Assessing pain as a fifth vital sign in long-term care facilities: Recommendations from the field.

In long-term care facilities, pain management is complex because dementia, delirium, and other reasons for residents' altered communication ability are a significant barrier to pain assessment. The purpose of this study was to explore the status of implementation of pain as a fifth vital sign in a sample of long-term care facilities. A three-round Delphi survey was used to obtain consensus from personnel in 60 long-term care facilities in NY State. Findings are presented in terms of recommendations related to pain criteria, assessment methods, frequency of pain assessment, responsibility for pain assessment, monitoring strategies, education, documentation, and pain management education. The results of this study highlight many important considerations in the treatment of pain as a fifth vital sign in long-term care facilities. Evidence-based practice will be facilitated by further research related to underexplored aspects of pain assessment and management, and further attention to care delivery systems that support continued knowledge acquisition and the implementation of best practices.

Kinesin motors and microtubule-based organelle transport in Dictyostelium discoideum.

Movement of membrane cargoes and chromosomes is driven by kinesin and dynein motors in most eukaryotic cells. In this review, we describe the known kinesin and dynein genes in Dictyostelium. Dictyostelium primarily utilizes two conventional kinesins, an Unc104/KIF1 kinesin, and cytoplasmic dynein to transport membrane organelles within its cytoplasm. We describe how the biological functions of these motors has been dissected through a combination of biochemical to genetic approaches.