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Reject rate analysis is considered an integral part of a diagnostic radiography quality control (QC) program. A rejected image is a patient radiograph that was not presented to a radiologist for diagnosis and that contributes unnecessary radiation dose to the patient. Reject rates that are either too high or too low may suggest systemic department shortcomings in QC mechanisms. Due to the lack of standardization, reject data often cannot be easily compared between radiography systems from different vendors. The purpose of this report is to provide guidance to help standardize data elements that are required for comprehensive reject analysis and to propose data reporting and workflows to enable an effective and comprehensive reject rate monitoring program. Essential data elements, a proposed schema for classifying reject reasons, and workflow implementation options are recommended in this task group report., (© 2023 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, LLC on behalf of The American Association of Physicists in Medicine.)

Ketamine has played a versatile role in medicine due to its wide spectrum of uses in history including use in sedation, catalepsy, somatic analgesia, bronchodilation, and recent trial in complex chronic pain syndromes. There is very little, if any, discussion in the literature of ketamine use in stroke, particularly in improving symptoms of pain after stroke. We present a case of a 40-year-old female with a past medical history of right-sided thalamic ischemic stroke complicated by Central post-stroke pain syndrome (CPSP) presented for refractory severe diffuse pain causing debility and immobility. The patient failed outpatient medical therapy consisting of anxiolytics, serotonin, and norepinephrine reuptake inhibitors. This led to increased opioid use which resulted in dependence and opioid-hyperalgesia. Upon admission, the patient was unable to sit still, with severe, sharp 10/10 pain localized to her left lower extremity. Palliative medicine was consulted for management of refractory central neuropathic pain. Inpatient oral ketamine was initiated, and titrated over the patient's hospital course. During this time, the patient showed marked improvement in GAD-7, PHQ-9, and Short Mcgill pain scores while significantly decreasing opioid requirements. We present this case to demonstrate how oral ketamine usage in centrally mediated neuropathic pain such as in CPSP can lead to pain control, decreased opioid usage, and overall improved quality of life.

Neuropsychologists are increasingly called upon to conduct evaluations with individuals involved in personal injury litigation. While the inclusion of measures of effort within a test battery may help clinicians determine whether a client has put forth full effort, attorney coaching may allow dishonest clients to circumvent these efforts. The purpose of this study was to determine the degree to which frequently used measures of effort are susceptible to coaching, as well as to explore and classify strategies undertaken by coached malingering simulators. Overall, coached simulators performed significantly better on 7 of 14 measured variables. Potential improvements in the external validity of the simulation design were also explored.

The Hawaiian Studies Program (HSP) integrates the learning of Hawaiian culture with more traditional secondary curriculum in science, social studies, and English. Students also participate in weekly community service-learning sessions. Fifty-five HSP students and 29 peers (who were not involved in the program), completed a survey measuring: students' connection to, pride in, and responsibility for their community; civic attitudes; and career knowledge and preparedness. HSP teachers, community members, and students were also interviewed about program outcomes. Compared to other peers, HSP students tended to report feeling more connected to their community and school and to agree that they had career-related skills. Participants believed that service- learning contributed to these outcomes by making connections between school and community life and by exposing students to a variety of careers.