Exploring dental academics' perceptions of and experience with discrimination in the UK and Ireland: a qualitative study.

Introduction Diversity is known to be important but diversity of dental school academics in the UK and Ireland is low in comparison with the dental profession and the overall population. The aims were to explore whether UK and Ireland dental school academics are satisfied with their career progression, whether they believe that there are barriers to career progression in dental schools based on protected characteristics, and experience of discrimination at work.Methods An online survey, including four free-text questions related to the study aims, was circulated by the Dental Schools Council to dental academics at all UK and Ireland dental schools. Qualitative content analysis was used to analyse free-text comments.Results and discussion There were 192 responses from 20 dental schools. Five data categories were constructed which highlight the impact of discrimination in dental academia, the importance of opportunities and support, different perspectives of diversity and discrimination, and academic and institutional culture.Conclusion Staff perceived and experienced barriers to career progression. Many were satisfied with their career progression, but a proportion of staff expressed dissatisfaction and attributed this to discrimination based upon protected characteristics. The culture in dental schools is beginning to change to address factors contributing to inequality in dental academia.

Altered reward and effort processing in children with maltreatment experience: a potential indicator of mental health vulnerability.

In this longitudinal study of children and adolescents with a documented history of maltreatment, we investigated the impact of maltreatment on behavioral and neural indices of effort-based decision making for reward and examined their associations with future internalizing symptoms. Thirty-seven children with a documented history of maltreatment (MT group) and a carefully matched group of 33 non-maltreated children (NMT group) aged 10-16, completed an effort-based decision-making task during functional magnetic resonance imaging (fMRI). Internalizing symptoms were assessed at baseline and again 18 months later. Computational models were implemented to extract individual estimates of reward and effort sensitivity, and neural signals during decision-making about different levels of reward and effort were analyzed. These were used to predict internalizing symptoms at follow-up. We identified lower effort-related activation in the anterior cingulate cortex (ACC), a prespecified region-of-interest, in the MT relative to the NMT group. No group differences were observed in the striatum, or in behavioral indices of reward and effort processing. Lower effort-related ACC activation significantly predicted elevated internalizing symptoms at follow-up in the MT group. These findings suggest that disrupted effort-related activation may index latent vulnerability to mental illness in children who have experienced maltreatment.

Understanding dental students' use of feedback.

INTRODUCTION: Feedback can enhance learning and is thought to be highly valued by students; however, it is not clear from the literature how dental students actually use feedback. AIM: This study aimed to explore how dental students use feedback in a variety of contexts. METHODS: Qualitative methods involving audio-recorded focus groups were used to explore the use of feedback by undergraduate dental students studying at three UK dental schools. A purposive sampling strategy was used to ensure diverse representation across the undergraduate dental programmes in each of the schools. RESULTS: Six focus groups, involving a total of 72 students, were undertaken. Thematic analysis identified five main themes relating to the use of feedback: value, future applicability, accessibility, variability and understanding. The inter-connectivity and interaction of the themes (along with their subthemes) were used to develop a model for optimising feedback with the aim of enhancing its potential use by students. CONCLUSION: The use of feedback by students would appear to be strongly influenced by several factors. Understanding these factors and how they interlink may be helpful to education providers who are seeking to optimise their feedback processes.

Obtaining patient feedback for quality assurance of undergraduate dental teaching.

Introduction In order to achieve the educational standards of the General Dental Council, providers of UK dental education programmes are required to demonstrate that feedback from patients is collected and used to inform programme development. Aims To determine areas of undergraduate dental training programmes that patients feel able to comment upon, allowing development of a patient feedback questionnaire. Methods Patients receiving treatment from undergraduate students were recruited to focus groups (n = 5, n = 6) where their experience of receiving student care was explored. Audio transcriptions were analysed for emergent themes. These themes informed the design of a questionnaire which was presented to a further patient focus group (n = 4) for content and face validity testing. Staff (n = 4) and student (n = 8) focus groups discussed its delivery. Results Patients were able to comment upon treatment quality, safety, the student-teacher interaction, and appointment times. An 18-question questionnaire was developed to include free text comments and answers on a visual analogue scale. It was modified following focus groups with patients, staff, and students. Conclusion Patients undergoing student treatment identified aspects of the clinical teaching programme that could be included in a feedback questionnaire. Following a pilot, the questionnaire will form part of the teaching quality assurance process.

The KdpD/KdpE two-component system: integrating K⁺ homeostasis and virulence.

The two-component system (TCS) KdpD/KdpE, extensively studied for its regulatory role in potassium (K(+)) transport, has more recently been identified as an adaptive regulator involved in the virulence and intracellular survival of pathogenic bacteria, including Staphylococcus aureus, entero-haemorrhagic Escherichia coli, Salmonella typhimurium, Yersinia pestis, Francisella species, Photorhabdus asymbiotica, and mycobacteria. Key homeostasis requirements monitored by KdpD/KdpE and other TCSs such as PhoP/PhoQ are critical to survival in the stressful conditions encountered by pathogens during host interactions. It follows these TCSs may therefore acquire adaptive roles in response to selective pressures associated with adopting a pathogenic lifestyle. Given the central role of K(+) in virulence, we propose that KdpD/KdpE, as a regulator of a high-affinity K(+) pump, has evolved virulence-related regulatory functions. In support of this hypothesis, we review the role of KdpD/KdpE in bacterial infection and summarize evidence that (i) KdpD/KdpE production is correlated with enhanced virulence and survival, (ii) KdpE regulates a range of virulence loci through direct promoter binding, and (iii) KdpD/KdpE regulation responds to virulence-related conditions including phagocytosis, exposure to microbicides, quorum sensing signals, and host hormones. Furthermore, antimicrobial stress, osmotic stress, and oxidative stress are associated with KdpD/KdpE activity, and the system's accessory components (which allow TCS fine-tuning or crosstalk) provide links to stress response pathways. KdpD/KdpE therefore appears to be an important adaptive TCS employed during host infection, promoting bacterial virulence and survival through mechanisms both related to and distinct from its conserved role in K(+) regulation.

Cwp84, a surface-associated cysteine protease, plays a role in the maturation of the surface layer of Clostridium difficile.

Clostridium difficile is a major and growing problem as a hospital-associated infection that can cause severe, recurrent diarrhea. The mechanism by which the bacterium colonizes the gut during infection is poorly understood but undoubtedly involves protein components within the surface layer (S-layer), which play a role in adhesion. In C. difficile, the S-layer is composed of two principal components, the high and low molecular weight S-layer proteins, which are formed from the post-translational cleavage of a single precursor, SlpA. In the present study, we demonstrate that a recently characterized cysteine protease, Cwp84 plays a role in maturation of SlpA. Using a gene knock-out approach, we show that inactivation of the Cwp84 gene in C. difficile 630DeltaErm results in a bacterial phenotype in which only immature, single chain SlpA comprises the S-layer. The Cwp84 knock-out mutants (CDDeltaCwp84) displayed significantly different colony morphology compared with the wild-type strain and grew more slowly in liquid medium. SlpA extracted from CDDeltaCwp84 was readily cleaved into its mature subunits by trypsin treatment. Addition of trypsin to the growth medium also cleaved SlpA on CDDeltaCwp84 and increased the growth rate of the bacterium in a dose-dependent manner. Using the hamster model for C. difficile infection, CDDeltaCwp84 was found to be competent at causing disease with a similar pathology to the wild-type strain. The data show that whereas Cwp84 plays a role in the cleavage of SlpA, it is not an essential virulence factor and that bacteria expressing immature SlpA are able to cause disease.

Recent origins of sperm genes in Drosophila.

Newly created genes often acquire testis-specific or enhanced expression but neither the mechanisms responsible for this specificity nor the functional consequences of these evolutionary processes are well understood. Genomic analyses of the Drosophila melanogaster sperm proteome has identified 2 recently evolved gene families on the melanogaster lineage and 4 genes created by retrotransposition during the evolution of the melanogaster group that encode novel sperm components. The expanded Mst35B (protamine) and tektin gene families are the result of tandem duplication events with all family members displaying testis-specific expression. The Mst35B family encodes rapidly evolving protamines that display a robust signature of positive selection within the DNA-binding high-mobility group box consistent with functional diversification in genome repackaging during sperm nuclear remodeling. The Mst35B paralogs also reside in a significant regional cluster of testis-overexpressed genes. Tektins, known components of the axoneme, are encoded by 3 nearly identical X-linked genes, a finding consistent with very recent gene family expansion. In addition to localized duplication events, the evolution of the sperm proteome has also been driven by recent retrotransposition events resulting in Cdlc2, CG13340, Vha36, and CG4706. Cdlc2, CG13340, and Vha36 all display high levels of overexpression in the testis, and Cdlc2 and CG13340 reside within testis-overexpressed gene clusters. Thus, gene creation is a dynamic force in the evolution of sperm composition and possibly function, which further suggests that acquisition of molecular functionality in sperm may be an influential pathway in the fixation of new genes.