Initiatives with a specific emphasis on improving care related to pain resulted in notable improvements in quality of clinical care in specific homes as well as within the network as a whole.
 
  The Seniors Quality Leap Initiative demonstrates that a partnership between organizations in 2 countries can foment quality transitions through a shared commitment to identifying needs; employing flexible, but practical initiatives; and evaluating the impact of those initiatives through a transparent reporting mechanism.
 The Seniors Quality Leap Initiative demonstrates that a partnership between organizations in 2 countries can foment quality transitions through a shared commitment to identifying needs; employing flexible, but practical initiatives; and evaluating the impact of those initiatives through a transparent reporting mechanism.Extramammary Paget disease (EMPD) is a rare neoplasm with uncertain histogenesis, usually presenting in the anogenital area, most commonly in the vulva. The disease is characterized by slow grow and high recurrence rates. This article reviews the epidemiological, clinical, morphological, genetic and treatment features of EMPD of the vulva reported in recent years.
  Moderate to severe pain has been frequently reported in hospitalized older adults. Pain in hospitalized persons with dementia within the context of other common symptoms, functional decline, delirium, and behavioral and psychological symptoms of dementia (BPSD), has received little attention.
 
  Describe the incidence of pain, the pharmacologic management of pain, and the association of pain with physical function, delirium, and BPSD in hospitalized persons with dementia.
 
  Descriptive, cross-sectional study.
 
  Six medical units in three hospitals.
 
  Baseline data from 299 hospitalized persons with dementia enrolled in the Family-centered Function-focused Care (Fam-FFC) cluster randomized trial.
 
  Descriptive analyses of pain used the Pain Assessment in Advanced Dementia (PAINAD) scale and the use of medication for pain management.  https://www.selleckchem.com/products/iruplinalkib.html  Linear regression analyses tested relationships between pain and1) physical function (Barthel Index), 2) delirium severity (Confusion Assessment Method Severity Short Form) and 3) BPSD severity (Neuropsychiatric Inventory- Questionnaire).
 
  The majority of the sample was female (61.9%), non-Hispanic (98%), and Black (53.2%), with a mean age of 81.58 (SD=8.54).Of the 299 patients, 166 (56%) received pain medication. Of the 108 individuals who demonstrated pain, 40% (n=43) did not receive pain medication. When controlling for age, gender, cognition, and comorbidities, pain was significantly associated with function, delirium severity, and BPSD severity.
 
  Results suggest that pain may be undertreated in hospitalized persons with dementia, and should be considered upon admission to optimize function, decrease delirium, and prevent or decrease BPSD.
 Results suggest that pain may be undertreated in hospitalized persons with dementia, and should be considered upon admission to optimize function, decrease delirium, and prevent or decrease BPSD.Bloom's Taxonomy, an integral component of learning theory since its inception, describes cognitive skill levels in increasing complexity (Remember, Understand, Apply, Analyze, Evaluate, and Create). Considering Bloom's Taxonomy when writing learning objectives and lecture material, teaching residents at the workstation and creating multiple choice questions can increase an educator's effectiveness. The incorporation of higher Bloom levels aids in cultivating critical thinking skills vital to image interpretation and patient care, and becomes increasingly important as the radiologist's role evolves with the continued development of artificial intelligence. Following established tenets of multiple choice question writing, involving trainees in the question writing process, and incorporating audience response systems into lectures are all strategies in which higher Bloom level skills can be accomplished.
  To assess the safety and efficacy of multilevel thoracolumbar vertebroplasty in the simultaneous treatment of ≥ 6 painful pathologic compression fractures.
 
  Retrospective review was conducted of 50 consecutive patients treated with vertebroplasty for ≥ 6 pathologic compression fractures in a single session for pain palliation at a tertiary single cancer center from 2015 to 2019. Outcomes measured included procedural safety according to Common Terminology Criteria for Adverse Events (CTCAE), change in 4-week postprocedure back pain by numeric rating scale (NRS), comparison of daily opioid medication consumption, and development of skeletal-related events.
 
  A total of 397 pathologic compression fractures were treated during 50 sessions (mean, 7.9 per patient ± 1.5). Mean procedure duration was 162 minutes ± 35, mean postoperative hospitalization duration was 1.6 days ± 0.9, and mean follow-up duration was 401 days ± 297. Seven complications were recorded, including 1 case of symptomatic polymethyl methacrylate pulmonary embolism. No major complications (CTCAE grade 4/5) were reported. NRS pain score was significantly decreased (5.0 ± 1.8 vs 1.7 ± 1.4; P < .0001), with a mean score decrease of 3.3 points (66%). Opioid agent use decreased significantly (76 mg/24 h ± 42 vs 45 mg/24 h ± 37; P= .0003), with a mean decrease of 30 mg/24 h (39%). Skeletal-related events occurred in 7 patients (14%).
 
  Multilevel vertebroplasty for ≥ 6 pathologic compression fractures is safe and provides significant palliative benefit when performed simultaneously.
 Multilevel vertebroplasty for ≥ 6 pathologic compression fractures is safe and provides significant palliative benefit when performed simultaneously.
  To evaluate the diagnostic yield of 3T in-Bore magnetic resonance-guided biopsy (3T IB-MRGB) for detection of clinically significant prostate cancer (csPCa), based on assessment using the Prostate Imaging Reporting and Data System version 2.1 (PIRADSv2.1).
 
  This single-center study examined individuals who underwent 3T multiparametric prostate magnetic resonance (MR) imaging and subsequent 3T IB-MRGB. The final study cohort included 379 men (with 475 targets) divided into 3 subcohorts biopsy-naïve men (n= 123), individuals with a history of negative trans-rectal-ultrasonography (TRUS) biopsy results (n= 106), and men with low-grade PCa under active surveillance (n= 150). csPCa was defined as having a Gleason score (GS) ≥3+4.
 
  3T IB-MRGB detected PCa and csPCa in 69.1% (262 of 379) and 50.3% (193 of 379) of patients, respectively. The PCa and csPCa detection rates per target were 64.2% (305 of 475) and 43.8% (208 of 475), respectively. The rate of urosepsis, treated with intravenous antibiotics, was 1% (4 patients).