A diagnosis of cancer places considerable stress on patients and requires them to make major adjustments in many areas of their lives. As a consequence, considerable demands are placed on health care providers to satisfy the complex care needs of cancer patients. Currently, there is little available information to indicate the extent to which cancer patients are satisfied with the quality of care they receive. The present study assessed the perceptions of 232 ambulatory cancer patients about the importance of and satisfaction with the following aspects of care: doctors technical competence and interpersonal and communication skills, accessibility and continuity of care, hospital and clinic care, nonmedical care, family care, and finances. The results indicate that all 60 questionnaire items used were considered to reflect important aspects of care, but that greater importance was given to the technical quality of medical care, the interpersonal and communication skills of doctors, and the accessibility of care. Most patients were satisfied with the opportunities provided to discuss their needs with doctors, the interpersonal support of doctors, and the technical competence of doctors. However, few patients were satisfied with the provision of information concerning their disease, treatment, and symptom control and the provision of care in the home and to family and friends.

The diagnosis and management of cancer can have a major impact on every aspect of a patient's quality of life. Despite its importance, quality of life is rarely a reported outcome in randomized clinical trials in cancer patients. Failure to collect quality-of-life information may reflect a lack of information among researchers and clinicians about the adequacy and relative merits of measures available for assessing quality of life. We reviewed the adequacy of the 17 existing scales for assessing quality of life in cancer patients against characteristics needed for an adequate measure. None of the existing measures met all of the criteria. Recommendations about the relative adequacy of existing scales were made.

SUMMARY: In a survey of milk obtained from individual farms and creameries, 87% of samples were found to contain fewer than one cell of Bacillus cereus/ml. The remaining 13%, although they all yielded low counts, showed that the organism tended to occur in milk received from particular farms and creameries. On investigating sources of contaminated milk, it was found that the organism was derived chiefly from cans which, after being emptied of milk, had been allowed to stand for a long time before being washed properly and ‘sterilized’. The vegetative cells of B. cereus were shown to form spores readily in thin films of diluted milk, such as may occur in a rinsed can.

SUMMARY: A medium is described by means of which cells of Bacillus cereus in milk may be estimated without the prior use of a heat treatment. Into a nutrient agar are incorporated: egg yolk, to demonstrate production of the characteristic opacity; citrate, to render the inoculated medium more transparent; lithium chloride and polymyxin, to reduce the growth of other bacteria. A cover of water agar limits the development of certain spreading organisms. The medium has proved of value in a survey of samples of raw milk, providing information additional to that obtained by plating after a heat treatment.

A medium has been developed that permits the viable count of milk bacteria to be combined with the determination of biochemical properties likely to be important in milk itself. This has involved the modification of standard glucose-tryptone skim-milk agar by incorporation of two indicators to detect alkali as well as acid production, substitution of lactose for glucose, and increasing the quantity of skim milk for the detection of proteolysis and casein precipitation. The medium has proved particularly valuable in the study of the thermoduric flora of pasteurized milk. The phenomenon of casein precipitation is, however, less reliably determined than are changes in hydrogen-ion concentration and proteolysis.