The authors evaluated whether a patient's perceived pain control influenced the relationships between four attributes (nursing, physician, staff, and environment) and patient satisfaction. Multiple linear regression analyses were conducted to examine overall satisfaction and intention to recommend, controlling for race, gender, age, and education. The authors found that no matter the level of pain control, nursing was always the most influential attribute in patient satisfaction. The influence of the other attributes varied, depending on the patients' pain control. Hospital managers may improve patient satisfaction by focusing on pain management nursing care.

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phenotypes may provide clues regarding the pathogenesis and prevention of subsequent asthma. The odds ratio (OR) of a diagnosis of MMA where sIgE to alpha-gal is positive is only 2.5 (95% CI 0.7-8.6, P = 0.16). The OR of the presence of atopy is 1.3 (95% CI 0.5-3.3, P = 0.64). However, the OR for a history of tick bite is 15.4 (95% CI 5.3-45.3, P < 0.001).Conclusions: sIgE to alpha-gal does not add any further information to clinical history in the diagnosis of MMA. It only confirms that the patient has had a tick bite (in our population by Ixodes holocyclus). In our experience, this can be ascertained by the individual or at a clinical review. A reduction in the number of assays to sIgE to alpha-gal performed would reduce costs to these tick-endemic communities.

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