Background: Nontraditional students bring to medicine inherent characteristics and perspectives that enrich the learning environment and contribute to expanding diversity in medicine. However, research has shown that these students, by virtue of their sociodemographic backgrounds, face unique challenges in medical education, which ultimately place them at a disadvantage compared to their peers. The purpose of this study is to explore relationships between sociodemographic characteristics, stress, and academic performance, in the context of outcomes that may be undermining efforts to diversify the physician workforce. Methods: Using a retrospective observational cohort methodology, we examined institutional and USMLE exam performance data in conjunction with Perceived Stress Scale-4 survey results from six cohorts of students at Kirk Kerkorian School of Medicine at UNLV (n = 358). Using independent samples t-test, mean stress and academic performance were compared between four sociodemographic groups: first-generation college students, underrepresented in medicine (URM), socioeconomically disadvantaged, and age 30 + at matriculation. Results were considered significant where P ≤ .05. Results: First-generation college students had significantly higher stress at the end of third year clerkships (mean 7.8 vs. 6.8, P* = .03). URM students had significantly lower scores on preclinical exams (mean 81.37 vs. 83.07, P* = .02). The students who were age 30 + at matriculation had significantly lower exam scores on all academic performance measures. Conclusion: Our results echo historic trends in academic performance for racial and ethnic minority students, and we present recent evidence of academic performance disparities based on age at matriculation. Residency program directors continue to use test scores as a primary metric to screen applicants and thus, poor academic performance has profound consequences on career trajectory. Finally, significantly higher stress in the first-generation students may be evidence of underlying psychological distress. Expanding the sociodemographic diversity among physicians, and by extension, medical students, has long been recognized as fundamental to addressing inequities in healthcare. However, results from our study suggest that aspects of medical education are unfavorable and disadvantageous for first-generation, URM, and older medical students. A deeper understanding of the interplay between sociodemographic characteristics and success in medical school is paramount as we pursue diversity in medicine.

The pandemic highlighted the need for alternative, more accessible access to mental health interventions that can be readily administered remotely. The purpose of this pre-post-interventional study was to evaluate the effectiveness of a virtual mind-body medicine training course on stress, anxiety, and depression levels. University employees and members of the Las Vegas community were recruited via self-selection and snowball sampling and subjected to online mind-body practice sessions in December of 2020. Stress, anxiety, depression, and quality of life were assessed pre- and post-intervention using standardized psychometric valid tools. The paired t-test and related samples marginal homogeneity tests were used for continuous and categorical outcomes, respectively. Depression and stress scores were significantly decreased (p < 0.001). Mean scores of professional quality of life improved post-intervention compared to pre-intervention (p = 0.03). A significantly larger proportion of participants reported no depression or stress post-intervention compared with pre-intervention (p < 0.001, p = 0.003, respectively.) This study suggests that virtual mind-body practices had a pronounced impact on stress and depression levels during the pandemic. These findings support virtual, online-guided mind-body medicine training as an effective intervention that can be administered virtually to reduce stress and depression symptoms.

Current medications have not been effective in reducing the prevalence of mental illness worldwide. The prevalence of illnesses such as treatment-resistant depression has increased despite the widespread use of a broad set of psychopharmaceuticals. Transcranial magnetic stimulation and ketamine therapy are making great strides in improving treatment-resistant depression outcomes but they have limitations. New psychotherapeutics are required that specifically target the underlying cellular pathologies leading to neuronal atrophy. This neuronal atrophy model is supplanting the long-held neurotransmitter deficit hypothesis to explain mental illness. Interest in psychedelics as therapeutic molecules to treat mental illness is experiencing a 21st-century reawakening that is on the cusp of a transformation. Psilocybin is a pro-drug, found in various naturally occurring mushrooms, that is dephosphorylated to produce psilocin, a classic tryptamine psychedelic functional as a 5-hydroxytryptamine 2A receptor agonist. We have focused this review to include studies in the last two years that suggest psilocybin promotes neuronal plasticity, which may lead to changes in brain network connectivity. Recent advancements in clinical trials using pure psilocybin in therapy suggest that it may effectively relieve the symptoms of depression in patients diagnosed with major depressive disorder and treatment-resistant depression. Sophisticated cellular and molecular experiments at the systems level have produced evidence that demonstrates psilocybin promotes neuritogenesis in the mouse brain - a mechanism that may address the root cause of depression at the cellular level. Finally, studies with psilocybin therapy for major depressive disorder suggest that this ancient molecule can promote functionally connected intrinsic networks in the human brain, resulting in durable improvements in the severity of depressive symptoms. Although further research is necessary, the prospect of using psilocybin for the treatment of mental illness is an enticing possibility.

On October 1, 2017 in Las Vegas, Nevada, the largest mass shooting in US history was committed by a shooter high above the Route 91 Harvest Festival. In light of this tragedy and the increasing incidence and prevalence of mass shootings in America, it is important to examine how exposure to traumatic events (specifically mass shootings) affects the mental health of hospital physicians through the treatment of victims. This study sought to examine how witnessing mass shootings through the treatment of shooting victims psychologically affects physicians. Nine physicians who had direct contact with the victims were interviewed, and the data were analyzed for common themes using phenomenology. From the interviews, five central themes emerged: normalization of the event, denial, feelings of guilt, the positive outcomes associated with the event, and the magnitude of the patient volume. These themes show specifically how physicians are impacted by traumatic events and can be used to implement strategies to promote physician mental health.  

BACKGROUND Sexual health education is a critical aspect of adolescent development, equipping students with the knowledge, skills, and attitudes necessary to make informed decisions about their well-being. Despite its importance, sexual health education in the United States remains inconsistent, with only a minority of states mandating comprehensive, inclusive, and evidence-based curricula. Addressing these disparities, this study evaluates the current landscape of interdisciplinary collaboration and delivery of sexual health education programs for K-12 students. OBJECTIVE By examining existing research and program outcomes, this scoping review aim to provide actionable recommendations for educators and policymakers to foster equitable, holistic, and effective sexual health education. METHODS Studies considered for inclusion are those focused on children and adolescent sexual health programs with interdisciplinary collaboration (including medicine, social work, psychology, nursing, dental). Studies will be limited to those published in English within the United States from inception to November 2024. Five electronic databases, namely PubMed, EMBASE, ERIC, APAPsycInfo, and CINAHL will be searched for published reports. Two reviewers will independently screen titles and abstracts. The reviewers will then assess the full texts selected. In both cases, disagreements will be discussed with a third reviewer and consensus will be achieved. Data analysis will be descriptive with a narrative summary. RESULTS As this study does not have the direct involvement of human participants, an institutional ethical review will not be warranted. CONCLUSIONS As this study does not have the direct involvement of human participants, an institutional ethical review will not be warranted. CLINICALTRIAL This protocol is registered on the Open Science Framework Repository (https://doi.org/10.17605/OSF.IO/U894B)

Parkinson’s disease (PD) is one of the fastest-growing neurological diseases in the world. Pharmaceutical and surgical interventions continue to advance to better address motor symptoms. However, disability from non-motor symptoms, such as depression, anxiety, and stress persist. Expressive therapies, including art, music, and dance are being explored and implemented more frequently to address this growing need. We developed this study to examine the feasibility of a novel program using online narrative therapy, with constructs from Joseph Campbell’s Hero’s Journey, and improvisation for people with PD (PWPD). Participants from across the U.S. and U.K. met online via Zoom once a week for one hour over the course of 27 consecutive sessions. A PhD student with a professional background in filmmaking and improvisation developed the sessions and led the program. The primary aim was to assess feasibility, the threshold for which was set at 70% of participants attending a minimum of 75% of the classes. Sixteen of 21 participants (76%) completed the study, with all 16 attending at least 85% of the classes. All participants who completed the study stated they enjoyed the class and would like to continue in the program and see it offered to others with PD. The secondary aim was to explore the participants’ experience within the program using a phenomenological approach. Four major themes emerged: 1) There was a high level of interest in the intervention itself as it was deemed unique; 2) Participants struggled to see their own heroic qualities; 3) They reported high levels of connection within the group and 4) The emphasis on having PD faded, replaced by journeys of self-discovery beyond having PD.