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Things don't get better until those nerve endings regrow. And they grow very, very slowly. We have not found anything that makes them grow faster. CALLER: It got a lot better when I stopped taking the drug. In fact, my physical therapist was very pleased. He thought I was going into a wheelchair, and I've gotten rid of the cane now. LYNN M. SCHUCHTER, MD: Oh, good. KATHY D. MILLER, MD: Wonderful. CALLER: So it seems that it certainly was due to the toxicity.Thank you very much. LYNN M. SCHUCHTER, MD: Thank you. KATHY D. MILLER, MD: You're welcome. I'm glad to hear you're doing better. CALLER: Thank you. INDIA: Our next question is coming from Kalamazoo, Michigan. CALLER: Hello, Doctor. I've enjoyed your talk so far. My question is about protecting bones. I've had bone metastases for the past five years, and my oncologist tells me to just do whatever I want, which can be a huge mistake with me. Because I'll just tend to run with it. And in the past year the mets have progressed into my spine and I've broken a couple of ribs, which I didn't feel, because another aside is I typically don't feel pain, which the down side is I don't know what's going on. Now, I'm not wiling to give up activities, and I guess I would, whatever I had to do. But I'm interested in learning how to protect the bones, because I backpack and I mountain bike and ride horses. But I'm really cognizant of the spine mets as being a little bit more serious than broken bones. Also I've been off Zometa [zoledronic acid] for the past six months because of the progression of the bone mets. So I want to know how to protect them. KATHY D. MILLER, MD: I think it would be worth checking in your.
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Far back as 1885, the foot issues of elephants in range countries are well-described. A Manual of the Diseases of the Elephant and of his Management and Uses, Steel 1885 ; . While it may seem logical to assume that elephants in range countries have substrates appropriate for their feet, it is well documented that foot disorders are found in wild elephants. 8 Yet, this does not preclude foot disorders. Until there is credible scientific research documenting substrate requirements, as there are for horses and cattle, any demand for one particular housing or substrate requirement over another is subjective and likely to be incorrect. Do captive elephants require a certain amount of exercise to maintain healthy feet? This is a key area in which the Petition misrepresents both what is known about elephants in the wild and what occurs in most U.S. facilities. Elephants in the wild do not `exercise'. They move to find food, sexual partners and shelter. In captivity, these items are generally provided for elephants. Petitioners and other animal rights activists frequently maintain that wild elephants travel extensively and daily. However, there is at best limited data to support this and what the Petition reflects are only, the observations of one controlled population of African elephants. Yet there is also credible data from several sources that confirms that the range of daily movements of wild elephants can vary greatly and is affected by distribution of food and water, breeding mates and climate. Hutchins, p. 165, citing The Living elephants: Evolutionary Ecology, Behavior and Conservation, Sukumar 2003 ; . See also Comments of the International Elephant Foundation IEF ; dated November 30, 2006 regarding the Smithsonian National Zoo Mynamar study ; . Since elephants do not exercise in the wild, and since the distance they move is related to the availability of necessities of life which is not an issue in captivity, IDA's demand that elephants in enclosures be able to "exercise similarly to how elephants exercise in the wild" is meaningless. Clearly adequate exercise is necessary both for foot health and overall health of elephants. See EHRG, Fowler Mikota, Spinage, AZA Standards. That is not disputed. But there is no universal answer to the question and the amount and type of exercise necessary for healthy elephants is going to vary with individual animal characteristics, including age, diet and behavior. See Fowler Comments. Ringling Bros. performing elephants are regularly exercised. Each week generally begins and ends with a brisk walk between our train and the arena covering an average about 3.5 miles. In addition, in every city our elephants begin their day with exercise by walking running approximately 3 miles in or outside the performance venue although this is tailored to meet the specific needs of individual animals ; . This activity is supplemental to practice sessions, rehearsals and performances that also help maintain their physical fitness. The fact that our elephants are kept in compatible social groups also provides opportunities for physical activity. Thus, based on our experience, we believe that exhibit or enclosure size or space is not directly correlative to health. Instead it is how available space is utilized and daily activities that is important. 9.
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485 43vrnat2 Johnson - cross 1 THE COURT: Yes. 2 MR. HUT: The subject of the paragraph -3 THE COURT: I know what the paragraph is about. But 4 the question asks him about the literature, and he is capable 5 of answering it yes or no. Then from there you can go back and 6 address the paragraph. I know what the paragraph is about. 7 Go ahead, answer the question, Doctor. Do you need it 8 read again? 9 THE WITNESS: No, sir. 10 A. There was no published literature that I was aware of in 11 2000. 12 Q. In most of the pregnancies that you have terminated, you 13 used medical induction abortion because you wanted an intact 14 fetus for genetic evaluation, isn't that right? 15 A. At our institution, that has been our bias, yes. 16 THE COURT: That's done what? 17 THE WITNESS: At our institution, that has been our 18 bias, yes. 19 THE COURT: Your bias? 20 THE WITNESS: Correct. 21 THE COURT: OK. 22 Q. It the practice, in fact, at Michigan that virtually all 23 terminations are done for genetic or developmental reasons, 24 isn't that right? 25 A. Yes. Virtually all the pregnancy terminations that we do SOUTHERN DISTRICT REPORTERS, P.C. 212 ; 805-0300.
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Patient-centeredness is increasingly regarded as a crucial element of quality for the health care delivery system. However, the culture of medical education seems to focus more on a biomedical, that on a patient-centred model of care. Objective. To describe the attitudes of medical students towards the patient-centred care, for the first time in Greece, to find demographic parameters that are associated with patient-cantered attitudes and to investigate whether these attitudes have an influence on sexual beliefs. Methods. A questionnaire was administered optionally to 301 students in the fourth year of medical school. The beliefs about doctor-patient relationship where measured with the Patient-Practitioner Orientation Scale PPOS ; , an 18-item scale that differentiates between a patient-centred versus a doctor-centred orientation. The students were also requested to answer anonymously to 34 sexual attitude questions and additional demographic data. Results. 240 fully answered questionnaires were returned response rate 79.7% ; . Greek students were more doctor centred compared to American students, according to the results of published papers. Female gender, origin from the lower-working class and being a civilian student versus military ; were significantly associated with patient-centred attitudes. Finally, patient centred orientation was correlated with more liberal sexual attitudes. Conclusion. The urge need for a more patient-centred medical education arises. The more open-minded attitudes even in sexual issues, that seem to be associated with the patient-centred orientation, reinforce this need, for instance, celebrex discount.
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