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Variability in physical therapy protocols following total shoulder arthroplasty

  • Samuel Schick;Alex Dombrowsky;Jamal Egbaria;Kyle D. Paul;Eugene Brabston;Amit Momaya;Brent Ponce
    • Clinics in Shoulder and Elbow
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    • v.26 no.3
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    • pp.267-275
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    • 2023
  • Background: Physical therapy (PT) plays an important role in the recovery of function following anatomic total shoulder arthroplasty (aTSA). While several PT protocols have been published for these patients, there is no standardized protocol for aTSA rehabilitation. This lack of standardization may lead to confusion between patients and physicians, possibly resulting in suboptimal outcomes. This study examines how PT protocols provided by academic orthopedic surgery programs vary regarding therapeutic goals and activities following aTSA. Methods: PT protocols for aTSA available online from the Accreditation Council for Graduate Medical Education accredited orthopedic surgery programs were included for review. Each protocol was analyzed to evaluate it for differences in recommendation of length of immobilization, range of motion (ROM) goals, start time for and progression of therapeutic exercises, and timing for return to functional activity. Results: Of 175 accredited programs, 25 (14.2%) had protocols publicly available, programs (92%) recommended sling immobilization outside of therapy for an average of 4.4±2.0 weeks. Most protocols gave recommendations on starting active forward flexion (24 protocols, range 1-7 weeks), external rotation (22 protocols, range 1-7 weeks), and internal rotation (18 protocols, range 4-7 weeks). Full passive ROM was recommended at 10.8±5.7 weeks, and active ROM was 13.3±3.9 weeks, on average. ROM goals were inconsistent among protocols, with significant variations in recommended ROM and resistance exercise start times. Only 13 protocols (52%) gave recommendations on resuming recreational activities (mean, 17.4±4.4 weeks). Conclusions: Publicly available PT protocols for aTSA rehabilitation are highly variable. Level of evidence: IV.

Study on economic effects of outsourcing of food materials on the hotel kitchen - Focus on cooking Western food in the first class hotel - (식재료 아웃소싱이 경제적 주방에 미치는 영향에 관한 연구 - 특1급호텔 양식조리를 중심으로 -)

  • 성태종
    • Journal of Applied Tourism Food and Beverage Management and Research
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    • v.13 no.2
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    • pp.45-69
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    • 2002
  • This study is designed to examine feasibility and limitation of outsourcing in cooking Western food in a hotel, to interpret importance of outsourcing(eg. outside order, outside procurement, outside supply) in a broad sense in order to reinforce the core capacity in the cooking department, and to know whether the cooking human power is efficiently used and how much the chefs recognize outsourcing of food materials. As many companies conduct restructuring to cut down its size, the reduction of human power led the Western food cooking in the hotel to lower core capacities, lower quality, and lower efficiency. In addition, the sagging morale of chefs undermined creativity. To change from the traditional kitchen to an economic kitchen needs to look into importance of outsourcing, cognitive attitude of chefs, relation with outside suppliers. Here suggests performance of positive changes in the structure The study examined feasibility and limitation of outsourcing in the hotel kitchen as well as chefs' cognitive attitude toward outsourcing of food materials to reinforce core capabilities of the hotel kitchen. 1. Companies of outsourcing are selected according to variability of price conditions, flexibility of contract conditions, popularity of the outsourcing company, and reputation of the outsourcing company. 2. The importance of outsourcing in the Western food cooking is divided into 4 factors such as standard of selecting outsourcing companies, policies of cooking manu, quality of cooking, and quantity of cooking. 3. The most feasible section in outsourcing of food materials is a process of kneading flour for bread, which shows that many Western-food chefs expect to put higher possibility of outsourcing on the kneading. In other words, when it comes to confectionery and bakery, there are many outside expert processing companies supplying high quality products. In the order of outsourcing feasibility, sauce is followed by processed vegetable, garnish of main dish, and soup. The least feasible section in outsourcing of food materials is appetize. Appetize includes a concept of a improvised dish and needs speed. Due to its color, freshness, and sensibility of taste, the appetize plays a key role in the Western food cooking. 4. When outsourcing is taken in place, the highest risk is to lower the inner cooking skills. Therefore chefs in charge of the Western food sequently recognize both internal problems including storage of cooking skills, unstability of layoffs, and loss of cooperation between departments, and external problems including inferior goods, difficulty of differentiating manu, delay of delivery, and expiration date. It shows that most of the Western food chefs consider risks of the internal problems at first. 5. A effective outsourcing needs appropriate selection of outsourcing companies, maintenance of credibility, active communication, check and management of hygiene. However regardless of their position or career, chefs in charge of the Western food have the same cognitive attitude toward selecting successful outsourcing companies after the outsourcing system is enforced. The core of cooking, or a final stage in the full process of so-called artistic cooking, should be treated with insourcing. Reduction of several cooking processes resulted in shortened cooking time, increased efficiency, faster cooking, cutting the waiting-lines, and finally more room for customers. The outsourcing system can reduce or eliminate the following processes in cooking: buying various food materials, checking, storing, preparing, and processing. Especially in the Western food cooking department of a hotel, the outsourcing system should be enforced to make an economic kitchen and to efficiently manage it. Wow it's time to change from the traditional kitchen to an economic kitchen in the hotel cooking department. For that, the cooking department should become a small but strong organization by outsourcing except its core work.

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The Daily Experiences of People with Chronic Schizophrenia (만성 정신분열병환자의 살아온 경험)

  • Min, So-Young
    • Journal of Korean Academy of Nursing
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    • v.35 no.6
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    • pp.1125-1134
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    • 2005
  • Purpose: This research investigated the daily experiences of patients' lives to develop a formal theory that explains the lives of schizophrenic patients. Method: A grounded theory method(Strauss & Corbin, 1998) guided the data collection and analysis. Thirteen patients who were diagnosed with schizophrenia in regional communities participated. Result: The experiences of chronic schizophrenic patients are defined as "escaping from a fallen mine" comparing their suffering to that of entrapped miners trying to free themselves from a collapsed mine tunnel with much difficulty and without hope. In observing participant's time lines of having lived with chronic schizophrenia, it advances with 'surrender', 'collapse', 'reaching out', 'rising', 'preparing to spring up', and 'starting anew'. Conclusion: The results of this study indicate that the experience of a chronic schizophrenic patient is like that of a miner caught under a fallen mine channel, who, without external help cannot escape the depths 'Of the mine, but at the same time must have conviction and hope of rescue and avert fear to cooperate with outside help. The result indicates that family members, doctors and nurses as well as an institute's persistent and active support is most critical for the patient's adjustment to social life.

Automotive ECU Biometric Authentication Using Blockchain (블록체인을 이용한 자동차 ECU 생체인증 기법)

  • Hong, Ji-Hoon;Lee, Keun-Ho
    • Journal of Internet of Things and Convergence
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    • v.6 no.1
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    • pp.39-43
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    • 2020
  • The Internet of Things plays a role as an important element technology of the 4th Industrial Revolution. This study is currently developing intelligent cars with IT technology, and is at a time when the development of intelligent cars is active and network data communication is possible. However, security solutions are needed as security is still at a weak stage, which can be threatened by intrusions into the network from outside. In this paper, in order to improve security of intelligent cars without causing security problems, we will apply blockchain technology, propose biometric authentication techniques using users' biometric information, and continue to study them in the future.

A Study on Deconstructured Space and Visibility in Clothes - Regarding Hussein Chalayan′s Design- (의복에서의 탈구조적 공간과 가시성에 대한 연구 -후세인 칼라얀의 디자인을 중심으로-)

  • 김혜영
    • Journal of the Korean Society of Costume
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    • v.50 no.4
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    • pp.5-20
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    • 2000
  • Through his geometric design, the Cyprus born fashion designer Hussein Chalayan raises intriguing questions about the very fact of wearing clothes. By purposefully displacing the function of each part of the clothing, such as neck line, hem line, seam, sleeve, etc., Chalayan transforms the meaning of the body that wears clothes. of the human subject as a sovereign possessor of the clothing and the visibility related to fashion. This transformation is achieved by distorting the spaces of his clothing in an unorthodox way. This thesis argues that the significance of such a practice can not be properly understood without relation to the current debate on deconstructionism under way in humanities. Instead of immediately negating the modern frame of Ideas and practices, deconstructionism asks what the assumptions for the modern regime of truth is. In this process, things that lead human beings to sovereign master of knowledge and truth such as reason, subject, body and vision are questioned. In the same context, Chalayan's design not only forces us to rethink the very function of dividing inside and outside by the clothing but also the meaning of boundary operating in numerous sites of modern life. As the human subject is not something pre-given but constructed according to the cultural representation, to which the clothing belongs, fashion can be evaluated to be an active ingredient of constructing the subject. Therefore, Hussein Chalayan's design is at the cross road between the modern and the postmodern regime of fashion.

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Development and Durability Evaluation of a Bimaterial Composite Frame by Pultrusion Process (인발성형 공정을 통한 이종재료 복합소재 프레임 개발 및 내구성 평가)

  • Lee, Haksung;Kang, Shinjae
    • Journal of the Korean Society of Manufacturing Technology Engineers
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    • v.23 no.2
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    • pp.145-151
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    • 2014
  • Recently, the growing demand for weight reduction and improved structure durabilityfor commercial vehicles has led to active research into the development and application of suitablecomposite materials. This studysuggests abimaterial composite frame produced by apultrusion process to replace steel frames. We focused on the development of a composite frameconsisting of two types of materialsby mixing anorthotropic material with anisotropic material. The inside layer consisted of an aluminum pipe, and the outside layer was composed of a glass fiber pipe. To determine the strength and failure mechanisms of the composite material, tensile tests, shear tests, and three-point bending tests were conducted, followed by fatigue tests. After static testing, the fatigue tests were conducted at a load frequency of 5 Hz, a stress ratio (R) of 0.1, and an endurance limit of $10^6$ for the S-N curve. The resultsshowed that the failure modes were related to both the core design and the laminating conditions.

A Case Study on Housing Alterations and Construction for the Elderly and the Disabled - Comparison among Korea, Japan, and Sweden - (노인과 장애인의 주택 신축 및 개조 사례 비교연구 - 한국, 일본, 스웨덴 3국의 사례를 중심으로 -)

  • 최재순;이의정
    • Journal of the Korean Home Economics Association
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    • v.39 no.10
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    • pp.39-53
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    • 2001
  • Housing is the most important factor for the elderly and the disabled to live safely and independently. If they want to stay in their familiar community as long as possible, to support their stay in their house must be needed. The purpose of this study was to investigate the housing alterations for the elderly and the disabled. To accomplish the purpose of this study, three cases that had altered housing to fit their needs in three countries, were selected. In Korean case of alterations for the disabled, bathroom and kitchen were the altered spaces in the house. But active alterations were not done, because of the limited expense for the alterations and housing ownership, rented. In one case of housing construction for the elderly in Japan, there was no level difference in the interior. Two bedrooms were provided for the husband and the wife, because of the difference of time to bed. The sunroom for enjoying the outside of the nature was provided. In swedish case, due to the supports of the government and local authority, the house was altered at many spaces such as bathroom, kitchen, ramp at the entrance, elevator and so forth. In conclusion, sufficient supports of government and community services can increase the housing quality of people. The ultimate goal of housing alterations must be done not for the elderly and disabled but for all people.

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Improving Student Learning through a Team-Based Learning Approach in a Retailing Math Course

  • Oh, Keunyoung
    • Fashion, Industry and Education
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    • v.14 no.1
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    • pp.50-58
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    • 2016
  • Passive learning attitudes and lack of enthusiasm in a retailing math course is quite common and a significant number of students do express their frustrations and struggles by seeking extra help outside the classroom. In order to promote students' active participation in class and to improve their performance and overall satisfaction with the course, a modified team-based learning (TBL) method was implemented in a retailing math course in two consecutive semesters. Implementing TBL into a retailing math course would improve students' accountability for their own learning, increase student interactions and engagement, and develop teamwork and collaboration skills. The scores on the midterm and final tests indicated that students' performance improved especially for the students who scored below 80% on each test when TBL was implemented. Students' reflection on the TBL activities done in class throughout the semester indicated that these TBL activities help them solidify the concepts taught in class better. They were able to realize their own mistakes and other group members who got the question right helped them understand. To maximize the benefit of TBL, it is suggested to implement TBL within the flipped classroom. Further research is called for to evaluate the effect of TBL on long-term knowledge retention among college students.

ROENTGENOGRAPHIC STUDY ON THE GROWTH AND DEVELOPMENT OF TOOTH GERM AND DENTAL ARCH IN HUMAN FETUS (태아(胎兒)의 치배(齒胚) 및 치열궁(齒列弓)의 성장(成長)과 발육(發育)에 관(關)한 방사선적(放射線的) 연구(?究))

  • Chean, Ok Kyung;Suhr, Cheong Hoon
    • The korean journal of orthodontics
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    • v.12 no.2
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    • pp.95-108
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    • 1982
  • The purpose of this study was to analyze the growth and development of tooth germ and dental arch related to the bone growth during the fetal period. From 70 maxillae and 61 mandibles of the fetus aged 5, 6, 7, 8, 9 and 10 months, X-ray films were taken and measured. The results were as follows; 1. There was remarkable bone growth in the anterior and posterior area of palatum osseum, that were the intetior portion of both deciduous canines anteriorly and the intero-posterior portion of both deciduous second molars posteriorly, where there was active bone growth and radiate formation of bony trabeculae was found. 2. The Growth of anterior tooth germ was greater than that of posterior tooth germ, so anterior tooth germs were crowded. Especially in maxilla, the tooth germs of deciduous lateral incisors were located inside of dental arch and the tooth germs of deciduous canines were located outside of dental arch. 3. Crowding amount increased with the fetal age because the growth of tooth germs was greater than that of jaw bone. 4. In the growth of upper dental arch, the increase of width was greater than that of length. 5. There was proportional relationship between the area of Palatal Trapezoid and the fetal age.

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Design of Electrical equivalent circuit of Planar Buried Heterostructure Laser Diode (평면 매립형 레이저 다이오드의 전기적 등가회로 모델)

  • Kim Jeong-Ho;Park Dong-Kook
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.10 no.4
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    • pp.718-723
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    • 2006
  • Optical module plays an important role in the construction of high speed communication network. Laser diode is a component of optical module, and its characteristics are dependent of temperature, so many researches are reported. In this paper, we proposed the electrical equivalent circuit of PBH-LD based on the rate equations. And, the two leakage paths exit outside the active region. One path is converted pn-diode and the other path is converted two transistors using npn-Tr and pnp-Tr. In order to reduce the leakage currents, we observed the dependence of carrier concentrations of current blocking layers using PSPICE simulator.