What makes medical graduates practise close to home?
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Biomedical subjects
Publications and source records attributed to John Wootton.
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In summary, rural practice in Canada has had its image burnished in recent years and its model of practice (comprehensive, multi-tasking autonomous practice in multiple environments--"polyvalence" in good Québecois) increasingly recognized as an efficient model, which could apply to many settings. Where it thrives it has succeeded in distributing these tasks among enough individuals to allow itself room to breathe, and it has developed its skills and scope of practice in ways that support the self-reinforcing duality of competence and confidence. In short, it has made rural practice into "something someone would want to do." Whether this success will be repeated in enough places for it to be said that rural medicine is no longer in jeopardy remains to be seen.
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An organized approach to CXR interpretation will take you most of the way toward your goal, which is to lead you to a well grounded differential diagnosis or, in the case of a normal CXR, to rule out a variety of possibilities. Working in collaboration with your radiologist, your own interpretations will allow you to institute treatment in a timely fashion, and the subsequent radiological review will serve to confirm, or correct, initial impressions. Over time this process will improve your skill, and your patients will reap the benefits.
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We have investigated intragenic recombination in Block 2 of the merozoite surface protein-1 (MSP-1), where three allele-specific families: K1, Mad20, and RO33 were previously known. Using parasites from western Kenya, we have found a fourth Block 2 allele type, which is a recombinant between Mad20 and RO33 alleles. These recombinant alleles, which we have termed MR, contain sequence from the 5' region of Mad20 and the 3' region of RO33. The results of this study provide new data on the complexity of the MSP-1 antigen gene, which is a candidate vaccine antigen, and further support the importance of intragenic recombination in generating genetic variability in Plasmodium falciparum parasites in nature.