Reflections on Dementia-Related Stigma and Direct Support Seeking by Family Caregivers as Mediating Associations Between Caregiver Stress, Burden, and Well-Being.

The demanding nature of caring for relatives with Alzheimer's disease and related dementias (ADRD) can lead to family caregiver burden and poor health. The stigmatization of people with ADRD can also impact caregivers' stress, while their support-seeking strategies may mitigate negative impacts of burden on their health. To examine hypothesized relationships, the present study considered whether different dimensions of ADRD family stigma influenced the association between a care recipient's behavioral symptoms and their family caregiver's perceived burden and if direct support seeking explained a connection between caregiver burden and well-being. Family caregivers (n = 375) completed a Qualtrics survey. Path analysis revealed ADRD behavioral symptoms predicted both caregiver and layperson forms of stigma. Layperson stigma also intervened between behavioral symptoms and caregiver burden. Direct support seeking mediated the association between caregiver burden and well-being. Findings underscore the utility of including stigma within ADRD caregiver stress models and studying caregiver health from network and communication perspectives.

Are We Really Retaining URiM Faculty in Academic Medicine?

INTRODUCTION: Previous studies have identified the need to improve recruitment and retention of faculty who are underrepresented in medicine (URiM); however, it is unclear to what extent medical schools have been able to sustain growth and retain URiM faculty representation. METHODS: Numbers of URiM faculty at each AAMC medical school from 2012 to 2021 were obtained from the Association of American Medical Colleges Faculty Administrative Management Online User System database. Year-over-year percent change was calculated for each school and year of the study period for all URiM faculty, junior URiM faculty, and senior URiM faculty. Pearson's correlation was used to compare percent change in 1 year to the previous and subsequent years for all three groups. Pearson's correlation coefficients were also used to compare percent change between junior and senior URiM faculty for the same, previous, and subsequent years. RESULTS: The percentage change for URiM faculty at all ranks between adjacent years occurring from 2012 to 2021 was weakly and negatively associated (r = - 0.06, p value = 0.03). There was significant positive correlation between the percent change in junior URiM faculty and senior URiM faculty in the same year (r = 0.11) and previous year (r = 0.09). DISCUSSION: URiM faculty growth in 1 year is not sustained in the next year. More research is needed to better understand efforts at retention of URiM faculty in academic medicine.

Overcoming Mission Competition in Departments of Family Medicine.

Departments of family medicine are centered around the tripartite mission of education, research, and clinical care. Historically, these three missions have been balanced and interdependent; however, changes in the funding and structures of health systems have resulted in shrinking education and research missions and an increased emphasis on clinical care. In the wake of waning state and federal contributions to primary care research, many departments of family medicine have adopted a private practice approach. This approach is centered on generating revenue for the institution, incentivizing physicians to remain clinically focused through productivity and intense attention to volume targets. As a department's focus shifts to the clinical care mission, education and research are increasingly neglected and underresourced. Meanwhile, the administrative burden of electronic health records (EHRs) has further encroached on time previously allocated to research, with the EHR burden disproportionately affecting the primary care workforce. To counteract mission competition in departments of family medicine and to recover the vital missions of education and scholarship, devising a clear plan for reclaiming and sustaining a tripartite mission is important. Advocating for increased primary care research funding, enhancing EHRs, balancing clinical and education metrics, and supporting primary care research, especially for groups underrepresented in medicine, are interventions to help fully support education and research missions and to recover and sustain mission balance in departments of family medicine.