Beyond Burnout: A Physician Wellness Hierarchy Designed to Prioritize Interventions at the Systems Level.

Burnout has been implicated in higher physician turnover, reduced patient satisfaction, and worsened safety, but understanding the degree of burnout in a given physician or team does not direct leaders to solutions. The model proposed integrates a long list of variables that may ameliorate burnout into a prioritized, easy-to-understand hierarchy. Modified from Maslow's hierarchy, the model directs leaders to address physicians' basic physical and mental health needs first; patient and physician physical safety second; and then address higher-order needs, including respect from colleagues, patients, processes, and the electronic health record; appreciation and connection; and finally, time and resources to heal patients and contribute to the greater good.

Using a Simulation of a Frustrated Faculty Member During Department Chair Searches: A Proof of Concept Project.

Problem: Vitae reviews, interviews, presentations, and reference checks are typical components of searches used to screen and select new department chairs/heads, but these strategies may fail to identify leaders who can communicate effectively with faculty in common, tense situations.

Approach: Between May 2015 and November 2016, the authors piloted simulation scenarios in four department chair searches at Penn State College of Medicine/Penn State Health to assess candidates' skill at handling common, challenging situations with faculty members. In the scenarios, a frustrated faculty member complains that he/she has too little time for academic pursuits.

Efficacy and safety of moxifloxacin as an additive in Optisol-GS a preservation medium for corneal donor tissue.

Purpose: To assess the endothelial toxicity and the microbiological efficacy of moxifloxacin (250 microg/mL) as an additive to Optisol-GS.

Methods: Five hundred nine donor rims were studied. One half of each donor rim was placed in standard Optisol-GS and the other half of the rim in Optisol-GS fortified with moxifloxacin (250 microg/mL).

Laboratory model of tissue adhesive (2-octyl cyanoacrylate) in sealing clear corneal cataract wounds.

Purpose: To determine the efficacy of a tissue adhesive (2-octyl cyanoacrylate with parabens; Liquid Bandage, Johnson & Johnson, Skillman, New Jersey) in sealing clear corneal cataract wounds.

Design: Laboratory investigation.

Methods: Seven human donor globes were prepared for Miyake video microscopy.

Liquid bandage (2-octyl cyanoacrylate) as a temporary wound barrier in clear corneal cataract surgery.

Purpose: To determine the feasibility and side effect profile of 2-octyl cyanoacrylate with parabens (Liquid Bandage) as an adjunct wound sealant and barrier against the inflow of ocular surface fluid after clear corneal cataract surgery.

Design: Prospective interventional case series.

Participants: Fifty-one eyes of 51 patients undergoing clear corneal cataract surgery.

A pilot study of the use of guided imagery for the treatment of recurrent abdominal pain in children.

Few effective therapies are available for children with recurrent abdominal pain (RAP). Relaxation and guided imagery have been shown to impact the autonomic nervous system, which is altered in patients with functional gastrointestinal disorders. Ten children with RAP were enrolled in the study after evaluation by a pediatric gastroenterologist.

Ethical and legal issues in e-mail therapy.

Psychologists and psychiatrists recently started using electronic mail (e-mail) to conduct therapy. This article explores relevant ethical and legal issues including, among others, the nature of the professional relationship, boundaries of competence, informed consent, treating minors, confidentiality, and the duty to warn and protect. To illustrate these complex issues, two services currently operating are discussed.