The impact of medical students on rural general practitioner perceptors.

INTRODUCTION: As universities rely more heavily on rural GPs to precept medical students, the formation of symbiotic partnerships benefiting students, universities and GPs, becomes imperative. In order to develop and consolidate these partnerships Universities must understand who their rural GP preceptors are and how precepting impacts on them. METHODS: A review of the literature was undertaken to determine the significant themes of student impacts from articles where conclusions were clearly based on empirical findings. RESULTS: Forty-three articles were included in the final review, but only nine specifically looked at impacts on rural GPs. Impacts were categorised into six domains: personal; time; patient care; professional relationships and professional development; business and infrastructure; and recognition and remuneration. CONCLUSIONS: Literature specifically addressing the impact of precepting on rural GPs is scarce. Further studies are required to evaluate the relationship between the quality of teaching delivered to students, the type and length of student attachments and the likely impacts on rural GPs.

Desmoid tumour: a pleomorphic lesion.

BACKGROUND: Desmoid tumour (DT) is an uncommon locally invasive non-metastasizing neoplastic lesion. The aetiology of this tumour is unknown and its treatment is controversial. Twelve cases of DT are presented and the literature is reviewed. METHODS: Twelve cases of DT treated at our institution during a 3.5-year period are analysed and the literature reviewed. Ten patients were referred with a primary tumour, one with local recurrence and one patient with a second primary desmoid tumour. One patient had multiple mesenteric DT (familial adenomatous polyposis coli-FAP), and in the remaining 11 patients the tumour was located in the abdominal wall in four, at an extremity in three, in the upper back in two patients, in the pelvis in one and retroperitoneally in one. RESULTS: The largest mesenteric DT was marginally excised en bloc with total jejunectomy. In the remaining 11 DT, complete excision to microscopically tumour-free margins was possible in nine cases and to microscopically involved margins in two cases. At a mean follow-up of 22 months (range 7-38 months), one patient was alive with stable disease (Gardner's syndrome), 10 patients were alive and free of recurrence and one patient (9%) developed local recurrence which was re-excised-she is disease-free 10 months later. CONCLUSIONS: Complete excision is the main modality of treatment for primary and recurrent DT. This is feasible in most cases except for tumours involving the base of the bowel mesentery. Surgical resection alone achieved local control of the tumour in most of the patients in this series (92%).

Temporal responses to environmental scale in the lizard Anolis carolinensis (reptila, lacertilia, iguanidae).

An influence of spatial scale on temporal processing has been described in humans (De Long, 1981). The hypothesis that a similar relationship exists in reptiles was tested by placing twelve lizards in volumetrically constant but large-scale or small-scale "home" environments and alternately exposing them to large and small scale novel environments in a counterbalanced design. Behavioral measures included latencies and frequencies for four types of behavior associated with behavioral arousal and exploration and for duration of behavioral states. Results indicate (1) behavioral latencies are significantly reduced in small-scale novel environments and (2) as predicted, the ratio of latencies in large-scale divided by small-scale novel environments is essentially identical to the ratio of the scales of the environments themselves. Linear regression analyses relating latencies to the ratio yield results remarkably similar to those previously reported for temporal experience and spatial scale in human subjects. This research suggests that an experiential temporal-spatial relativity may be phylogenetically primitive.