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Despite recommendations, few have reported on quality improvement initiatives to implement length of rehabilitation stay benchmarks, while actively monitoring functional outcomes. This article describes the development, implementation, and evaluation of a precision case management model across all inpatient rehabilitation client groups in a Canadian facility. To develop the length of rehabilitation-stay (LoRS) benchmarks, patient data was retrospectively analyzed. A severity specific method was used to stratify median length of stay. A target reduction on 8.6 days in LoRS was established. Functional discharge targets were also set and monitored at specific intervals via the Functional Independence Measure (FIM®). The implementation used an incremental quality improvement phased approach. Following 12-months, a statistically significant reduction in mean LoRS of 13.2 days was achieved, along with a small increase in FIM® change across all rehabilitation client groups. A similar pattern was seen across the three main client groups, where a LoRS reduction greater than the target was achieved, along with important improvements in LoRS efficiency. This study demonstrates how the implementation of a precision case management model can assist a facility in markedly reducing LoRS across inpatient groups, without compromising functional change or community discharge rates and begin its transformation to a value-based organization. [ABSTRACT FROM AUTHOR]

Advancing understanding of human coronary artery disease requires new methods that can be used in patients for studying atherosclerotic plaque microstructure in relation to the molecular mechanisms that underlie its initiation, progression and clinical complications, including myocardial infarction and sudden cardiac death. Here we report a dual-modality intra-arterial catheter for simultaneous microstructural and molecular imaging in vivo using a combination of optical frequency domain imaging (OFDI) and near-infrared fluorescence (NIRF) imaging. By providing simultaneous molecular information in the context of the surrounding tissue microstructure, this new catheter could provide new opportunities for investigating coronary atherosclerosis and stent healing and for identifying high-risk biological and structural coronary arterial plaques in vivo., Atherosclerosis is an inflammatory, progressive disease of the arteries that accounts for the majority of deaths in the United States (1). One of the major contributors to this high mortality [...]

The purpose of this study was to establish an objective method for identifying the heart-rate threshold (HRT) in cyclists. Fifty-six male cyclists were tested on a cycle ergometer to volitional fatigue. Identification of the HRT used a heart-rate increase above a logarithmic regression line of best fit, coupled with the crossover of a linear regression line of best fit. The measures of [Vco.sub.2.] and blood lactate for ventilatory threshold (VT) and lactate threshold (HLaT), respectively, were used as criterion measures to validate the HRT. Comparison of HRT with VT and HLaT showed significant associations (r = 0.98). Statistical variance between HRT, VT, and HLaT indicated no difference. From these findings, the logarithmic regression method provides an objective means to determine the HRT. Through this method, cyclists may obtain information for establishing accurate training levels and protocols. Key Words. myocardium, vagal, parasympathetic, metaboreceptor