Patients' reluctance to report pain and to use analgesics are considered major barriers to pain management. To explore this problem, 270 patients with cancer completed a 27-item self-report questionnaire (BQ) that assessed the extent to which they have concerns about reporting pain and using pain medication. The 8 specific concerns included fear of addiction, beliefs that 'good' patients do not complain about pain, and concern about side effects. Patients also completed a measure of pain severity and pain interference (the BPI). The percentages of patients having concerns assessed by the BQ ranged from 37% to 85%. Those who were older, less educated, or had lower incomes were more likely to have concerns. Higher levels of concern were correlated with higher levels of pain. Based on their reports of pain medications used in the past week and on their reports of pain severity, patients were categorized as under-medicated versus adequately medicated. Those who were under-medicated reported significantly higher levels of concern. The data are discussed in terms of implications for research and practice.

A 25 kDa antigen of Mycobacterium bovis has previously been identified as immunodominant during badger infections. This 25 kDa antigen was partially purified from sonicated M bovis bacilli by using water precipitation and ion exchange chromatography, and its purification was monitored with a mouse monoclonal antibody, MBS43, which was specific for the antigen. The partly purified antigen was used to develop an ELISA for the assay of badger sera for the presence of specific antibodies. A presumed negative badger population was used to calculate the assay's threshold of seropositivity and using this value, its sensitivity (37 percent) and specificity (98 percent) were determined in a second population of known culture status. The results indicate that it may be possible to develop a specific and cost effective serological field assay for the diagnosis of M bovis infection in living badgers.

No abstract

Monoclonal antibody CMA134.1 reacted with a protein antigen of apparent molecular mass 22 kDa from Mycobacterium bovis and Mycobacterium tuberculosis, and with an apparently 24 kDa antigen of Mycobacterium kansasii, but not with other mycobacteria or related species. This antibody was used to screen a gene library of M. bovis in Agtll and identified a recombinant clone that expressed a protein with an apparent molecular mass of 1% 20 kDa. Gene expression occurred from the lac promoter in lgtll, but used an unidentified vector promoter, possibly that of the replication primer RNA, in the final plasmid construct. The sequence of an 840 bp fragment was determined and shown to code for a product of 15 kDa. This sequence is identical to that, independently determined, of a gene from M. tuberculosis, usually referred to as the 19 kDa antigen. The reasons for the apparent size discrepancies are discussed.

Implementation of I-PASS has been associated with substantial improvements in patient safety and can be applied to a variety of disciplines and types of patient handoffs. Widespread implementation of I-PASS has the potential to substantially improve patient safety in the United States and beyond.