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Objective: Investigate the effect of a targeted wellness program on burnout in Otolaryngology residents., Methods: Residents and faculty collaboratively developed a program aimed at improving resident wellness. Program implementation began in July of 2018 and after 1 year, residents evaluated the program's effects on burnout. We used the Maslach Burnout Inventory (MBI) and a Likert scale to evaluate the effects of the program., Results: After 1 year of the resident wellness program, the MBI results showed an increase in the number of residents in the "engaged" category and a decrease in those rated as "burnout." Residents rated favorably initiatives grouped into the following themes: time away from work, faculty engaging with residents outside of the hospital environment, efforts to enhance residents' self-efficacy, fostering a positive culture among residents, and providing easy access to physical activity. The majority of initiatives were targeted to the "culture of wellness" domain, as defined by the Stanford Well MD framework. Our program targeted to a lesser extent the other 2 domains, "efficiency of practice" and "personal resilience.", Conclusion: After 1 year, the wellness program resulted in a trend toward improving burnout. Future efforts should be focused on targeting the multidimensional drivers of burnout as defined by established wellness frameworks. Realizing new stressors brought on by the COVID-19 pandemic will also be an area of active effort and research.

Much of the brain is devoted to vision. Damage causes visual problems ranging from profound impairment, to cognitive visual problems only. A child with cerebral blindness may have intact perception of movement. The principal cognitive visual pathways comprise the dorsal and the ventral streams. The dorsal stream runs between the occipital lobes (which process incoming visual data), the posterior parietal lobes (which process the whole visual scene and give attention to component parts), the motor cortex (which facilitates movement through the visual scene) and the frontal cortex (which directs attention to chosen parts of the visual scene). The ventral stream runs between the occipital lobes and the temporal lobes (which enable recognition of people and objects, facilitate route finding and serve visual memory). Damage to these pathways disrupts these functions in a variety of combinations. This paper reviews cerebral visual impairment in children, the differential diagnosis and the management., (Copyright 2002 Elsevier Science Ltd.)

Helical CT has become a valuable imaging tool for detection of pulmonary embolism, deep venous thrombosis, ureteral colic, acute small-bowel obstruction, and acute appendicitis. Generally, helical CT has good sensitivity and specificity values, and scans can be performed more quickly than previous gold standard diagnostic examinations for the conditions mentioned. In some cases, helical CT can also identify other findings that may be responsible for a patient's symptoms. One notable disadvantage of helical CT is the charge for the procedure, which in some circumstances can be considerably more costly than diagnostic examinations preferred previously. However, because helical CT can often obviate the need for other tests--and may consequently reduce hospital stays--this technology may have the ability to reduce overall expenditures. Cost of helical CT is therefore a multifaceted issue and requires further study before conclusions can be drawn.

The immature visual system in infants born preterm is vulnerable to adverse events during the perinatal period. Periventricular leukomalacia affecting the optic radiation has now become the principal cause of visual impairment and dysfunction in children born prematurely. Visual dysfunction is characterized by delayed visual maturation, subnormal visual acuity, crowding, visual field defects, and visual perceptual-cognitive problems. Magnetic resonance imaging is the method of choice for diagnosing this brain lesion, which is associated with optic disk abnormalities, strabismus, nystagmus, and deficient visually guided eye movements. Children with periventricular leukomalacia may present to the ophthalmologist within a clinical spectrum from severe cerebral visual impairment in combination with cerebral palsy and mental retardation to only early-onset esotropia, normal intellectual level, and no cerebral palsy. Optimal educational and habilitational strategies need to be developed to meet the needs of this group of visually impaired children.