Health professions school applicant experiences of discrimination during interviews.

BACKGROUND: Bias pervades every aspect of healthcare including admissions, perpetuating the lack of diversity in the healthcare workforce. Admissions interviews may be a time when applicants to health profession education programs experience discrimination. METHODS: Between January and June 2021 we invited US and Canadian applicants to health profession education programs to complete a survey including the Everyday Discrimination Scale, adapted to ascertain experiences of discrimination during admissions interviews. We used chi-square tests and multivariable logistic regression to determine associations between identity factors and positive responses. RESULTS: Of 1115 respondents, 281 (25.2%) reported discrimination in the interview process. Individuals with lower socioeconomic status (OR: 1.78, 95% CI [1.26, 2.52], p = 0.001) and non-native English speakers (OR: 1.76, 95% CI [1.08, 2.87], p = 0.02) were significantly more likely to experience discrimination. Half of those experiencing discrimination (139, or 49.6%) did nothing in response, though 44 (15.7%) reported the incident anonymously and 10 (3.6%) reported directly to the institution where it happened. CONCLUSIONS: Reports of discrimination are common among HPE applicants. Reforms at the interviewer- (e.g. avoiding questions about family planning) and institution-level (e.g. presenting institutional efforts to promote health equity) are needed to decrease the incidence and mitigate the impact of such events.

Blocking serotonin 2A (5-HT2A) receptors attenuates the acquisition of methamphetamine-induced conditioned place preference in adult female rats.

Methamphetamine withdrawal can induce intense cravings leading to relapse. Contexts/cues paired with chronic methamphetamine use develop incentive motivational properties, promoting future drug-seeking and taking behavior. Research has shown that, in adult male rats, the selective 5-HT2A receptor antagonist M100907 attenuates the acquisition of methamphetamine-induced conditioned place preference (CPP), a measure that examines conditioned associations between the rewarding properties of drugs and contexts. However, these findings have not been extended to adult female rats. The present study investigated the effects of M100907 on the acquisition of methamphetamine-CPP in adult female rats. During conditioning, rats were administered M100907 (0, 0.025, 0.25 mg/kg, i.p.) 15 min before methamphetamine (1 mg/kg, i.p.) and then placed into their initially non-preferred chamber for 30 min, or administered saline and placed into their initially preferred chamber for 30 min. Conditioning sessions were separated by four hours. Following four days of conditioning, the effects of M100907 on the acquisition of methamphetamine-CPP were assessed during a 15 min drug-free test trial. Pretreatment with M100907 dose-dependently attenuated the acquisition of methamphetamine-induced CPP. Blocking 5-HT2A receptors with a low dose of the selective antagonist M100907 attenuated the rewarding effects of methamphetamine in adult female rats. These data provide further evidence that the 5-HT2A receptor subtype is involved in the behavioral effects of methamphetamine.

Chronic Methamphetamine Exposure Attenuates Neural Activation in Hypothalamic-Pituitary-Adrenal Axis-Associated Brain Regions in a Sex-specific Manner.

Sex differences in methamphetamine (MA) abuse and consequences of MA have been reported with females showing an increased addiction phenotype and withdrawal symptoms. One mechanism through which these effects might occur is via sex-specific alterations in the hypothalamic-pituitary-adrenal (HPA) axis and its associated brain regions. In this study, mice were administered MA (5 mg/kg) or saline for 10 consecutive days. During early withdrawal, anxiety-like behaviors were assessed in the open field, light/dark box, and elevated plus maze. At ten days of withdrawal, mice were injected with a final dose of MA (5 mg/kg) or saline. Chronic MA did not alter anxiety-like behaviors or corticosterone responses to a final dose of MA, although females showed elevated corticosterone responses compared to males. Chronic MA attenuated final MA-induced c-Fos in both sexes in the paraventricular hypothalamus (PVH), bed nucleus of the stria terminalis (BNST), cingulate cortex, central and basolateral amygdala. In CA1 and CA3 hippocampal areas, c-Fos attenuation by chronic MA occurred only in females. Within the PVH, final MA injection increased c-Fos to a greater extent in females compared to males regardless of prior MA exposure. Dual-labeling of c-Fos with glucocorticoid receptor revealed a specific attenuation of neural activation within this cell type in the PVH, central and basolateral amygdala, and BNST. Together these findings demonstrate that chronic MA can suppress subsequent activation of HPA axis-associated brain regions and cell phenotypes. Further, in select regions this reduction is sex-specific. These changes may contribute to reported sex differences in MA abuse patterns.

Pain problems in young adults and pain reduction strategies.

The purpose of this study was to survey young adults about their pain and pain treatments to identify ways to decrease risk for chronic pain. The sample consisted of 89 young adults between the ages of 18 and 25 who had experienced some pain during the past month and who did not have a chronic condition commonly associated with a pain problem. Community dwelling young adults were screened for eligibility and administered the Brief Pain Inventory Short Form (BPI-SF) during a face-to-face interview. They were asked to describe the intensity of their pain during the past month using the 0 to 10 numeric scales from the BPI-SF. A pilot study supported these methods. Participants reported their worst pain as M = 6.5 (SD = 1.71), their average pain as M = 4.1 (SD = 1.85), and their least pain intensity as M = 1.8 (SD = 1.68). They reported 20 different self-treatments for their pain. Although 56.2% used nonopioid analgesics, 22.5% used no pain treatments. Participants reported 61.3% pain relief from self-treatments. Young women used analgesics more often than young men (64.9% and 40.6%, respectively, Chi;(2) [1] = 4.91, p <.03). Pain moderately interfered with their mood (M = 4.1; SD = 3.00) and general lives (M = 3.9; SD = 2.42). Identifying young adults at risk for chronic pain provides the first step in educating them about effective ways to prevent chronic pain. Results from this study provide some initial groundwork for educational interventions to prevent chronic pain in young adults.