Orbit structure and (reversing) symmetries of toral endomorphisms on rational lattices

We study various aspects of the dynamics induced by integer matrices on the invariant rational lattices of the torus in dimension 2 and greater. Firstly, we investigate the orbit structure when the toral endomorphism is not invertible on the lattice, characterising the pretails of eventually periodic orbits. Next we study the nature of the symmetries and reversing symmetries of toral automorphisms on a given lattice, which has particular relevance to (quantum) cat maps.Comment: 29 pages, 3 figure

A design thinking approach to evaluating interprofessional education

The complex challenge of evaluating the impact of interprofessional education (IPE) on patient and community health outcomes is well documented. Recently, at the Radcliffe Institute for Advanced Study in the United States, leaders in health professions education met to help generate a direction for future IPE evaluation research. Participants followed the stages of design thinking, a process for human-centred problem solving, to reach consensus on recommendations. The group concluded that future studies should focus on measuring an intermediate step between learning activities and patient outcomes. Specifically, knowing how IPE-prepared students and preceptors influence the organisational culture of a clinical site as well as how the culture of clinical sites influences learners' attitudes about collaborative practice will demonstrate the value of educational interventions. With a mixed methods approach and an appreciation for context, researchers will be able to identify the factors that foster effective collaborative practice and, by extension, promote patient-centred care

Ecological distribution conflicts and the vocabulary of environmental justice

Unidad de excelencia María de Maeztu MdM-2015-0552There is a fundamental clash between economy and the environment due to the growing social metabolism of industrial economies. Energy cannot be recycled. Therefore, the energy from the fossil fuels is used only once, and new supplies of coal, oil, and gas must be obtained from the "commodity extraction frontiers". Similarly, materials are recycled only in part, and therefore, even an economy that would not grow would need fresh supplies of iron ore, bauxite, copper, and paper pulp. The industrial economy is entropic. Meanwhile, permanent "funds" such as aquifers, forests, and fisheries are overexploited, the fertility of the soil is jeopardized and biodiversity is depleted. Thus, the changing social metabolism of industrial economies (including waste disposal such as the excessive production of carbon dioxide) gives rise to growing numbers of ecological distribution conflicts that sometimes overlap with other social conflicts on class, ethnicity or indigenous identity, gender, caste, or territorial rights. The term Ecological Distribution Conflicts (EDC) was coined to describe social conflicts born from the unfair access to natural resources and the unjust burdens of pollution. Such conflicts give birth to movements of resistance, to the point that we can speak already of a global movement for Environmental Justice

Physicians’ Use of Email With Patients: Factors Influencing Electronic Communication and Adherence to Best Practices

BACKGROUND: With the public’s increased use of the Internet, the use of email as a means of communication between patients and physicians will likely increase. Yet, despite evidence of increased interest by patients, email use by physicians for clinical care has been slow. OBJECTIVE: To examine the factors associated with physician-patient email, and report on the physicians’ adherence to recognized guidelines for email communication. METHODS: Cross-sectional survey (March–May, 2005) of all primary care physicians (n = 10253), and a 25% stratified, random sample of all ambulatory clinical specialists (n = 3954) in the state of Florida. Physicians were surveyed on email use with patients, adherence to recognized guidelines, and demographics. RESULTS: The 4203 physicians completed the questionnaire (a 28.2% participation rate). Of these, 689 (16.6%) had personally used email to communicate with patients. Only 120 (2.9%) used email with patients frequently. In univariate analysis, email use correlated with physician age (decreased use: age > 61; P = .014), race (decreased use: Asian background; P < .001), medical training (increased use: family medicine, P = .001; or surgical specialty, P = .007; but not internal medicine, P = .112), practice size (> 50 physicians, P < .001), and geographic location (urban 17.2% vs. rural, 7.9%; P < .001). Multivariate modeling showed that only practice size greater than 50 (OR = 1.94; 95% CI = 1.01-3.79) and Asian-American race (OR = 0.26; 95% CI = 0.14-0.49) were related to email use with patients. Remarkably, only 46 physicians (6.7%) adhered to at least half of the 13 selected guidelines for email communication. CONCLUSIONS: This large survey of physicians, practicing in ambulatory settings, shows only modest advances in the adoption of email communication, and little adherence to recognized guidelines for email correspondence. Further efforts are required to educate both patients and physicians on the advantages and limitations of email communication, and to remove fiscal and legal barriers to its adoption