Government and societal interests in additive manufacturing have increased scrutiny on process analysis, cross-cutting sustainability, and integrated decision-making methods to address commercialization and sustainability challenges. One of the key challenges is the absence of standardized metrics to assess design parameters and manufacturing practices. The primary objective of this research is to create a knowledge-based multi-criteria decision-making framework for enhancing sustainability across the design and fabrication of medical devices. The motivation behind this study lies in the inherent limitations of the existing methods. The proposed framework herein improves the traditional approaches by integrating extensive sharing of information and feedback among all design and manufacturing steps, and consequently coupling the economic and environmental sustainability dimensions. The framework includes sets of qualitative (e.g., data processing and design analysis) and quantitative (e.g., build time and energy use analyses) methods to assess transforming the raw material into optimal and sustainable final products. As an application of this study, optimal and sustainable approaches for the developing and competitive market of Orthotic and Prosthetic, particularly Ankle Foot Orthosis (AFO), is examined. Decision makers, such as managers and manufacturers, will benefit from the integrated methods in the proposed framework. The results indicate the framework offers a promising approach to address existing sustainability challenges in the AFO industry.
Background: Scapular dyskinesis is considered a risk factor for the shoulder pain that may warrant screening for prevention. Clinicians of all experience screen scapular dyskinesis using the scapular dyskinesis test yes-no classification (Y-N), yet its reliability in asymptomatic individuals is unknown. We aimed to establish Y-N’s intra- and inter-reliability between students and expert physical therapists. Methods: We utilized a cross-sectional design using consecutive asymptomatic subjects. Six students and two experts rated 100 subjects using the Y-N. Cohen’s kappa (κ) and Krippendorff’s alpha (K-α) were calculated to determine intra- and inter-rater reliability. Results: Intra- and inter-rater values for experts were κ=0.92 (95% confidence interval [CI], 0.91–0.93) and 0.85 (95% CI, 0.84–0.87) respectively; students were κ=0.77 (95% CI, 0.75–0.78) and K-α=0.63 (95% CI, 0.58–0.67). Conclusions: The Y-N is reliable in detecting scapular dyskinesis in asymptomatic individuals regardless of experience.
Purpose: To investigate the attitudes and beliefs of physical therapy (PT) and physical therapist assistant (PTA) program directors towards interprofessional education (IPE). We hypothesized that Communication and Ethics would be the most important competencies among program directors. Methods: A cross-sectional survey based on previously utilized instruments modified for the profession of PT was sent to PT and PTA program directors. One hundred sixteen responses were analyzed using frequency analysis for demographic data and non-parametric Mann-Whitney U t-test for group differences. Results: While the majority of program directors agree that IPE is important, with Communication as the most important IPE competency, most PTA program directors do not support the importance of accreditation in implementing IPE (pConclusion:Program directors agree that IPE is vital to student learning, with Communication as the most important IPE competency. However, specific differences between PT and PTA program directors emerged primarily on IPE implementation, the role of accreditation, resource support, and resource utilization.
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