An estimate of the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada.

BackgroundInterest in the impact of burnout on physicians has been growing because of the possible burden this may have on health care systems. The objective of this study is to estimate the cost of burnout on early retirement and reduction in clinical hours of practicing physicians in Canada.MethodsUsing an economic model, the costs related to early retirement and reduction in clinical hours of physicians were compared for those who were experiencing burnout against a scenario in which they did not experience burnout. The January 2012 Canadian Medical Association Masterfile was used to determine the number of practicing physicians. Transition probabilities were estimated using 2007-2008 Canadian Physician Health Survey and 2007 National Physician Survey data. Adjustments were also applied to outcome estimates based on ratio of actual to planned retirement and reduction in clinical hours.ResultsThe total cost of burnout for all physicians practicing in Canada is estimated to be $213.1 million ($185.2 million due to early retirement and $27.9 million due to reduced clinical hours). Family physicians accounted for 58.8% of the burnout costs, followed by surgeons for 24.6% and other specialists for 16.6%.ConclusionThe cost of burnout associated with early retirement and reduction in clinical hours is substantial and a significant proportion of practicing physicians experience symptoms of burnout. As health systems struggle with human resource shortages and expanding waiting times, this estimate sheds light on the extent to which the burden could be potentially decreased through prevention and promotion activities to address burnout among physicians

Isogeometric analysis for functionally graded microplates based on modified couple stress theory

Analysis of static bending, free vibration and buckling behaviours of functionally graded microplates is investigated in this study. The main idea is to use the isogeometric analysis in associated with novel four-variable refined plate theory and quasi-3D theory. More importantly, the modified couple stress theory with only one material length scale parameter is employed to effectively capture the size-dependent effects within the microplates. Meanwhile, the quasi-3D theory which is constructed from a novel seventh-order shear deformation refined plate theory with four unknowns is able to consider both shear deformations and thickness stretching effect without requiring shear correction factors. The NURBS-based isogeometric analysis is integrated to exactly describe the geometry and approximately calculate the unknown fields with higher-order derivative and continuity requirements. The convergence and verification show the validity and efficiency of this proposed computational approach in comparison with those existing in the literature. It is further applied to study the static bending, free vibration and buckling responses of rectangular and circular functionally graded microplates with various types of boundary conditions. A number of investigations are also conducted to illustrate the effects of the material length scale, material index, and length-to-thickness ratios on the responses of the microplates.Comment: 57 pages, 14 figures, 18 table

Complete Embedded Self-Translating Surfaces under Mean Curvature Flow

We describe a construction of complete embedded self-translating surfaces under mean curvature flow by desingularizing the intersection of a finite family of grim reapers in general position.Comment: 42 pages, 8 figures. v2: typos correcte

How does burnout affect physician productivity? A systematic literature review

BACKGROUND: Interest in the well-being of physicians has increased because of their contributions to the healthcare system quality. There is growing recognition that physicians are exposed to workplace factors that increase the risk of work stress. Long-term exposure to high work stress can result in burnout. Reports from around the world suggest that about one-third to one-half of physicians experience burnout. Understanding the outcomes associated with burnout is critical to understanding its affects on the healthcare system. Productivity outcomes are among those that could have the most immediate effects on the healthcare system. This systematic literature review is one of the first to explore the evidence for the types of physician productivity outcomes associated with physician burnout. It answers the question, “How does burnout affect physician productivity?” METHODS: A systematic search was performed of: Medline Current, Medline in process, PsycInfo, Embase and Web of Science. The search period covered 2002 to 2012. The searches identified articles about practicing physicians working in civilian settings. Articles that primarily looked only at residents or medical students were excluded. Productivity was captured by hours worked, patients seen, sick leave, leaving the profession, retirement, workload and presenteeism. Studies also were excluded if: (1) the study sample was not comprised of at least 50% physicians, (2) the study did not examine the relationship between burnout and productivity or (3) a validated measure of burnout was not used. RESULTS: The search identified 870 unique citations; 5 met the inclusion/exclusion criteria. This review indicates that globally there is recognition of the potential impact of physician burnout on productivity. Productivity was examined using: number of sick leave days, work ability, intent to either continue practicing or change jobs. The majority of the studies indicate there is a negative relationship between burnout and productivity. However, there is variation depending on the type of productivity outcome examined. CONCLUSIONS: There is evidence that burnout is associated with decreased productivity. However, this line of inquiry is still developing. A number of gaps are yet to be filled including understanding how to quantify the changes in productivity related to burnout

First occurrence of the little-known genus Noteriades (Hymenoptera, Megachilidae) from Vietnam: discovery of a new species and a key to the Southeast Asian fauna

The little-known megachiline genus Noteriades Cockerell, 1931 is recorded from Vietnam for the first time. A new species, Noteriades hangkia Tran, Engel & Nguyen sp. nov. is described and figured based on a series of females collected from the provinces of the northern and central highlands of Vietnam. The genus is briefly discussed and a new subtribe is established, Noteriadina Engel, Tran & Nguyen subtrib. nov. of Megachilini. Lastly, an identification key and distribution map are provided for those species occurring in Southeast Asia