Wellness Review 2020, Part 2

Abstract

Introduction: This article comprises Part 2 of the Journal of Wellness review of 2020 wellness literature (July – December). In this review, JWellness editors continue the goal of offering a cohesive summary of recent publications within the wellness domain. We summarize new science and resilience initiatives published outside of JWellness that seek understanding of either burnout and its prevention or thriving in the medical community. Methods: From the interval of 01 July – 31 Dec 2020, PubMed was queried for empirical research studies, review articles, and editorials in accordance with the following algorithm: an article was required to have two delineating keywords, each from a separate grouping. The first identified medical professionals in either the title or the abstract: (“clinical professionals,” “physicians,” or “caregivers”), and the other identified a wellness-related keyword in the title: (“wellness,” “burnout,” “resilience,” or “resiliency”). Literature in Review: A total of 234 articles resulted. The list for inclusion was then narrowed to sixty-three articles plus one that was hand-picked. Recent literature into physician wellness, burnout and resilience continues to focus heavily on COVID-19. Well-researched topics include burnout surveillance, proposals for and small investigations into resilience, multiple studies attempting to differentiate characteristics that predispose to burnout, and the impact of the pandemic. Less has been written on leadership, financial wellness, and sustainable resilience-building initiatives. We note relatively few control-measured interventional studies—the majority of which remain small in endeavor and short in duration, limiting generalizability. Conclusion: Recent literature into physician wellness, burnout and resilience focuses heavily on COVID-19. Many workplace / organizational factors negatively influence wellness: cumbersome EHRs, cultures not focused on socialization and self-compassion, and high physician task load. We express optimism regarding future interventional studies of burnout mitigation and resilience enhancement.

Death Due to Adrenal Crisis

“…This will allow the pathologist to search for possible adrenal tissue microscopically. The main histological features of adrenal insufficiency include 12,13 cortical atrophy, lymphoplasmacytic infiltration, and residual adrenal medulla. Inflammation is accompanied by a tendency toward fibrosis of varying degrees.…”