-antigens and microbiota-derived antigens.

The psychological construct broadly known as time perspective is potentially useful in understanding a range of adolescent behaviours, including alcohol use. However, the utility of the construct has been hindered by measurement and conceptual problems. To date the vast majority of studies have assessed the relationship between time perspective and other measures in a variable-focussed (correlational) rather than a person-centred way. The present series of studies used a person-centred approach to assess the relationship between temporal profiles and alcohol use in a large sample (n = 1620) of adolescents from High Schools in Northern Ireland. Although a ‘Balanced’ time perspective has been suggested as optimal, the present study suggests that having a ‘Future’ temporal profile is associated with less problematic use of alcohol, while having a ‘Past Negative’ or ‘Hedonist’ profile is associated with more problematic consumption. Results are discussed in the context of the time perspective and alcohol use literatures.