Burnout among surgeons before and during the SARS-CoV-2 pandemic: an international survey

Background: SARS-CoV-2 pandemic has had many significant impacts within the surgical realm, and surgeons have been obligated to reconsider almost every aspect of daily clinical practice. Methods: This is a cross-sectional study reported in compliance with the CHERRIES guidelines and conducted through an online platform from June 14th to July 15th, 2020. The primary outcome was the burden of burnout during the pandemic indicated by the validated Shirom-Melamed Burnout Measure. Results: Nine hundred fifty-four surgeons completed the survey. The median length of practice was 10 years; 78.2% included were male with a median age of 37 years old, 39.5% were consultants, 68.9% were general surgeons, and 55.7% were affiliated with an academic institution. Overall, there was a significant increase in the mean burnout score during the pandemic; longer years of practice and older age were significantly associated with less burnout. There were significant reductions in the median number of outpatient visits, operated cases, on-call hours, emergency visits, and research work, so, 48.2% of respondents felt that the training resources were insufficient. The majority (81.3%) of respondents reported that their hospitals were included in the management of COVID-19, 66.5% felt their roles had been minimized; 41% were asked to assist in non-surgical medical practices, and 37.6% of respondents were included in COVID-19 management. Conclusions: There was a significant burnout among trainees. Almost all aspects of clinical and research activities were affected with a significant reduction in the volume of research, outpatient clinic visits, surgical procedures, on-call hours, and emergency cases hindering the training. Trial registration: The study was registered on clicaltrials.gov "NCT04433286" on 16/06/2020

Pena natural y conmensuración de la pena = Natural penalty and sentencing process

Aborda a chamada “penalidade natural” e como a Filosofia descartou durante séculos considerá-la na pena judicial. Mostra como essa situação muda graças ao pensamento de Rousseau e ao trabalho de alguns criminalistas da era do Iluminismo. Busca estabelecer a relevância da punição natural no processo de comensuração da pena judicial, tendo como base o conceito moral de compaixão e a ideia legal de humanidade

Carta de Martín Luis Guzmán a Miguel de Unamuno. [S.l.], 19--?

Carta del escritor y periodista mexicano Martín Luis Guzmán a Miguel de Unamuno pidiéndole una cita para hablar del artículo que no van a publicar en “El Sol”

Carta de Martín Luis Guzmán a Miguel de Unamuno. [S.l.], 29 de noviembre de 1932

Carta del escritor y periodista mexicano Martín Luis Guzmán a Miguel de Unamuno comentándole que no puede publicar en “El Sol” el artículo que le envió porque sus ideas pueden chocar con el sentimiento republicano de los lectores y se lo devuelve, pero quieren que continúe colaborando con unos artículos más aceptables

Carta de Martín Luis Guzmán a Miguel de Unamuno. Madrid, 20 de octubre de 1927

Carta del escritor y periodista mexicano Martín Luis Guzmán a Miguel de Unamuno preguntándole si se ha enterado de los fusilamientos de México y le envía un cuestionario que quiere que responda e informándole que las respuestas se publicarán en “El Universal” de México

Por Don Lvis de Gvzman y Acvña, marques del Algaua, y Ardales contra el adelantado de Castilla sobre la sucesion del Estado de Dueñas...

A 026/08