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Keyword: Jean-Claude Juncker
Counting the cost of Europe's 'Eurocrats'
May 16, 2019 By Quentin Ariès
Well-paid: Commission president Jean-Claude Juncker, left, and Donald Tusk, president of the European Council. © Reuters
A communist candidate in the forthcoming European Parliament elections in France recently called for Commission president Jean-Claude Juncker's salary to be drastically reduced. At the same time Mediapart has examined the high levels of pay and other benefits enjoyed by the civil servants who work in the Brussels-based bureaucracy. In all some 60,000 or so officials work for the EU, a number of whom have told Mediapart that their salaries are justified. Quentin Ariès reports.
Juncker visit to French parliament canceled following riots
Dec 4, 2018 By La Rédaction De Mediapart
Address by European Commission president cancelled to 'give priority' to a hearing on the 'gilets jaunes' protests that have swept across France.
France and Germany lead EU budget concerns
May 4, 2018 By La Rédaction De Mediapart
France is outraged by proposed cuts in farm aid after the European Commission unveiled its post-Brexit finance plan.
Juncker and MEPs face off in cronyism row over choice of Europe's top civil servant
Apr 19, 2018 By Ludovic Lamant
Martin Selmayr (right) with European Commission president Jean-Claude Juncker at the European parliament on March 13th. © Reuters/Vincent Kessler
The highly questionable circumstances of the appointment of German conservative Martin Selmayr as secretary-general of the European Commission, a move initiated by commission president Jean-Claude Juncker for whom Selmayr until then served as chief of staff, has been met with outrage within the European Parliament, which on Wednesday adopted a motion describing the promotion as "coup-like" and "which possibly even overstretched the limits of the law". But it pulled back from demanding Selmayr's resignation, thereby avoiding a serious institutional crisis. Meanwhile, the commission, accused of blatant cronyism, has refused to compromise and insists Europe's new top civil servant will remain in the post. Mediapart Brussels correspondent Ludovic Lamant reports.
EU staff aim to punish ex-boss Barroso over Goldman job
Aug 7, 2016 By Ludovic Lamant
Under fire: ex Commission boss José Manuel Barroso. © Reuters
The recent decision by former European Commission president José Manuel Barroso to join Wall Street bank Goldman Sachs as an advisor caused outrage across much of Europe. Apart from, that is, at the heart of the Brussels institution itself where Barroso's successor Jean-Claude Juncker has only just, and grudgingly, criticised the move. However, disgruntled EU staff feel Barroso's appointment further tarnishes the EU's image and are examining ways to sanction their former boss. Ludovic Lamant reports.
Brexit, a welcome catastrophe
Jun 24, 2016 By François Bonnet
A London taxi driver celebrates the Brexit victory. © Reuters
The British 'no' vote in the referendum on the European Union marks the victory of the extreme right, represented by the repugnant Nigel Farage and his UKIP party. In that sense it is a tragedy. But this 'no' vote also signs the death warrant of a European Union that has turned away from its citizens. Now the whole European project needs to be rebuilt and Mediapart's editor François Bonnet wonders whether that isn't good news...
EU discontent over French budget deal
Mar 8, 2015 By La Rédaction De Mediapart
Officials fear leaving Paris unpunished for persistently failing to curb its budget deficit may make it harder for euro to weather a future crisis.
France joins call for fresh assault on tax havens
Paris, Berlin and Rome want new EU law to ban 'aggressive tax planning' in move seen as an attack on current practices in Luxembourg.
France's Moscovici struggles to convince EU lawmakers
Oct 2, 2014 By La Rédaction De Mediapart
MEPs gasped when ex-finance minister told commissioner confirmation hearing that Paris had never broken EU budget rules.
MEP cries foul at attempt to curb French commissioner's powers
Leaked memo says former finance minister Pierre Moscovici's powers in EU Commission will be shared with Latvian hardliner.
The new French EU commissioner's austerity 'bodyguards'
Sep 11, 2014 By Ludovic Lamant
Pierre Moscovici en marge d'un Eurogroupe à Bruxelles, en mars 2014, sous l'oeil de Mario Draghi (BCE). ©CE.
France's Pierre Moscovici has been named as the new European Union commissioner for economic and monetary affairs in Brussels. At first glance it appears a clear-cut triumph for President François Hollande who has installed his former finance minister in a key economic post at the heart of the EU despite German opposition. It is also a sign that the new European Commission president Claude Juncker wants to display his independence from German chancellor Angela Merkel. But as Ludovic Lamant reports, Juncker has also shaken up the Commission's structure and placed two economic hawks alongside the French commissioner. Some observers believe their main role is to stop the French "social democrat" being too soft on member countries struggling to cut their deficits – and in particular France.
France gets key economic post in new Juncker European Commission
Former French finance minister Pierre Moscovici will take up the important economic and monetary affairs portfolio despite some German misgivings.
The prospects for Juncker's pledge of a pan-European minimum wage
Aug 20, 2014 By Ludovic Lamant
The European Commission's incoming president, centre-right politician Jean-Claude Juncker, caused surprise this summer when he pledged his support for a continent-wide minimum wage. Juncker, who will take up his post in November, has not yet detailed the potentially complicated practical framework for applying the minimum wage, a move which runs against the tide of the blanket austerity policies until now championed by Brussels. While Juncker faces numerous obstacles to succeed with the scheme, not least from European treaty texts, the idea that raising low incomes would be beneficial to economies appears to be gaining support even from the most unexpected quarters. Mediapart's Brussels correspondent Ludovic Lamant reports on the arguments for and against, and in just what form a pan-European minimum wage might finally see the light of day.
Outcry as future European Commission set for massive male domination
Future European Commission President Jean-Claude Juncker, due to take up his functions this autumn, already faces an immediate problem as he composes his list of 28 European commissioners. For out of the 23 nominations so far officialised, only four are women. That represents five less than the outgoing commission, whose female contingent have now co-signed an open letter to Juncker demanding he find at least ten women. As Mediapart's Brussels correspondent Ludavic Lamant reports, there is increasing uproar over the issue, notably among members of the European Parliament to who Juncker must submit his final list of commissioners for approval.
France's voice barely heard in debate on top EU job
Jun 25, 2014 By La Rédaction De Mediapart
President François Hollande has played a background role in saga over who should be Commission president as UK and Germany slug it out.


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Artigo 18.o - Direito de asilo
Artigo 19.o - Protecção em caso de afastamento, expulsão ou extradição
FRA Director speaks with Greek authorities about migration
Greece needs solid, sustained support and solidarity as it faces great migration challenges, says FRA Director Michael O'Flaherty after 2 days of meetings in Athens with authorities.
Relocation of unaccompanied children from Greece
The EU Agency for Fundamental Rights (FRA) urges Member States to agree on a simple and practical workflow as soon as possible, to avoid lack of clarity and delays in the relocation process. This paper provides practical suggestions on relocation of unaccompanied children from Greece, building on lessons learned from previous mandatory and voluntary relocation schemes. The paper provides FRA input on the initiative of the European Commission and a group of Member States to relocate unaccompanied children.
Watch Director's video message from Athens
E-Media Toolkit on Migration ― Trainer's Manual
In today's media landscape the way in which journalists and editors receive, process and publish news is constantly changing. Journalists face immense time pressure, as news frequently breaks online To facilitate training on the coverage of migration news, this Trainer's Manual is a tool to be used together with the e-Media Toolkit.
Access the e-Media Toolkit
Migration: Key fundamental rights concerns - Quarterly bulletin 1 - 2020
The EU Agency for Fundamental Rights has been regularly collecting data on migration since September 2015. This report focuses on the fundamental rights situation of people arriving in Member States and EU candidate countries particularly affected by large migration movements. It addresses key fundamental rights concerns between 1 October and 31 December 2019.
Access all quarterly updates
Direito de informação ― Guia para as autoridades quando recolhem impressões digitais para o EURODAC
Este folheto apoia as pessoas no terreno e as autoridades a prestar informação aos requerentes de asilo e aos migrantes intercetados nas fronteiras externas de modo acessível e compreensível sobre o tratamento das impressões digitais no Eurodac.
Integration of young refugees in the EU: good practices and challenges
Over 2.5 million people applied for international protection in the 28 EU Member States in 2015 and 2016. Many of those who were granted some form of protection are young people, who are likely to stay and settle in the EU. The EU Agency for Fundamental Rights interviewed some of them, as well as professionals working with them in 15 locations across six EU Member States: Austria, France, Germany, Greece, Italy and Sweden. This report presents the result of FRA's fieldwork research, focusing on young people between the
ages of 16 and 24.
Practical guidance in the area of asylum, migration and borders
Based on its findings and research FRA provides practical guidance to support the implementation of fundamental rights in the EU Member States. This series contains practical guidance on: Initial-reception facilities at external borders; Apprehension of migrants in an irregular situation; Guidance on how to reduce the risk of refoulement in external border management when working in or together with third countries; Fundamental rights implications of the obligation to provide fingerprints for Eurodac; Twelve operational fundamental rights considerations for law enforcement when processing Passenger Name Record (PNR) data and Border controls and fundamental rights at external land borders.
Child rights in the EU - Supporting you, Supporting them
Child rights come first. Measures to ensure child protection and participation apply to all children in the EU. This brochure guides you to relevant FRA reports and tools that can support you when promoting and protecting the rights of all children in the EU.
Migration: Key fundamental rights concerns - Quarterly bulletin 4
The EU Agency for Fundamental Rights has been regularly collecting data on asylum and
migration since September 2015. This report focuses on the fundamental rights situation
of people arriving in Member States and EU candidate countries particularly affected by
migration. It addresses fundamental rights concerns between 1 July and 30 September 2019.
Access all 2019 updates
Video blog by Michael O'Flaherty: situation in Greek hotspots
In this edition Michael O'Flaherty reports back from his visit to the asylum seeker facility in Lesbos and calls for the support of all EU Member States to improve in particular the situation of unaccompanied children.
Returning unaccompanied children: fundamental rights considerations
Individuals who are not entitled to stay in the European Union are typically subject to being returned to their home countries. This includes children who are not accompanied by their parents or by another primary caregiver. But returning such children, or finding another durable solution, is a delicate matter, and doing so in full compliance with fundamental rights protections can be difficult. This focus paper therefore aims to help national authorities involved in return-related tasks, including child-protection services, to ensure full rights compliance.
Second European Union Minorities and Discrimination Survey - Migrant women - selected findings
FRA's second EU Minorities and Discrimination survey (EU-MIDIS II) collected information from over 25,000 respondents with different ethnic minority and immigrant backgrounds across all 28 EU Member States. The main findings from the survey, published in 2017, pointed to a number of differences in the way women and men with immigrant backgrounds across the European Union (EU) experience how their rights are respected. This report summarises some of the most relevant survey findings in this regard, which show the need for targeted, gender-sensitive measures that promote the integration of – specifically – women who are immigrants or descendants of immigrants.
The EU Agency for Fundamental Rights has been regularly collecting data on migration since September 2015. This report focuses on the fundamental rights situation of people arriving in Member States and EU candidate countries particularly affected by migration movements. It addresses fundamental rights concerns between 1 April and 30 June 2019.
Video blog by Michael O'Flaherty: rescue in the Mediterranean
In the latest edition of his video blog, FRA Director Michael O'Flaherty focuses on the migration situation in the Mediterranean Sea and makes three proposals.
Forced return monitoring systems - 2019 update
The EU Return Directive (2008/115/EC) in Article 8 (6) introduced an important fundamental rights safeguard for third-country nationals ordered to leave the EU because they do not or no longer fulfil the conditions for entry and/or stay. According to the directive, Member States must provide for an effective forced-return monitoring system.
Severe labour exploitation: A Woman Captured - Trailer
A Woman captured – a film by Bernadett Tuza-Ritter
Ongoing challenges to advancing child rights
Fundamental Rights Report 2019: Not all children benefit equally from efforts to guarantee child rights.
Some groups face particular difficulties.
Migration remains politically charged
Fundamental Rights Report 2019: Although migrant arrivals to the EU continue to drop, it remains a divisive issue politically and
across society. Nearly 4 in 10 Europeans think immigration is more of a problem than a solution.
And nearly a half overestimate the number of irregular migrants in their country.

redpajama_set_name: RedPajamaCommonCrawl


The markets of the East End tend to divide between those for recreational shopping at weekends and those which are weekday and utilitarian, where people seek the essentials of life at the keenest prices. Both are interesting in different ways, yet the recreational markets tend to get photographed much more than the utilitarian ones, which makes Contributing Photographer Phil Maxwell's pictures of Watney Market over the last thirty years especially fascinating.
Once one of the East End's largest, Watney Market boasted an early branch of Sainsburys in 1881 – selling cheese and salt bacon to dockers – and by 1900 it was claimed there were a hundred stalls and a hundred shops. By 1928, the number of businesses had more than doubled, drawing protests from nearby churches for trading on Sundays. Yet by the sixties it was in decline and Tony Bock photographed the last days of the old market before it was redeveloped into its current form in the eighties.
Watney Market is a pedestrianised precinct now, creating an uninterrupted theatre of human life with a lively immersive atmosphere where locals feel free to linger, enjoying the socialising and banter for which East End markets are justly famous.
Yes, terrific photos. All that energy and strength that they convey. I wish daily and utilitarian markets were in better shape but fear they are highly endangered, everywhere. This is a great record Phil. Thanks.


Weaving a Basket (or Something) (Kevin Y.; 14-Mar-2001; TADS 2).
The story file is SpeedIF_weave.gam.
Weaving a Basket (or Something) (archived) - at Baf's Guide.
Weaving a Basket (or Something) - at IFDB.
Weaving a Basket (or Something) - at IF Ratings.
This page was last modified on 22 October 2014, at 18:28.


A round-the-clock courier and haulage firm has undergone a major re-brand – after quadrupling its workforce in just 12 months.
The company – now known as Dulogis – had been operating as UKSameday based in Biddulph, offering a fast and reliable distribution service to customers across the country.
But after enjoying recent steady growth, the firm has relocated to a new headquarters in Stone Road, Tittensor, increased its fleet of vehicles to around 30 and quintupled the size of its workforce – from a team of eight to 40.
Now it plans to expand even further across the UK – with additional sites and the creation of more jobs.
Craig Chapman, who founded the company in 2003, said: "When I started the business it was just me. I borrowed a van and basically knocked on people's doors asking if there was anything I could do for them.
"Quite early on I picked up regular work for Roberts Bakery and everything just went from there. I bought new vans to cope with their demands, and the demands from new customers.
"When I first started out it was just a way of earning money for me, but in about 2013 I really started to see the potential of the business and started to put plans in place to grow.
Dulogis is part of a national distribution network of 10,000 vehicles which allows it to offer a 24/7 delivery service at just one hour's notice.
The company has recently invested £100,000 in developing its website and introducing new, bespoke digital software where customers can get an instant quote and book a vehicle online.
Craig said: "We are quite a young company so we are investing in and embracing new technology to take the business forward.
The new technology will also allow Craig and his management team to monitor 'hot spots' around the country – paving the way for the launch of additional Dulogis sites, both inside and outside of Staffordshire.


No, we are not Lula voters.
We are not PT voters.
But we are 'legalists' or 'constitutionalists'.
We believe individual rights guaranteed by the Brazilian Constitution should be respected and enforced by unbiased judges.
We believe the law can not be adapted to suit political and economical interests.
The Brazilian Judiciary system created a whole new interpretation of the law to stop one man from running for president. Our supreme court reverted many of its previous decisions to incarcerate and prevent one Brazilian citizen from running for president. Our supreme court went to the extreme of imposing a gag order on a person who doesn't even have a final sentence pronounced.
That's the real reason behind the turmoil Brazil is going through now, with the risk of a nazi-fascist candidate finally completing the cycle of the military coup initiated with the impeachment of 2016.
1- Chico Buarque & MPB-4 performing Apesar De Você at a TV show called 'Ensaio' at TV Tupi in 1971. This song was an anthem hope and resistance against oppression and censorship during the darkest times of the military dictatorship in Brasil.
2- Antônio das Mortes sung by Sergio Ricardo was part of the original soundtrack for the film 'Deus e o Diabo Na Terra do Sol' directed by Glauber Rocha. Here we see a clip with some scenes of Antônio das Mortes, character that was created based on a previous work by Sérgio Ricardo. Glauber is also credited for co-writing the lyrics.
3- Não Recomendados is an activist trio of singers dedicated to raise awareness about gender issues and here they perform 'Não Recomendado' remixed by Deep Lick in the video directed by Leandro HBL that brings us references to the emblematic 'Parangolés' created by the 60s/70s artist Hélio Oiticica.
All that right below the complete playlist of CAS 460 !


text:
Gerontius
'Worst day of my life' says man having to wait his turn at McDonalds drive thru
A Dewsbury man has told of his pain and suffering after being forced to join the queue at his local McDonalds drive-thru.
Jason Beesley took to social media to complain about the ordeal saying that it was 10 minutes of his life he would never see again.
The father of four says his kids had endured an agonisingly long wait before their meal arrived and had missed part of their favourite TV show as a result.
Jason said he could not think of anything worse than having to sit helplessly in his car as he watched other people in the queue get served before him.
'It was carnage in that drive-thru, I witnessed things I thought had been consigned to the history books. By the time it arrived we had gone off the idea of a burger and so threw it in the bin….we went and got pizza instead.
I made comments about it on Facebook. People need to know about these things and should not suffer in silence.'
'It was an ordeal I hope my kids will never have to suffer again. I've a good mind to ask McDonalds for compensation', continued Beesley. 'They don't suffer inconvenience like that in other countries…..so why here?'
Image: Pixabay/LordLucas
NASA to divert next asteroid towards Earth
Government sets up independent enquiry into independent enquiries
GB News given official 'sanctuary' status by RSPB


ShangHai Shibang Machinery Co., Ltd is a professional manufacturer and supplier specialized in the research and development of industrial crushing & screening equipments.
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Shanghai Shibang Machinery Co., Ltd. Is a professional manufacturer of crushing and powder making equipment. It is major production and export base of sandstone and powder making machinery in China, achieved CQC ISO9001:2000, CE Certification and ACP verification by Global Authentication & Verification Division, and is a TCM member of Tejari, located in Shanghai.
About Shanghai Shibang Machinery Co., Ltd. Shanghai Shibang Machinery Co., Ltd. is professional manufacturer of crushing and powder making equipment. It is a major production and export base of sandstone and powder making machinery in China.
Shanghai Shibang has become a major production and export base of sandstone and powdermaking machinery in the world. Company History Shanghai Shibang Machinery Co., Ltd. was founded in 1988.located in beautiful Pudong New District, China.
Shanghai Shibang Machinery Co., a hightechnology enterprise of Shanghai city. It is a professional manufacturer of mining crushers and industrial grinding mills, located in beautiful Pudong New District, with factory area of more than 70,000 square meters.


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Average gasoline prices in Texas have fallen 13.6 cents per gallon in the last week, averaging $3.10/g today, according to GasBuddy's survey of 13,114 stations in Texas. Prices in Texas are 34.4 cents per gallon lower than a month ago and stand 28.7 cents per gallon higher than a year ago. The national average price of diesel has declined 5.5 cents in the last week and stands at $5.01 per gallon.
According to GasBuddy price reports, the cheapest station in Texas was priced at $2.75/g yesterday while the most expensive was $4.73/g, a difference of $1.98/g. The lowest price in the state yesterday was $2.75/g while the highest was $4.73/g, a difference of $1.98/g.
The national average price of gasoline has fallen 7.6 cents per gallon in the last week, averaging $3.67/g today. The national average is down 26.9 cents per gallon from a month ago and stands 52.3 cents per gallon higher than a year ago, according to GasBuddy data compiled from more than 11 million weekly price reports covering over 150,000 gas stations across the country.
Historical gasoline prices in Texas and the national average going back ten years:
September 12, 2021: $2.81/g (U.S. Average: $3.15/g)
Neighboring areas and their current gas prices:
Midland Odessa- $3.25/g, down 9.7 cents per gallon from last week's $3.35/g.
San Antonio- $3.01/g, down 11.4 cents per gallon from last week's $3.12/g.
Austin- $3.11/g, down 13.1 cents per gallon from last week's $3.24/g.
"We continue to see the national average price of gasoline decline, now for the thirteenth straight week. But, we're seeing drastically different price behaviors from coast to coast, with some areas seeing noticeable increases while others are seeing decreases," said Patrick De Haan, head of petroleum analysis at GasBuddy. "Refinery issues in California are leading to increases in areas supplied by the state's refineries, including areas of Arizona, Nevada, Oregon, Washington and of course, California. Gasoline supply remains tight for the East Coast with some modest moves up, while prices continue to edge lower in the Plains, South and areas of the Great Lakes. For now, I believe the drop in prices will overpower the increases, leading to potentially another decline this week, but we're in a very fragile time and certainly could see a broader move higher in the weeks ahead."
GasBuddy is the authoritative voice for gas prices and the only source for station-level data. GasBuddy's survey updates 288 times every day from the most diverse list of sources covering nearly 150,000 stations nationwide, the most comprehensive and up-to-date in the country. GasBuddy data is accessible at http://prices.GasBuddy.com.
SOURCE GasBuddy
Posted in Breaking News, News


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Predictors of burnout among US healthcare providers: a systematic review
http://orcid.org/0000-0003-4523-7098Lisa S Meredith1,
Kathryn Bouskill1,
Joan Chang2,
Jody Larkin1,
Aneesa Motala1,3,
http://orcid.org/0000-0003-1597-5110Susanne Hempel1,3
1RAND Corporation, Santa Monica, California, USA
2Pardee RAND Graduate School, RAND Corporation, Santa Monica, California, USA
3Southern California Evidence Review Center, University of Southern California, Los Angeles, California, USA
Correspondence to Dr Lisa S Meredith; lisa_meredith{at}rand.org
Objective One potential barrier to optimal healthcare may be provider burnout or occupational-related stress in the workplace. The objective of this study is to conduct a systematic review to identify the predictors of burnout among US. healthcare providers.
Design Systematic review using in-depth critical appraisal to assess risk of bias and present the quality of evidence in synthesised results from the prognostic studies.
Data sources We searched 11 databases, registries, existing reviews and contacted experts through 4 October 2021.
Eligibility criteria for selecting studies We included all studies evaluating potential predictors and documenting the presence and absence of associations with burnout assessed as a multidimensional construct. We excluded studies that relied solely on a single continuous subscale of burnout. Data were abstracted from eligible studies and checked for accuracy by a content expert and a methodologist.
Data extraction and synthesis Two reviewers independently screened citations and full-text publications using predetermined eligibility criteria.
Results The 141 identified studies evaluated a range of burnout predictors. Findings for demographic characteristics were conflicting or show no association. Workplace factors, such as workload, work/life balance, job autonomy and perceived support from leadership, had stronger associations with risk for burnout. Mental health factors, such as anxiety, and physical health risks may increase the risk, although the direction of these associations is unclear as few prospective studies exist to address this question. Factors such as social support appear to have a protective effect.
Conclusion We found the most evidence for workplace, mental health and psychosocial factors in predicting burnout but limited evidence for other potential predictors. However, more prospective studies are needed to improve our understanding about how to prevent provider burnout.
PROSPERO registration number CRD4202014836.
GENERAL MEDICINE (see Internal Medicine)
This systematic review incorporates a broad range of predictors of burnout including both individual-level variables and work context variables.
The target population is US healthcare providers, including medical providers and behavioural health providers.
Our information sources were 11 research databases, research registries, previous systematic reviews from inception through 4 October 2021.
We included both individual-level and organisational-level predictors.
We used in-depth critical appraisal to determine risk of bias and synthesised the findings by type of predictors.
The health and well-being of the healthcare workforce is critical for providing quality patient care. One barrier to optimising mental healthcare may be provider burnout in the workplace. Broadly, burnout relates to chronic emotional and interpersonal stress stemming from one's work environment. Burnout1 has now been widely explored across a range of professional settings from human resources to information technology and is most readily associated with so-called 'helping professions', particularly among healthcare providers.2
The term burnout was first used in the 1970s to describe the predictable exhaustion, cynicism and the reduced professional efficacy that psychologists experienced shortly after beginning their careers.3 Since then, core symptoms of burnout have been intense emotional exhaustion, depersonalisation or cynicism and lower job performance.4 5 Existing research has identified a range of potential professional, environmental and personal factors believed to be associated with developing burnout.6
As expected, burnout has also been linked to indicators of low job satisfaction for professionals, such as turnover, attrition, job loss, absenteeism and early retirement.6–8 Given these potential downstream effects of burnout on individuals and their work,9–11 it is critical to understand predictors in order to potentially mitigate or prevent burnout.
Burnout has become an important point of discussion among healthcare personnel. Even the US American Medical Association12 offers a range of resources, from weekly emails to podcasts, to help clinicians manage burnout and improve workplace satisfaction. Calls have been made to address the 'crisis of burnout' among US-based clinicians, to which some attribute the high suicide rate observed in this population.13 Despite this push for collective action to address provider burnout,13 understanding which populations are at a differential risk for burnout remains unclear.
Our primary objective of this review was to identify the predictors that can reliably predict burnout in US healthcare providers. In this article, we contribute to the evidence base on the complex topic of burnout through a systematic review of predictors of burnout among US healthcare workers.
This review builds on existing systematic reviews that have addressed specific areas of potential predictors such as adverse childhood experiences of providers or futile or potentially inappropriate care.9 14–20 For example, although the review by Abraham et al14 also looked at predictors of burnout among US primary care providers, it used a more narrowly defined set of eligibility criteria that included only personal or organisational predictors, which resulted in only one-fifth of the articles included in this review. We included both individual-level variables (eg, marital status) as well as work context aspects (eg, electronic health record use requirement). Some of the other recent systematic reviews restricted the provider definition to surgeons21 or were more focused on prevalence rather than predictors of burnout.22 One study23 that included a variety of provider types and predictors covered defining and measuring burnout; who is harmed by burnout; incidence of burnout; causes of burnout and interventions and remediation strategies for mitigating burnout. However, this review did not present the data in the standard style of a systematic review; rather, it was used to develop a framework for action and identified two strategies shown to be highly effective for restoring provider well-being: (1) aligning personal and organisational values and (2) enabling physicians to carve out one-fifth of practice time that is of special important and valuable personally. Our review contributes uniquely to the burnout literature by incorporating a broader range of predictors and determinants of burnout.
This systematic literature review was part of a series of literature reviews on burnout. The review is registered in PROSPERO. Throughout, a description of burnout as an outcome refers to self-reports of burnout or burnout based on accepted burnout measures and scales. The targeted population is US healthcare providers including medical providers (physicians, physician assistants, nurse practitioners (We included nurse practitioners because, in the USA, they may prescribe treatments, order tests and diagnose patients. We excluded other types of nurses such as registered nurses and licenced practical nurses who may not independently manage patients.)), and behavioural health providers (psychologists, mental health counsellors and social workers).
The RAND librarian and content experts developed and tailored the search strategies to this literature review in a series of five total for the broader project. However, since we anticipated considerable overlap in search results across reviews, we used a central citation database for all reviews (see online supplemental material 1).
We searched the databases PubMed, PsycINFO, Web of Science and Business Source Complete for this review specifically, broader searches relevant to multiple topics in the literature series included CINAHL, AMED, DTIC, ERIC, Scopus, CENTRAL, ClinicalTrials.gov and ICTRP. We also screened bibliographies of existing systematic reviews (identified through PubMed and PsycINFO searches) and contacted content experts.
Participants: eligible study participants were US healthcare medical providers (physicians, physician assistants, nurse practitioners) and behavioural health providers (psychologists, mental health counsellors, social workers). We included mixed samples as long as more than 50% of the samples were eligible participants. For example, if a study included other types of providers (eg, dentists), it would be included if half of the study participants were medical providers.
Exposure: studies reporting on potentially associated participant (eg, resiliency, perceived stress, coping mechanism), interpersonal (eg, perceived support from colleagues), workplace (eg, organisation type, setting, provider type), organisational (eg, panel size, lack of control over workload, value conflicts, insufficient reward, work overload, work inefficiency, inadequate staffing, breakdown of community, loss of meaning from work, work–life balance issues, perception of unfairness, call/watch duty, rotation schedule, post-call day off, access to care expectations) or patient (eg, complex or high-risk patients), predictors are eligible.
Outcomes: studies had to predict burnout to be eligible. Studies exclusively predicting resilience and other related constructs were excluded. Because the literature on burnout is vast, we specifically focused on studies that operationalise burnout using a total burnout score on different measurement tools. For the Maslach Burnout Inventory (MBI),24 we required the outcome(s) to incorporate at a minimum the concepts of emotional exhaustion and depersonalisation—we did not include studies that were only based on a single MBI component, for example, emotional exhaustion.
Timing: there were no restrictions regarding the timing of the exposure relative to the burnout outcome. The review is from inception through 4 October 2021.
Setting: settings included inpatient and outpatient professional healthcare settings in the US
Study design: eligible studies were restricted to multivariate analyses simultaneously evaluating multiple competing variables and case–control studies.
Inclusion screening
Two reviewers independently screened each title and abstract of retrieved citations. Full-text publications were retrieved for citations deemed potentially eligible by one or both reviewers. Two independent reviewers applied explicit eligibility criteria to full-text publications; discrepancies were resolved through discussion, including a subject matter expert. Reasons for exclusion were recorded in an electronic database for systematic reviews.
Data abstraction procedure
The project team created a detailed extraction form to standardise the data collection process. To ensure consistency of interpretation of all fields on the form, reviewers pilot tested the form and discussed revisions. One reviewer abstracted data which were checked by a content expert and an experienced methodologist. We abstracted the study ID and setting, the sample characteristics, the study design and analytic method, the predictor variables, the controlled variables, the outcome definitions and operationalisation and the results in terms of presence or absence of an association between potential predictors and the outcome burnout.
Risk of bias
We assessed studies with Quality In Prognosis Studies.25 This critical appraisal tool accounted for the methodological approach (eg, prospective studies) and analytic methods (eg, multivariate analyses).
We summarised the evidence by predictor type, which enabled us to document the range of predictors that have been assessed in the literature and the research evidence supporting them. The synthesis is limited to predictors that were evaluated in at least five studies.
We rated the quality of the evidence for predictors of burnout across all identified pertinent studies. Based on GRADE (Grading of Recommendations, Assessment, Development, and Evaluations)(guidelines,26 we categorised the quality of the evidence as follows:
High: we are very confident that the true effect lies close to that of the estimate of the effect.
Moderate: we are moderately confident in the effect estimate; the true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different.
Low: our confidence in the effect estimate is limited; the true effect may be substantially different from the estimate of the effect.
Very low: we have very little confidence in the effect estimate; the true effect is likely to be substantially different from the estimate of effect.
We took eight criteria into account to determine the level of evidence quality following an adaptation of the GRADE framework for prognostic factor research.26 The Phase of Investigation criterion was used as a starting point (high or moderate quality of evidence). The criteria Study Limitations, Inconsistency, Indirectness, Imprecision and Publication bias can decrease the quality of evidence. The criteria Moderate/Large effect size and Exposure-response gradient could increase the quality of the evidence.
The Phase of Investigation differentiates whether the predictor evidence is primarily based on a study that aimed to identify potential prognostic factors (moderate quality) rather than based on studies aiming to confirm identified associations or explanatory research aiming to understand prognostic pathways (high quality). Study limitations assess the quality and risk of bias of the identified pertinent studies into account. Inconsistency assesses whether the identified association was consistently present across independent studies. Indirectness takes into account whether the available research studies do not accurately reflect the review question (eg, reporting only on a selected subgroup). Evidence was downgraded for Imprecision if the sample size of included studies was insufficient, the CI for effect estimates was wide, there were few outcome events for each prognostic variable or cases reaching included in the study. Publication bias was addressed by critically reviewing results based on only positive associations. Evidence for individual predictors could be upgraded for moderate/large effects or an exposure-gradient response was identified.
Throughout, we downgraded the quality of evidence for study limitation (eg, all studies are high risk of bias or the result has not been confirmed in a prospective study) or inconsistency (inconsistent results across studies regarding an association, regarding the direction of effect or both); the evidence grade could be downgraded by one or two categories.
The literature flow is shown in figure 1. Of 14 322 identified citations, 3418 were obtained as full text. A total of 141 studies met inclusion criteria for this systematic review of predictors of burnout (see the Evidence Table and full list of citations in the online supplemental material 1). These studies were published between 1987 and 2021.
Flow diagram.
Most of the studies employed concurrent (or cross-sectional) designs, although some used prospective designs, and a few used retrospective designs. All analyses included some form of multivariate analysis (eg, multivariate regression, multivariate intercorrelations, multivariate χ2 tests) given that the goal was to identify associations between one or more predictors and burnout. A wide variety of settings were covered in this set of studies. These included healthcare professional organisations; hospitals and units within hospitals; university medical centres, health departments, the military and veterans' health administration. In these studies, the number of participants ranged from as few as 21 to as many as 40 382 providers.
Outcome definitions and operationalisation
Most of the studies employed the full 22-item MBI. A few studies combined the scales into phases of low, medium and high burnout. Twenty-five studies (18%) used abbreviated versions of the MBI including 12-item, 6-item, 5-item and 2-item versions. Other instruments used to measure burnout included the Professional Quality of Life V Scale,27 28 the Mini Z,29 the Burnout subscale from the Compassion Fatigue and Satisfaction Self-Test for Helpers,30 the Staff Burnout Scale for Health Professionals,31 the Stanford Professional Fulfillment Index,32 and the 16-item Oldenburg Burnout Inventory33 or a 4-item measure from the Physician Worklife Study.34 One study used the 19-Item Copenhagen Burnout Inventory35 36 and one study used the Expanded Physician Well-Being Index.37 Finally, one study developed a 6-item measure of COVID-19-related burnout.38
Studies assessed variables predicting higher levels of burnout as well as protective factors associated with lower levels of burnout. Most of the documents operationalised burnout as a binary measure as opposed to using the full range of scores with a continuous measure. For example, many studies defined burnout with the MBI if high on the emotional exhaustion subscale (score of 27 or above) or high on the depersonalisation subscale (score of 10 or above).39 This tendency for using cut scores was in part an artefact of our exclusion criteria since we did not include studies that used just a single continuous MBI subscale measure.
Risk of bias assessment
Overall risk of bias across the included studies was moderate (see figure 2). The largest source of bias was due to study participation for which the majority of documents were deemed at high risk. This was mostly due to low or unknown response rates. For study attrition, the risk level was moderate for most documents closely mirroring the overall pattern of risk. Ratings for prognostic factor measurement were low risk for a few documents and moderate for most with none rated as high risk. The pattern for outcome measurement was similar to prognostic factor measurement. Study confounding and statistical analysis and reporting were rated as low risk for more than half of the documents with the remainder rated as moderate. Other sources of bias included small sample size or simplistic analysis (eg, used only a two-sample Wilcoxon rank sum test).
Summary of risk of bias assessment by source.
Predictors of burnout
A variety of different types of predictors were explored in the existing studies aiming to predict burnout in healthcare providers. These included: demographic characteristics; professional and clinical practice characteristics; psychological health factors; health risks and health behaviours and psychosocial variables. We summarise the types of predictors by each of these categories in the following narrative and the summary of findings table. The findings are summarised with the quality of evidence in table 1 by predictor. More details about the design, predictors and results are provided in the Evidence Table in the Appendix.
Summary of findings and quality of evidence
Demographic characteristics
Almost all studies examined the effect of one or more demographic characteristics (also referred to as personal characteristics) as predictors of burnout. The effect of gender on burnout was examined in 73 studies. While 30 studies found that women had a greater risk than men, four studies found that men were at greater risk for burnout, including two prospective studies.39–41 Thirty-nine studies did not find gender to be a significant predictor of burnout.
A total of 53 studies assessed age as a predictor. Twenty-eight studies found an association with burnout while 25 found none. Of those with an association, 17 studies found that younger age was a significant predictor of burnout while 11 found older age was a significant predictor. Five studies used prospective designs, which provide the strongest evidence. However, those studies reported mixed results ranging from a negative association of age with burnout, that is, younger providers have higher burnout levels,42–44 a positive relationship45 and no relationship.39 46
Race or ethnicity as a predictor was evaluated in 17 studies (including three prospective studies). However, this factor was a statistically significant predictor in only four studies and the three prospective studies found no effect.47–49
Other variables included having children, which was examined in 29 studies (3 that used a prospective design). Only 6 studies that addressed having children found this demographic characteristic to statistically significantly predict burnout and the direction of effects varied (some indicating that having children is associated with lower burnout levels, whereas others found having children was associated with greater burnout. In addition, another study found that having additional caregiving responsibilities (eg, caring for very ill children, spouses, parents or others) was associated with higher burnout rates.
A total of 24 studies examined marital status as a predictor of burnout. Of those, only two found a significant effect (being unmarried was significantly associated with burnout). None of these studies was prospective.
Professional and clinical practice characteristics
These characteristics included specialty, years in practice, type and size of practice setting, management support (ie, staffing, training resources), compensation or reimbursement. Other variables were job stress, autonomy, flexibility, work–life balance, workload/caseload (time spent on patient care, number of patients seen per week, hours worked, nights worked on call per week, charting or paperwork, electronic health record or computerisation) and team functioning.
Workload or job stress, as assessed by longer work hours, more shifts per month, on-call time and overall higher 'busyness' (eg, higher patient volume or per cent of time in direct patient care) was a consistent predictors of burnout. Of 56 studies, most found that workload was a significantly associated predictor for burnout. One study found that multiple workload factors including more hours worked, more nights on call, higher outpatient volume and higher percent of time in clinical practice were associated with higher burnout risk. One study found that working more than 60 hours per week, another for more than 70 hours per week and two of more than 80 hours a week was associated with a greater likelihood of burnout. In addition, working more than a one-night shift per week was associated with more burnout in a study of paediatric department Chairs.50 Five prospective studies provide the strongest evidence for workload—resident duty hours and shift type provides evidence that fatigue leads to increased burnout and workload among a sample of physiatrists was significantly associated with higher rates of burnout. Alternatively, satisfaction with workload, control over workload, workplace engagement were protective factors for burnout.
A large number of studies assessed the number of years in practice, many among medical residents comparing, for example, first year residents to others. Of the 45 studies, 16 found that practice duration was a predictor of burnout. One study identified the number of years in practice as a positive predictor of burnout in a sample of surgeons and another found that neurosurgery residents and postgraduate neurosurgeons experienced significantly higher burnout. However, other studies found that years in practice was negatively associated with burnout. One study among breast surgeons found that higher postgraduate year level was significantly associated with lower burnout, and one found that residents had more burnout than faculty. Among the five prospective studies, two found that more years in practice predict less burnout, one found that more practice years lead to more burnout, and two found no association.
A total of 34 studies examined specialty or subspecialty as a predictor of burnout but only 13 found an effect. One large study of all specialties observed wide variation in burnout across them. The highest rates were among frontline primary care physicians (ie, family medicine, general internal medicine and emergency medicine physicians). Studies of surgeons have found trauma surgeons to have higher burnout than other specialites. Five studies used prospective designs. One found that second-year residents in urology, neurology, emergency medicine and general surgery were at higher risk of burnout compared with internal medicine or dermatology.48 Another study found that primary care providers were more burned out than most of the other specialties studies.51 The other three studies47 51 52 found no effect.
Practice setting was also assessed in 35 studies; 26 found no effect. Among the eight studies that found positive effects, one study of hospice and palliative care providers identified smaller organisations as a factor associated with greater burnout. Working in profit-oriented clinical settings was also associated with more burnout in a study comparing physicians in end-of-life care compared with other general specialties. One found that practicing in a university or academic medical setting (vs non-university) was a significant predictor of higher burnout. A study of occupational and environmental physicians found that burnout was highest among physicians in government practice settings compared with physicians in private medical centre groups, occupational medicine employers, hospitals or medical centre groups or consulting groups. There were two prospective studies—one found that providers in private practice compared with academic and veteran hospital settings had lower burnout than providers in active military practices.44 The other found that community-based surgeons were more likely to experience burnout compared with surgeons in academic settings.53
Twenty studies addressed support from management, organisational leadership or mentors, and of these, 15 found an effect. One study found that feeling unsupported by leadership was linked with higher burnout. In another study, surgical trainees who did not have a self-identified mentor were significantly more likely to report burnout and residents that had a structured mentorship had lower burnout risk.54 High-quality supervisor leadership was also correlated with lower burnout among physicians and scientists in a large healthcare organisation. Unfavourable physician evaluations of supervisors and lower perceptions of meaningful feedback and professional development were associated with a greater degree of burnout, while feeling that faculty cared about the medical oncology fellows' educational success was protective against burnout. Finally, alignment with leadership values was also associated with lower burnout. Of the two prospective studies, one found that leadership support was associated with higher burnout, whereas the other found no effect.
Job autonomy, including increased flexibility in work schedule, was evaluated in 25 studies, 16 with an association. For example, reported autonomy served as a protective factor while perceived lack of control over work conditions and dissatisfaction with clinical autonomy were associated with greater burnout. One of the studies of military providers found that staying beyond the initial active duty service obligation was a protective factor for burnout.55 Among the seven prospective studies, six suggested that flexibility and clinical autonomy may protect providers against future burnout.
Problems with work–life balance including work-home conflicts and dissatisfaction with work–life integration were a common predictor of burnout across the 31 studies. The studies reported positive associations with burnout, including three studies with a prospective design46 52 56 adding strength to findings for this predictor.
Of the 10 studies that looked at the effect of compensation and reimbursement as a burnout predictor, 5 found an effect. In one study, additional compensation for consult calls was a significant protective factor for burnout. Another study found that concern about reimbursement was a factor associated with higher burnout. Having compensation based entirely on billing was associated with greater burnout. However, method of compensation was not a significant predictor of burnout in four studies. The other two studies found no effect.57 58 Similarly, only one of six studies reported an association between salary and burnout; all other studies found no effect.
Salary was identified as burnout predictors in six studies. Only one had a significant association. None of the studies used a prospective design.
Psychological health factors
Several studies examined provider psychological health factors associated with burnout. These factors included overall distress, depression, anxiety, suicidal ideation, personality disorders and personality traits.
Out of 14 studies that assessed depression as a predictor, 9 found that depression was significantly associated with higher burnout, including one prospective study. In addition, two studies found that providers who had suicidal ideation had higher burnout scores.
Anxiety was examined in five studies and was identified as a statistically significant predictor in three of these,48 59 60 including one prospective study.48 One study found that, among surgery residents, post-traumatic stress disorder was associated with high risk for professional burnout.61
Health risks and health behaviour factors
Among 12 studies, none of which were prospective, that examined physical health problems as a predictor, 7 identified low back pain, physical inactivity and distress from the physical work environment, including those attributed to electronic health record use as contributing to burnout. Two studies looked at the effect of physical quality of life but only one found it to be protective against burnout.
Twelve studies included substance use as a potential predictor, eight found no association with burnout. Of those that looked at alcohol use, higher alcohol consumption was identified as a predictor; the studies reported that consuming >5 drinks per week, alcohol consumption more than once per week and a high score on an alcohol abuse screener were associated with higher odds of burnout. Two studies addressed tobacco use, one looked at cannabis use and two at general substance use but did not find effects on burnout. Several studies looked at additional individual problems that adversely affect burnout. Three studies identified poor access to mental healthcare services or reluctance to seek mental healthcare as burnout predictors.
Three of nine studies found that sleep deprivation was associated with greater burnout; six had no association. Of the three prospective design studies, two found an association.62 63
Some studies looked at health behaviours that have potential to protect against or minimise burnout. Among the 11 studies of exercise and physical activity, 5 found it to be a protective factor,62–66 while the others found no effect. One study found that reporting good to excellent health67 was also protective.
Meditation and mindfulness specifically were assessed in eight studies. Five studies that examined the effect of mindfulness on burnout found that it was a protective factor. Three of these were based on prospective data. One of the three 68 found an association while the other three did not.
Psychosocial variables
The last category of predictors included social and psychological mechanisms such as perceived control, coping and social support. Factors associated with higher burnout included social stress outside of work. The role of coping strategies was unclear as studies reported conflicting results. On the other hand, several predictors had protective effects. Among all 17 studies that looked at perceived control, 10 found significant effects, all but one indicating that more perceived control is a protective factor. Four studies used prospective designs.47 52 56 69
Coping was a predictor in eight studies. Across studies, findings were inconsistent with only three studies reporting a protective effect and no effect. None of these studies used a prospective design.
Twenty-five studies identified social support as a factor associated with burnout. Of these studies, 12 found it to be a protective effect, but 13 did not. Of the six prospective studies, only two reported an association.
This review of predictors associated with burnout revealed a large number of studies spanning a wide array of different types of predictors. How predictors and burnout measures were operationalised also varied across studies. Age and gender were the most commonly studied demographic characteristics with the balance of findings pointing to younger age and female gender associated with more burnout, but more studies found no association and there were some conflicting results.
Among professional and clinical practice characteristics, unsupportive leadership, workload, job autonomy and poor work–life balance stand out as being important predictors of burnout while supportive leadership, perceived autonomy and adequate time spent outside of work are protective factors. Psychological health problems, such as anxiety, may be associated with greater burnout. Poor physical health and health behaviours such as lack of sleep were also predictors of greater burnout while exercise and meditation appear to have a protective effect. Finally, while social and psychological perceptions and experiences such as lack of control and social stress were found to increase burnout, other psychosocial factors were found to decrease or ameliorate burnout such as social support.
While we did identify several predictors of burnout, the body of evidence also shows that many predictors showed inconsistent and conflicting results across individual studies. Despite the large research volume, prospective studies that measure potential predictors to predict burnout at a later date are still sparse. The existing literature is dominated by studies documenting concurrent associations, that is, predictors and the outcome burnout are measured at the same time or are retrospectively assessed. These study designs do not allow definitive statements regarding predictors of burnout. In particular, in some cases, it is unclear whether burnout exacerbates health issues such as sleep problems or vice versa with burnout exacerbating sleep problems. More prospective studies are urgently needed.
Drawing attention to the differential impacts of workplace stressors leading to burnout and the consequences of having burnout across different demographic groups remains important. Consistent with West et al, both organisational-level interventions such as adequate staffing, supportive leadership and individual-level interventions such as training providers to recognise the signs of burnout and ways to address those signs are needed to lessen the onset of this growing problem among busy healthcare providers.70 Of note, we also identified seven studies that examined the association of COVID-19-related predictors of burnout and six found effects. Two studies found that caring for patients with COVID-19 increased burnout (#15263 & 15074). Another study found that exposure to patients being tested for COVID-19 was associated with burnout (#15206). Two studies found that providers experiencing COVID-19-related stress and challenges were more likely to report burnout (#15364 & # 15026). Another study looked at burnout specifically related to COVID-19 and found that women reported more burnout but older providers and providers with more years in practice reported less burnout (#15120). One of these studies did not find that COVID-19 surge or case rate were associated with burnout.
This study has several strengths. It incorporates a broader range of predictors (both individual level and organisational level) and uses a wider definition of healthcare providers than have previous systematic reviews to identify predictors of burnout. However, there are a few limitations that need to be considered when interpreting the findings. We did not include studies that exclusively predicted those other constructs such as resilience and excluded studies that reported on only a single component of burnout (eg, emotional exhaustion). By doing so, we may have under-represented some predictors that are linked to subscales. We also narrowed our sample to only medical and behavioural health provides whom may independently manage patients. Therefore, we do not represent potential burnout that may be faced by other types of providers such as nurses and medical assistants. These limitations limit the generalisability of findings across diverse outcomes and types of providers.
The challenges faced by healthcare professionals, particularly during the ongoing pandemic, underscore the need for system-level strategies for keeping the workforce healthy. This includes organisational factors that contribute to burnout of the workforce that is so critical to our healthcare system. Healthcare organisations should embrace compassionate leadership styles that trickle down throughout organisations to frontline healthcare workers and evaluating the impact of training initiatives, so that they may be scaled-up and replicated broadly.
Our systematic review to identify the predictors of burnout with a specific focus on burnout among healthcare providers in the USA found several individual-level and organisational-level factors associated with an increased risk for burnout. Factors such as supportive leadership and job autonomy were found to be protective against burnout, but questions remain as how to systematically operationalise such complex phenomenon to successfully prevent or reduce burnout. Many predictors showed inconsistent results, sometimes showing an association, sometimes not, and even documenting conflicting findings regarding the direction of associations. Going forward, interrogating and refining our understanding of burnout as well as actively and prospectively measuring burnout will be critical. In addition, studies of burnout among healthcare providers will have to remain in step with the rapidly shifting context of healthcare in the USA.
This study does not involve human participants or animals.
We thank Bradley Belsher for overseeing the project and providing helpful input. We thank Margie Danz and Sean Grant for helpful content input; Olamigoke Akinniranye, Armenda Bialas, Christine Chen and Dung Huynh for research assistance; and Judy Bearer for administrative support. We thank Erin Beech, Nigel Bush, Erin Finley, Marija Kelber, Julia Rollison, Lisa Rubenstein and Amanda Stewart for helpful comments and suggestions. The content and opinions expressed in this publication are solely the responsibility of the authors and do not reflect the official position of PHCoE. This study is registered with PROSPERO (CRD4202014836).
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. A survey evaluating burnout, health status, depression, reported alcohol and substance use, and social support of Anesthesiologists. Anesth Analg 2017;125:2009–18.doi:10.1213/ANE.0000000000002298pmid:http://www.ncbi.nlm.nih.gov/pubmed/28991114
Mirvis DM,
Graney MJ,
Kilpatrick AO
. Burnout among leaders of department of Veterans Affairs medical centers: contributing factors as determined by a longitudinal study. J Health Hum Serv Adm 1999;21:390–412.pmid:http://www.ncbi.nlm.nih.gov/pubmed/10538673
Sliwa JA,
Clark GS,
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. Burnout in Diplomates of the American Board of physical medicine and Rehabilitation-Prevalence and potential drivers: a prospective cross-sectional survey. Pm R 2019;11:83–9.doi:10.1016/j.pmrj.2018.07.013pmid:http://www.ncbi.nlm.nih.gov/pubmed/30703291
. Resilience and burnout among physicians and the general us working population. JAMA Netw Open 2020;3:e209385.doi:10.1001/jamanetworkopen.2020.9385pmid:http://www.ncbi.nlm.nih.gov/pubmed/32614425
Lindeman B,
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. Association of burnout with emotional intelligence and personality in surgical residents: can we predict who is most at risk? J Surg Educ 2017;74:e22–30.doi:10.1016/j.jsurg.2017.11.001pmid:http://www.ncbi.nlm.nih.gov/pubmed/29198973
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. Burnout in pediatric residents: three years of national survey data. Pediatrics 2020;145:11.doi:10.1542/peds.2019-1030pmid:http://www.ncbi.nlm.nih.gov/pubmed/31843859
Del Carmen MG,
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. Trends and factors associated with physician burnout at a Multispecialty academic faculty practice organization. JAMA Netw Open 2019;2:e190554.doi:10.1001/jamanetworkopen.2019.0554pmid:http://www.ncbi.nlm.nih.gov/pubmed/30874776
Burke SE,
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. Association of clinical specialty with symptoms of burnout and career choice regret among US resident physicians. JAMA 2018;320:1114–30.doi:10.1001/jama.2018.12615
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. A longitudinal study exploring learning environment culture and subsequent risk of burnout among resident physicians overall and by gender. Mayo Clin Proc 2021;96:2168–83.doi:10.1016/j.mayocp.2020.12.036pmid:http://www.ncbi.nlm.nih.gov/pubmed/34218879
McPhillips HA,
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. Role of a pediatric department chair: factors leading to satisfaction and burnout. J Pediatr 2007;151:425–30.doi:10.1016/j.jpeds.2007.03.016pmid:http://www.ncbi.nlm.nih.gov/pubmed/17889082
Major-Elechi B,
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. Physicians' Ratings of their Supervisor's Leadership Behaviors and Their Subsequent Burnout and Satisfaction: A Longitudinal Study. Mayo Clin Proc 2021;96:2598–605.doi:10.1016/j.mayocp.2021.01.035
Rabatin J,
Williams E,
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. Predictors and outcomes of burnout in primary care physicians. J Prim Care Community Health 2016;7:41–3.doi:10.1177/2150131915607799pmid:http://www.ncbi.nlm.nih.gov/pubmed/26416697
Lam C,
Kim Y,
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. Burnout and resiliency in Mohs surgeons: a survey study. Int J Womens Dermatol 2021;7:319–22.doi:10.1016/j.ijwd.2021.01.011pmid:http://www.ncbi.nlm.nih.gov/pubmed/34222590
C Goldman C,
F L Carvalho F, et al
. Resident burnout in USA and European urology residents: an international concern. BJU Int 2019;124:349-356.doi:10.1111/bju.14774pmid:http://www.ncbi.nlm.nih.gov/pubmed/30993851
Summers SM,
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April MD, et al
. The prevalence of faculty physician burnout in military graduate medical education training programs: a cross-sectional study of academic physicians in the United States department of defense. Mil Med 2019;184:e522–30.doi:10.1093/milmed/usz055pmid:http://www.ncbi.nlm.nih.gov/pubmed/30941415
Cydulka RK,
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. Career satisfaction in emergency medicine: the ABEM longitudinal study of emergency physicians. Ann Emerg Med 2008;51:714–22.doi:10.1016/j.annemergmed.2008.01.005pmid:http://www.ncbi.nlm.nih.gov/pubmed/18395936
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. Distress and career satisfaction among 14 surgical specialties, comparing academic and private practice settings. Ann Surg 2011;254:558–68.doi:10.1097/SLA.0b013e318230097epmid:http://www.ncbi.nlm.nih.gov/pubmed/21946217
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. Burnout and career satisfaction in women neurologists in the United States. J Womens Health 2019;28:515–25.doi:10.1089/jwh.2017.6888pmid:http://www.ncbi.nlm.nih.gov/pubmed/30620238
Firulescu L,
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. 42 training forgiveness – a novel approach to reducing physician burnout. CNS Spectr 2019;24:198–9.doi:10.1017/S109285291900035X
Kuhn G,
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. Tolerance for uncertainty, burnout, and satisfaction with the career of emergency medicine. Ann Emerg Med 2009;54:106–13.doi:10.1016/j.annemergmed.2008.12.019pmid:http://www.ncbi.nlm.nih.gov/pubmed/19201058
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. Ptsd and surgical residents: everybody hurts… sometimes. Am J Surg 2017;214:1118–24.doi:10.1016/j.amjsurg.2017.08.037pmid:http://www.ncbi.nlm.nih.gov/pubmed/28987413
Boss RW,
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. Burnout and its correlates in emergency physicians: four years' experience with a wellness booth. Acad Emerg Med 1996;3:1156–64.doi:10.1111/j.1553-2712.1996.tb03379.xpmid:http://www.ncbi.nlm.nih.gov/pubmed/8959173
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. Longitudinal analyses of pediatrician burnout. Acad Pediatr 2019;19:256–62.doi:10.1016/j.acap.2018.11.006pmid:http://www.ncbi.nlm.nih.gov/pubmed/30412766
Doolittle BR
. Association of burnout with emotional coping strategies, friendship, and institutional support among internal medicine physicians. J Clin Psychol Med Settings 2020.doi:10.1017/s109285291900035x
Shenoi AN,
Kalyanaraman M,
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. Burnout and psychological distress among pediatric critical care physicians in the United States. Crit Care Med 2018;46:116–22.doi:10.1097/CCM.0000000000002751pmid:http://www.ncbi.nlm.nih.gov/pubmed/29016364
Verduzco-Gutierrez M,
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. How physician compensation and education debt affects financial stress and burnout: a survey study of women in physical medicine and rehabilitation. Pm R 2021;13:836–44.doi:10.1002/pmrj.12534pmid:http://www.ncbi.nlm.nih.gov/pubmed/33301648
Starmer AJ,
Freed GL
. Burnout, and satisfaction of early career pediatricians. Pediatrics 2016;137:1–10.doi:10.1542/peds.2015-3183
Braun SE,
Auerbach SM,
Rybarczyk B, et al
. Mindfulness, burnout, and effects on performance evaluations in internal medicine residents. Adv Med Educ Pract 2017;8:591–7.doi:10.2147/AMEP.S140554pmid:http://www.ncbi.nlm.nih.gov/pubmed/28860889
Mullins CH,
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. Do internal or external characteristics more reliably predict burnout in resident physicians: a multi-institutional study. J Surg Educ 2020;77:e86–93.doi:10.1016/j.jsurg.2020.09.024pmid:http://www.ncbi.nlm.nih.gov/pubmed/33077415
Contributors LSM conducted the analysis and drafted the manuscript. KB reviewed the data abstraction. JC extracted and coded the data. JL developed the search strategy. AM managed the database and constructed tables and figures. SH (guarantor) designed the study and reviewed the data abstraction and analysis. All authors edited the manuscript.
Funding This work was supported by the Department of Defense Psychological Health Center of Excellence (PHCoE) contract number [HQ0034-16-D-0001].


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Officials with the Wilmington Fire Department are investigating a fatal house fire that happened in the 4400 block of Peachtree Avenue on Sunday night.
This entry was posted on Monday, October 20th, 2014 at 11:10 am	and is filed under Wilmington. You can follow any responses to this entry through the RSS 2.0 feed. Responses are currently closed, but you can trackback from your own site.


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text:
/* TEMPLATE GENERATED TESTCASE FILE
Filename: CWE401_Memory_Leak__wchar_t_calloc_65a.c
Label Definition File: CWE401_Memory_Leak.c.label.xml
Template File: sources-sinks-65a.tmpl.c
*/
/*
 * @description
 * CWE: 401 Memory Leak
 * BadSource: calloc Allocate data using calloc()
 * GoodSource: Allocate data on the stack
 * Sinks:
 *    GoodSink: call free() on data
 *    BadSink : no deallocation of data
 * Flow Variant: 65 Data/control flow: data passed as an argument from one function to a function in a different source file called via a function pointer
 *
 * */

#include "std_testcase.h"

#include <wchar.h>

#ifndef OMITBAD

/* bad function declaration */
void CWE401_Memory_Leak__wchar_t_calloc_65b_badSink(wchar_t * data);

void CWE401_Memory_Leak__wchar_t_calloc_65_bad()
{
    wchar_t * data;
    /* define a function pointer */
    void (*funcPtr) (wchar_t *) = CWE401_Memory_Leak__wchar_t_calloc_65b_badSink;
    data = NULL;
    /* POTENTIAL FLAW: Allocate memory on the heap */
    data = (wchar_t *)calloc(100, sizeof(wchar_t));
    if (data == NULL) {exit(-1);}
    /* Initialize and make use of data */
    wcscpy(data, L"A String");
    printWLine(data);
    /* use the function pointer */
    funcPtr(data);
}

#endif /* OMITBAD */

#ifndef OMITGOOD

/* goodG2B uses the GoodSource with the BadSink */
void CWE401_Memory_Leak__wchar_t_calloc_65b_goodG2BSink(wchar_t * data);

static void goodG2B()
{
    wchar_t * data;
    void (*funcPtr) (wchar_t *) = CWE401_Memory_Leak__wchar_t_calloc_65b_goodG2BSink;
    data = NULL;
    /* FIX: Use memory allocated on the stack with ALLOCA */
    data = (wchar_t *)ALLOCA(100*sizeof(wchar_t));
    /* Initialize and make use of data */
    wcscpy(data, L"A String");
    printWLine(data);
    funcPtr(data);
}

/* goodB2G uses the BadSource with the GoodSink */
void CWE401_Memory_Leak__wchar_t_calloc_65b_goodB2GSink(wchar_t * data);

static void goodB2G()
{
    wchar_t * data;
    void (*funcPtr) (wchar_t *) = CWE401_Memory_Leak__wchar_t_calloc_65b_goodB2GSink;
    data = NULL;
    /* POTENTIAL FLAW: Allocate memory on the heap */
    data = (wchar_t *)calloc(100, sizeof(wchar_t));
    if (data == NULL) {exit(-1);}
    /* Initialize and make use of data */
    wcscpy(data, L"A String");
    printWLine(data);
    funcPtr(data);
}

void CWE401_Memory_Leak__wchar_t_calloc_65_good()
{
    goodG2B();
    goodB2G();
}

#endif /* OMITGOOD */

/* Below is the main(). It is only used when building this testcase on
   its own for testing or for building a binary to use in testing binary
   analysis tools. It is not used when compiling all the testcases as one
   application, which is how source code analysis tools are tested. */

#ifdef INCLUDEMAIN

int main(int argc, char * argv[])
{
    /* seed randomness */
    srand( (unsigned)time(NULL) );
#ifndef OMITGOOD
    printLine("Calling good()...");
    CWE401_Memory_Leak__wchar_t_calloc_65_good();
    printLine("Finished good()");
#endif /* OMITGOOD */
#ifndef OMITBAD
    printLine("Calling bad()...");
    CWE401_Memory_Leak__wchar_t_calloc_65_bad();
    printLine("Finished bad()");
#endif /* OMITBAD */
    return 0;
}

#endif

redpajama_set_name: RedPajamaGithub


Boston Logan Airport, 30 April.
As usual, my first opportunity to reflect on this mini tour is at the airport on my way home. I think most of my creative writing has been done in equally sterile and impersonal spaces – while waiting. Two weeks of screenings almost every day, and many conversations and interesting encounters later, I'm sitting here with new questions, or seeds if you like, given to me by an incredibly varied audience. From Mexico City and Morelia to Toronto, Canada and then to Boston, USA, I've been surprised both by the different reactions at different screenings of the same festivals, but also by the similarity of responses from different nationalities.
I can make no generalization as to what country or what age group my film is best suited for, but I can see a clear connection between those who usually stay on after the Q&A and share their life story, their own project or understanding with me. So to you who shared your thoughts and feelings, whether they were about personal matters or local activism – thank you, I am processing what you shared with me now and wish you good luck!
"The dependency on money is not a philosophical problem; it's an incredibly real one..."
Romantic relationships are still intertwined with monetary needs, and the dependency on money is not a philosophical problem; it's an incredibly real one for each one of us who don't belong to that fraction of the world's population who are economically independent. We need each other to enable our individual liberations, and as Jacque says in the film, "change is always painful." But it is also exhilarating, especially if you have got to the point where not to change is not an option any more.
It takes courage of the kind a young man in Toronto showed when he decided to leave his secure salary and job in a bank. He had started to understand how the system he was working within worked around him, and started to feel more and more out of place. Although not knowing what to do instead in order to support himself, or what other social system he would rather be working towards, he knew he had to change and took that frightening step into the unknown.
The film is sometimes led by theory, and sometimes by emotion, since this is how I think we evolve. I often get the question if I think change has to come from the inside or the outside – if we change through social reforms that shape our behaviour and feelings, or feelings that lead to social reform.
I think change comes from connecting the two. There is enough emotion in the world to change it – enough anger, frustration, care, passion, humanism and environmentalism all wanting things to be different. And there is certainly enough knowledge – theory, science and technology that could be applied very differently, would it be redirected to do so. The problem is that the 'tools' for changing the world are so often not in the hands of those wanting to change it.
People can storm parliaments and riot in the streets without knowing what they want, and a scientist can create the most marvellous chemical reaction, having no idea what it will be used for. In the film Jacque points out that whenever a nation runs into problems, they call scientists to ask for solutions, and they always come up with a solution. The atomic bomb and the moon landing were both projects considered impossible at the time – but with enough funding and motivation, these projects were realised very quickly. He goes on to point out that "we never asked scientists how to feed everyone on the planet" or to develop a new infrastructure without social stratification.
Of course this is what Jacque has done as a scientist, working solely on social change. Understanding how our economic system works, this is what we have to do: find solutions ourselves, because – unless someone can make money out of it – there is no-one who will step in and do it for us; and connect those with the theoretical skills with those who crave for them to change their lives.
This is what the project of another young man in Morelia is about. He is trying to connect the skills within the science department of his university with the local farmers who are suffering more and more from new technology imposed on them by multinational companies.
It's of course brave to take on the multinationals for the sake of human and environmental benefits. Companies with enormous means to buy the knowledge needed to serve their cause seem to have no problem finding scientists to work for them. This man has the knowledge and wants to give it away for free, motivated by other values. We need people like him, we have always needed these kind of people.
As the one of the students at a design school in Mexico city pointed out, it is capitalism that has enabled us to specialise and excel in our particular fields. And she is right – capitalism has given us the chance to specialise in the same way as it has enabled an incredibly rapid development of technology through a monetary incentive. But where is this incentive taking us? And what is this separation doing to our holistic understanding of the world around us and ourselves? Perhaps we needed it for a time, perhaps we have to thank capitalism for this unique chance of liberation?
If so – I thank you capitalism for taking us here, but now it's time to let us go!


American Holistic Veterinary Medicine Association 2009 Conference, 7p.
"An Introduction to Veterinary Osteopathy; Treating the Whole Body Through Manual Therapy"
"Shoulder Injuries: Getting to the HEART of it!"
"Getting it Out of Your (Portal) System: Vascular Dynamics of the Liver and Associated Organs"
"Osteopathy from a VASCULAR and FASCIAL prospective!"
James Braly, M.D. and Ron Hoggan, M.A., 2002, Dangerous Grains, Avery, NY, 244pp.
Shari Lieberman, PhD, CNS, FACN, 2007, The Gluten Connection, Rodale Books, NY, 281pp.
William Davis, M.D., 2011, Wheat Belly, Rodale Books, NY, 292pp.
An Illustrated Text, 4th Edition, Schlutersche, Berlin, Germany, 209pp.
Saunders Elsevier, St. Louis, Missouri, 291pp.
Howard Evans, PhD, 1993, Miller's Anatomy of the Dog, 3rd Edition, W.B. Saunders Co., 1,113pp.
Thomas W. Myers, 2009, Anatomy Trains, 2nd Edition, Elsevier Limited, 295pp.
Alfred Pishinger, 2007, The Extracellular Matrix and Ground Regulation, North Atlantic Books, 204pp.
Robert Schlep, Thomas W. Findley, Leon Chaitow, Peter A. Huijing, 2012, Fascia: The Tensional Network of The Human Body, Elsevier Limited, 515pp.
Gerald H. Pollack, 2013, The Fourth Phase of Water 357pp.
assist in the Functional Indirect Technique classes when they are not on set for a movie or commercial.
One favorite dog of the class is Flint who just turned 18.


No need to pencil in a pasta night—our Penne Rigate is easy to enjoy any time with a variety of sauces. Penne rigate are hollow noodles cut on a slant and ribbed so they excel at sticking to the yummy sauce you make with it. We love Penne Rigate with pestos, creamy pink or red tomato sauces, or with a simple mixture of oil, garlic and your favorite vegetable. Buon' appetito!
Bring four quarts of salted water to a boil. Add the entire bag of Penne Rigate noodles. Continue to boil on high heat, stirring occasionally. Once the water returns to a rolling boil (approx. two minutes) lower the heat. Continue cooking for 6-9 minutes, checking for doneness. Drain pasta and mix with sauce as desired.