Find what you want. Multiple search engines. People & Public Records searches. Links and tips for finding stuff

By Sarah Carey

GAINESVILLE, Fla. - When it comes to making babies, the animal world is not so different from the human one -- planning is everything. In an effort to help animal breeders better manage reproduction-associated diseases and improve pregnancy success rates, the University of Florida College of Veterinary Medicine has launched a new service focused solely on small animal reproduction.

"We will offer cutting-edge methods to diagnose and treat both reproductive diseases and infertility cases in male and female animals, mostly dogs and cats," said John Verstegen, D.V.M., Ph.D., who heads the service in partnership with his wife, Karine Onclin, D.V.M., Ph.D. Verstegen is a founding member of the European Society for Small Animal Reproduction and of the European College for Animal Reproduction. The couple moved to Gainesville last summer from Belgium, where they had worked at the University of Liege. Their UF clinic opened in early September.

Among the tools the couple plans to offer breeders are a variety of hormone tests as well as vaginal smears, vaginoscopy, uterine endoscopy and endoscopic uterine drainage.

"We also will be able to provide sonography of the reproductive tract, including sonographic detection of follicular growth and ovulation to improve fertilization and artificial insemination success," Verstegen said, adding that the service's main activities will include pregnancy monitoring through Doppler ultrasonography, endocrine testing, parturition monitoring and neonatal care. Jackie Kensler, a border terrier breeder who lives in St. Augustine and is active in the Border Terrier Club of America, was Onclin's first UF client.

"Both female dogs I brought to Dr. Onclin had failed to be successfully bred under previous attempts," Kensler said. "Because of Dr. Onclin's breeding management program, one was successfully bred and delivered four puppies that are now 6 or 7 weeks old. In Dr. Onclin's hands, we were successful."

Kensler said breeders invest a great deal of effort, expense and emotion in hopes of arranging a successful mating, frequently transporting their dogs long distances.

"Therefore it behooves us to invest that little extra to make sure we have an optimum opportunity to succeed," she said. "Dr. Onclin provides us with that."

For more information or to make an appointment with the Small Animal Reproduction Service, call (352) 392-4700, ext. 4700.

Military metaphors upset some cancer patients, UF doctors say

By Patricia Bates McGhee JACKSONVILLE, Fla. - Well-meaning doctors seeking to explain treatment to cancer patients by comparing it to an all-out war might be wise to skip the military metaphors, University of Florida physicians caution. Although metaphors help patients understand their disease, battlefield analogies can be upsetting, say the researchers, who have published a study on doctor-patient communication in the Journal of Clinical Oncology. Case in point: Cyclist and six-time Tour de France winner Lance Armstrong switched oncologists after the first doctor he saw told him he would hit him so hard with chemotherapy he would virtually kill him. "Wars on drugs, poverty and illiteracy pervade our society, and war talk is easily adaptable to cancer," said Gary M. Reisfield, M.D., a professor of community health and family medicine at the UF Health Science Center Jacksonville. "The enemy is cancer, the commander is the physician, the combatant is the patient, the allies are the health-care team and the weapons are chemical, biological and nuclear." Yet thinking of cancer in terms of war strikes some as masculine, power-based, paternalistic and violent, Reisfield said. And it suggests winning the war - or defeating the cancer - is only a matter of fighting hard enough, he added. It also forces patients to keep fighting so they don't lose the battle, when opting out of treatment may be a better choice if little or no medical benefit is evident. Reisfield and George R. Wilson, M.D., associate chairman of community health and family medicine at UF Jacksonville, analyzed dozens of illness narratives gleaned from books, newspaper accounts and Web logs and examined how patients used or felt about metaphors. The human brain is wired to operate in metaphors, the researchers said, processing abstract or complex concepts in part by thinking of analogies derived from more familiar experiences. But oncologists need to be sensitive to the language they - and their patients - use. "I first realized the power of metaphors a few years ago when my Aunt Fran complained about an orthopedic surgeon she visited for her arthritic knee," said Reisfield, who specializes in palliative care and pain management. "He compared my aunt to an old car and her knee to a part that had to be replaced. She was incensed by this comparison and refused to go back to him." From then on, Reisfield started paying attention to his own use of metaphors. "We all think in metaphors, and carefully choosing our language is especially important in today's medicine, when some office visits last only five minutes," he said. "Metaphors are part of our (physicians') bag of tricks - some are enabling for our patients, and others are disabling." Metaphors can express understanding and empathy, but unfortunately practitioners don't always use this powerful tool wisely, said Alan Rubin, M.D., director of the doctoring skills program and a research associate professor of medicine at the University of Vermont College of Medicine in Burlington. "I once saw a videotape of a doctor giving bad news to a breast cancer patient," Rubin said. "He said he could liken breast cancer to dogs. Some cancers are poodles and some are Rottweilers. He needed to figure out which kind she had. I watched the patient cringe and feltmyself cringe, too." About 90 million American adults - roughly half the adult population - have difficulty understanding basic medical information, according to an Institute of Medicine study published last year. Choosing metaphors wisely can increase patient satisfaction, improve health-care outcomes and reduce health-care costs, Wilson said. The figures of speech also "can impose order on a suddenly disordere world," the researchers wrote in the journal, helping patients to "understand, communicate and thus symbolically control their illness." "Metaphors, analogies and comparisons give patients and physicians a context for understanding and discussing something highly technical, specialized and biologic - a common scenario for newly diagnosed cancer patients," Wilson said. The UF study does not identify metaphors as intrinsically good or bad, appropriate or inappropriate. Instead, it suggests that a metaphor's usefulness depends on each individual's value system. Finding the best metaphors for a patient's situation and frame of reference is the goal, Reisfield said, adding that a journey metaphor may be especially relevant as an increasing number of cancer patients may live with the disease for years. "The life-is-a-journey comparison is a quieter metaphor and has the depth, richness and seriousness to apply to the cancer experience," said Reisfield. "The road may not be as long as one hoped, and important destinations may be bypassed, but there's no winning, losing or failing. There are different roads to travel, various avenues to explore and always exits to take." Physicians should ask their patients which metaphors work for them and listen to the metaphors their patients use, the authors suggest. Patients devise their own metaphors based on things they know and value. "Armstrong adopted the metaphor of the most important bicycle race in the world," Wilson said, and a businessman described in the study used a building project as a metaphor, where physical setbacks during treatment became "change orders" or "project delays." Other patients thought of cancer in terms of climbing Mount Everest, a chess match, a marathon, a drama, a dance and a collaborative exploration. "Simply by being mindful, physicians can become more aware of metaphorical language," Reisfield said. "They can tailor metaphor use to individual patients based on unique patient characteristics such as personal and cultural values, specific aspects of the disease, stage of illness and prognosis." Language that works for one patient may not work for another, Wilson said, "but metaphorical skill, imagination and sensitivity can help create rapport and communicate the nature of unshared experience."