The importance of near-peer mentorship for LGBTQ+ medical students

Navigating medical school can be especially challenging for LGBTQ+ medical students. LGBTQ+ medical students face unique barriers and may struggle to find support for their professional and personal growth since the LGBTQ+ identity is often unrecognized or unacknowledged within medical education and practice. Currently, there is not enough support for LGBTQ+ medical students. One emerging resource to navigate transitioning through medical training is near-peer mentorship. A near-peer mentor is a peer who is at least one year senior to a mentee in the same level of educational training who provides guidance on career development and psychosocial growth. In order for any mentorship programming or relationship development to occur, LGBTQ+ medical students need to feel safe. Given the generally small number of LGBTQ+ students at each institution, programming to support LGBTQ+ medical students through near-peer mentorship would have to happen at both a local level and through social media. Here we explore the barriers that LGBTQ+ medical students face, the importance of near-peer mentoring, and some examples of potential mentorship programming

Understanding Vulnerability and Adaptation in Early Brain Development using Network Neuroscience

Early adversity influences brain development and emerging behavioral phenotypes relevant for psychiatric disorders. Understanding the effects of adversity before and after conception on brain development has implications for contextualizing current public health crises and pervasive health inequities. The use of functional magnetic resonance imaging (fMRI) to study the brain at rest has shifted understanding of brain functioning and organization in the earliest periods of life. Here we review applications of this technique to examine effects of early life stress (ELS) on neurodevelopment in infancy, and highlight targets for future research. Building on the foundation of existing work in this area will require tackling significant challenges, including greater inclusion of often marginalized segments of society, and conducting larger, properly powered studies

Does an Autism Spectrum Disorder Care Pathway Improve Care for Children and Adolescents with ASD in Inpatient Psychiatric Units?

Youth with autism spectrum disorder (ASD) are psychiatrically hospitalized at high rates. Though specialized psychiatric units are effective, few specialized units exist. The ASD Care Pathway (ASD-CP) was developed as a scalable approach to improving care in general psychiatric units through staff training and a package of autism-specific intervention strategies. An evaluation of the effectiveness of the ASD-CP in a public hospital child psychiatric service compared 18 months (n = 17) versus 18 months (n = 20) post implementation. Average length of hospital stay decreased 40% (22.4-13.4 days) and use of crisis interventions decreased 77% (holds/restraints; 0.65/day to 0.15/day), though each result only approached statistical significance (p = 0.07; 0.057). This study provides preliminary evidence for improved outcomes after implementation of an ASD-CP

Newborn amygdala connectivity and early emerging fear

Connectivity between the amygdala, insula (Amygdala-aI) and ventral medial prefrontal cortex (Amygdala-vmPFC) have been implicated in individual variability in fear and vulnerability to psychiatric disorders. However, it is currently unknown to what extent connectivity between these regions in the newborn period is relevant for the development of fear and other aspects of negative emotionality (NE), such as sadness. Here, we investigate newborn Am-Ins and Am-vmPFC resting state functional connectivity in relation to developmental trajectories of fear and sadness over the first two years of life using data from the Infant Behavior Questionnaire Revised (IBQ-R) and Early Childhood Behavior Questionnaire (ECBQ) (N=62). Stronger newborn amygdala connectivity predicts higher fear and sadness at 6-months-of-age and less change from 6 to 24-months-of-age. Interestingly, Am-Ins connectivity was specifically relevant for fear and not sadness, while Am-vmPFC was associated only with sadness. Associations remained consistent after considering variation in maternal sensitivity and maternal postnatal depressive symptomology. Already by the time of birth, individual differences in amygdala connectivity are relevant for the expression of fear over the first two-years-of-life. Additionally, specificity is observed, such that connections relevant for fear development are distinct from those predicting sadness trajectories. Keywords: Amygdala, Fear, Sadness, Infancy, Resting state fMRI, Developmen

Inclusive Approaches for Measuring Demographics of Underrepresented Populations in STEM and Biomedical Research Training Programs

Federal strategic plans call for increased diversity within the biomedical workforce. The National Institutes of Health (NIH) defined underrepresented populations in biomedical science (NOT-OD-20-031), though operationalization remains a challenge for training programs. Implementing inclusive demographic measures may help to identify key demographic groups facing barriers to participation and retention in STEM programs and the biomedical workforce. Approaches for measuring demographic variables were sourced from scientific literature and research stakeholders. Gender, race/ethnicity, disability, and disadvantaged background were prioritized for comparison given their focus by NIH, with opportunities for stakeholders to identify additional demographic variables important in their work. Gender minorities, sex minorities, and sexual minorities were largely absent from programs’ demographic practices and warrant greater inclusion. Oregon Health Authority’s Race, Ethnicity, Language, and Disability (REALD) offers a vetted tool for expanding granularity of racial/ethnic data, which can be merged with NIH categories for reporting. Disability can be measured as functional limitations through REALD. Disadvantaged background included several variables that were underreported when verified, including first-generation college student status and rural eligibility. Summaries for operationalizing demographic variables in biomedical research training efforts are described. Inclusive demographics permit the identification of individuals who are being excluded, marginalized, or improperly aggregated, increasing our capacity to address inequities in biomedical research training. As trainees do not enter training programs with equal access, accommodations, or preparation, inclusive demographic measures can help inform a nuanced set of program outcomes, facilitating research on intersectionality, and ultimately supporting the retention of underrepresented students in biomedical research. Please provide feedback: https://docs.google.com/forms/d/e/1FAIpQLScNnF9Jm2e-7YA8v57vbECv0H5RwZrYgXjlvkdlaAs0izXymg/viewform?usp=sf_lin

Inclusive approaches for measuring demographics of underrepresented populations in STEM and biomedical research training programs

Increasing diversity within the biomedical workforce has been prioritized by federal strategic plans. The National Institutes of Health (NIH) expanded definitions of underrepresented populations in biomedical science (NOT-OD-20-031), though training programs remain challenged in approaches for accurately measuring and evaluating diversity. This study examined ways to measure demographic variables used in scientific literature and by research stakeholders. Gender, race/ethnicity, disability, and disadvantaged background were prioritized for comparison given their focus by NIH, with opportunities for stakeholders to identify additional demographic variables important in their work. Gender, sex, and sexual minorities were largely absent from programs’ demographic practices and warrant greater inclusion, consistent with recommendations from a NIH-commissioned report calling for routine collection of gender, sex, and sexual orientation information using standardized language. Oregon Health Authority’s Race, Ethnicity, Language, and Disability (REALD) offers a validated tool for improving resolution of racial/ethnic data and allows measurement of functional limitation in disability. The REALD tool can be merged with NIH categories for reporting. NIH re-defined ‘disadvantaged background’ yet first-generation college student status and rural eligibility were significantly underreported by trainees when verified. Inclusive demographics permit identification of individuals who are being excluded, marginalized, or improperly aggregated, increasing capacity to address inequities in biomedical research training. As trainees do not enter training programs with equal access, accommodations, or preparation, inclusive demographic measures can inform a nuanced set of program outcomes, facilitating research on intersectionality and supporting the recruitment and retention of underrepresented students in biomedical research