Medical treatments for lower urinary tract symptoms due to benign prostatic hyperplasia are frequently associated with changes in sexual function. While these medications are generally well-tolerated and have both reduced and delayed more invasive surgical options, the ramifications of long-term chronic use are largely unknown. Sexual side effects of these medications are frequently either reported as part of a short-term initial drug study or have inflexible endpoints that are not able to gauge more subtle changes in sexual performance. This review will delineate the currently known effects of these medications on sexual function and will consider mechanisms of dysfunction.

An information onslaught accompanies cancer diagnoses, but patient comprehension (health literacy; HL) is frequently low, impacting both immediate care and longer term follow-up. Knowledge and adoption of preventive measures is especially important for cancer survivors due to their increased risk of secondary malignant neoplasms. We sought to evaluate the Test of Functional Health Literacy Adult (S-TOFHLA) against the recently developed cancer-specific Cancer Message Literacy Test (CMLT-r) among an educated population of both cancer survivors and those cancer-free. Participants were recruited 2013 (May through December) from various units within a local hospital and from several local churches, and each completed the S-TOFHLA and CMLT-r and provided demographic information and cancer status. The 109 participants had a mean age of 58 years and were as follows: 65.1 % female; 92.7 % white, 50.4 % college graduates, and 41.3 % cancer survivors. S-TOFHLA scores ranged from 12-36 (mean 34.1) and non-significantly varied by gender, education, cancer status, and age. CMLT-r scores ranged from 28.6-100 % (mean 86.4 %) and significantly varied by education (p = 0.013), but not by gender, cancer status, or age. Overall, CMLT-r and S-TOFHLA significantly correlated (p < 0.001). Assessment scores were skewed towards the maximum with non-significant differences by cancer status. As cancer survivorship improves and as the population becomes more educated, more refined approaches to assess health literacy should be considered. Increased education does not imply increased health literacy, and cancer survivorship does not imply higher health or cancer literacy. Concerted efforts to improve patient understanding and implementation of preventive measures are imperative.

Problem Studies suggest that burnout and wellbeing are inversely associated, thus early identification of risk factors for burnout and targeted interventions to improve resident wellbeing could help mitigate these outcomes. However, little is known about the impact of department-sponsored wellbeing programs on improving personal physician wellbeing. Approach Our innovation attempted to create a culture of physician wellbeing within one year (October 2016-October 2017) after discovering high levels of burnout among our Internal Medicine residents and faculty. All residents and faculty were invited to participate in programming and an internally-developed "Wellness Needs Assessment" tracked the effectiveness of our efforts. Wellness endeavors were generally low-resource/high-yield interventions and included establishing a Physician Wellbeing Committee and budget, creating a robust social media presence, and providing over thirty event-based and continuous wellness interventions throughout the year. Outcomes Over one year, our wellbeing program demonstrated improvements across all ten sub-domains of wellness, although the distribution of responses when comparing their current overall level of wellness did not reach statistical significance. A large decrease in the rate of self-reported "thoughts of self-harm" was noted. Over 90% of participating physicians felt that the "culture of wellness" in the workplace had influenced their personal wellness. Next Steps Next steps include determining which wellbeing interventions are the most effective in promoting a culture of wellness and improving personal wellbeing. We plan to determine sustainability of the program over time, growing

Social media is an emerging and underutilized tool in graduate medical education. Current generations of physicians increasingly rely on social media for information and connectedness. The use of social media in medical education provides a low-resource/high-impact strategy to improve physician wellness, reduce burnout, enhance medical knowledge, and supplement residency programs' recruiting efforts. Creating and maintaining an effective social media presence necessitates the use of a well-rounded team of residents at varying levels of training to ensure diverse posting perspectives. Account managers should establish goals and policies to ensure continuity and cohesiveness in their posting. Social media teams should work to increase the account's reach and interaction through engaging images, topical hashtags, location geo-tags, and tagging other accounts and follow their own progress through analytics. Using these twelve tips will help your program create a robust, impactful social media presence.