End Of Life Options Research Articles

Leveraging Social Media to Gauge Public Opinion on Waste Electrical and Electronic Equipment Management

In recent years, the rapid advancement of technology has led to a significant increase in the global use of electrical and electronic devices. This has resulted in a surge in the generation of waste electrical and electronic equipment (WEEE), a critical component of the complex solid waste management process. Since consumers play a major role in generating WEEE, understanding their perspectives on WEEE disposal is essential for developing effective management strategies. This study employs a combined approach utilizing quantitative methods, such as the analysis of 2,905,579 Twitter tweets collected from May 2019 to April 2022, and the fuzzy analytic hierarchy process (FAHP) technique, to identify appropriate end-of-life (EOL) options for WEEE. While there have been numerous studies on factors influencing consumer participation in WEEE disposal programs, no prior research has focused on identifying suitable EOL options for WEEE. A review of the literature revealed that factors such as ease of access to recycling centers, awareness, distrust in governments, financial incentives, charitable contributions, and concerns about data disclosure influence consumers’ decisions to participate in WEEE disposal programs. Additionally, four EOL options, namely re-use, remanufacturing, recycling, and disposal, were suggested for these products. Subsequently, the FAHP technique was used to examine the relationships between these options, and a suitable EOL option was recommended for each factor. The findings of this research can serve as a valuable tool in the WEEE management process, aiding in the development of effective strategies for WEEE disposal and contributing to a more sustainable approach to handling electronic waste.

In-Hospital Death and End-of-Life Status Among Patients With Adult Congenital Heart Disease - A Retrospective Study Using the JROAD-DPC Database in Japan.

The end-of-life (EOL) status, including age at death and treatment details, of patients with adult congenital heart disease (ACHD) remains unclear. This study investigated the EOL status of patients with ACHD using a nationwide Japanese database.Methods and Results: Data on the last hospitalization of 26,438 patients with ACHD aged ≥15 years, admitted between 2013 and 2017, were included. Disease complexity (simple, moderate, or great) was classified using International Classification of Diseases, 10th Revision codes. Of the 853 deaths, 831 patients with classifiable disease complexity were evaluated for EOL status. The median age at death of patients in the simple, moderate, and great disease complexity groups was 77.0, 66.5, and 39.0 years , respectively. The treatments administered before death to patients in the simple, moderate, and great complexity groups included cardiopulmonary resuscitation (30.1%, 35.7%, and 41.9%, respectively), percutaneous cardiopulmonary support (7.2%, 16.5%, and 16.3%, respectively), and mechanical ventilation (58.7%, 72.2%, and 75.6%, respectively). Overall, 70% of patients died outside of specialized facilities, with >25% dying after ≥31 days of hospitalization. Nationwide data showed that patients with ACHD with greater disease complexity died at a younger age and underwent more invasive treatments before death, with many dying after ≥1 month of hospitalization. Discussing EOL options with patients at the appropriate time is important, particularly for patients with greater disease complexity.

Abandoned Wells Can Provide Use for Pulverized Wind-Turbine Blades

_ This article, written by JPT Technology Editor Chris Carpenter, contains highlights of paper SPE 213000, “Improving Economics for Abandoning Orphaned and Idle Oil and Gas Wells by Providing Storage for Pulverized Blades From Wind Turbines,” by Elena Ikeocha, SPE, and Iraj Ershaghi, SPE, University of Southern California. The paper has not been peer reviewed. _ The complete paper outlines a potential solution for handling leftovers from wind-turbine blades. Bisphenol A (BPA) is a chemical used in such blades. The risk of BPA leaching into groundwater resources and the soil from wind-turbine-blade landfills can damage the food chain and can harm future generations through exposure to contaminated resources. The solution discussed by the authors is the potential use of the casing of idle wells considered for plugging and abandonment (P&A) for housing pulverized blades mixed with Portland cement. ​​​ Introduction The first large wind farms in the US were installed in the 1980s. Since then, the US has experienced two generations of wind-turbine installations, meaning that many of the early-generation turbines have already reached their end of life (EOL). Approximately 85% of turbine components are recyclable. Because of the complexity of the recycling process, however, these parts typically end up in landfills. Using landfills is, unfortunately, the most-common method for blade disposal in the US because of its convenience and cost efficiency. Wind turbines are manufactured using composite materials formed by the combination of polymer resins and high-tensile-strength fibers to develop glass-fiber-reinforced (GFRP) or carbon-fiber-reinforced polymers. These composite materials provide strength, weight, and durability. The strength and durability of the turbines, in conjunction with their size, create a disposal problem during their EOL. A singular wind turbine blade can be up to 100 yards long. The average weight of a wind turbine blade 128 ft long is 5,200 lbm. Blades that measure 155 ft can weigh up to 27,000 lbm. The annual rate of blade decommissions is projected to reach 2.2 million tons per year by 2050. Breaking down the statistical outlook further, 400,000 tons of blades will be decommissioned annually by 2030. This number is projected to reach 800,000 tons annually by 2050. EOL Options for Wind Turbines Between 80 and 90% of a wind-turbine blade’s mass consists of composite materials. Of that percentage, 60–70% is made up of reinforced fibers, while the remainder is resin. BPA is a chemical produced mainly for use in polycarbonate plastics. The epoxy used to form the blade consists of approximately 30–40% BPA. BPA can leak out because of blade erosion after landfill placement. Wind-turbine-blade landfills have the potential not only to leach hazardous chemicals into the environment but also to affect subsurface aquifers. Because of their durable nature, they will remain in landfills forever and leach volatile organic compounds and other toxins for decades.

A Self-Adaptive Learning Approach for Uncertain Disassembly Planning Based on Extended Petri Net

Disassembly is the first phase to demanufacture end-of-life (EOL) products that are separated into parts/components for recovery. The quality conditions of EOL products are highly uncertain, which would result in some uncertain information during the disassembly process, e.g., the disassembly time and recovering revenue of each subassembly. It is quite challenging to determine the optimal/near-optimal disassembly solutions under uncertain information. This paper studies uncertain disassembly planning (UDP) and proposes a self-adaptive learning approach to quickly identify the near-optimal disassembly solutions. First, we model the UDP by extending Petri nets, where not only disassembly operations but also EOL options of each subassembly are represented in the extended Petri Net. Based on the UDP model, we develop the self-adaptive learning approach, which integrates an approximation procedure for estimating uncertain disassembly information, a <italic xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink">Q</i> -learning algorithm for training disassembly samples, and a heuristic method for selecting the best disassembly solution. Finally, a hybrid Li-ion battery pack of Audi A3 Sportback e-tron is selected as the case study and applied to test the proposed self-adaptive learning approach. The experimental results demonstrate that our proposed method can efficiently find a better disassembly solution than the existing disassembly solution within 200 trainings in the case study.

Linear programming approach to design bio-based plastics strategies for Japan: Integration of material characteristics, product applications, and end of life options

There is a growing interest in bio-based plastics for mitigating climate change; however, it remains unclear as to which products should be produced using bio-based plastics and how such plastics should be disposed of to minimize their environmental impact. To investigate the degree to which bio-based plastics can be applied toward the mitigation of climate change based on material characteristics, product applications, and end of life (EoL) options, we developed a linear-programming-based model to represent a plastic system of nine types of fossil-based plastics and 12 types of bio-based plastics in Japan. We found that introducing bio-based plastics could reduce life cycle greenhouse gas (LCGHG) emissions, provided that an appropriate EoL is coupled. Specifically, the ‘drop-in’ plastics were dominantly selected with feedstock recycling when only material property was constrained, and the LCGHG emissions from the system was −15.5 million t-CO2eq/year.

Endowing Polythioester Vitrimer with Intrinsic Crystallinity and Chemical Recyclability.

Technologically important thermosets face a long-standing end-of-life (EoL) problem of non-reprocessability, a more sustainable solution of which has resolved to nascent vitrimers that can merge the robust material properties of thermosets and the reprocessability of thermoplastics. However, the lifecycle of vitrimers is still finite, as they often suffer from significant deterioration of mechanical performance following multiple reprocessing cycles, analogous to mechanical recycling, and they often show undesired creep under working conditions. To address these two key limitations, we have developed a cross-linked semi-crystalline polythioester with both dynamic covalent bonds and intrinsic crystallinity and chemical recyclability, affording a vitrimeric system that exhibits not only reprocessability and crystallinity-restricted creep but also complete chemical recyclability to initial monomer by catalyzed depolymerization in solution or bulk. Therefore, reported herein is an "infinite" vitrimer system that is empowered with a facile closed-loop EoL option once serial reprocessing deteriorates performance and the material can no longer meet the application requirements. Specifically, the polythioester vitrimer was constructed by copolymerization of a bicyclic thioester with a bis-dithiolane, producing dynamically cross-linked polythioesters with excellent property tunability, from amorphous to semi-crystalline states and melting transition temperatures from 91 to 178 °C.

Physician Perceptions and Beliefs Regarding End-of-Life Care in a Central California Health System.

Objective: We sought to describe the preparedness, beliefs, and experience regarding end-of-life (EOL) care for in-training and attending physicians. We hoped to clarify how medical training impacts views about EOL, and topics where physicians desire more EOL training. Methods: An online anonymous survey was sent to 766 physicians who worked at Community Medical Centers in Fresno, California from October to December 2016. Descriptive statistics of the population were compiled. Chi-squared and Mann-Whitney U tests comparing differences in personal experience, and preparedness and confidence with palliative care topics by training level were performed. Results: 195 physicians responded to the survey (25%). Respondents were 42% in-training, 55% male, 57% Caucasian, and 38% Christian. Compared to attendings those in-training were younger, more often female, and more likely to have a DO degree. The 2 groups did not differ in ethnicity, specialty, or religion. Attendings were more likely than those in-training (46% vs 14%, P < .001) to have an advance directive, reported a higher level of formal training in discussing prognosis (P = .037), and had higher confidence with palliative care topics like delivering bad news (P = .002), discussing resuscitation status (P = .015), and discussing the new California EOL Option Act (P < .001). Thirty-two percent of respondents believed patients often starve at EOL. Otherwise, knowledge was 90% correct. Conclusions: Physicians in-training are less prepared to discuss EOL topics. Physicians in-training and attendings desire more education in pain management at EOL.

The sustainability debate on plastics: Cradle to grave Life Cycle Assessment and Techno-Economical Analysis of PP and PLA polymers with a “Polluter Pays Principle” perspective

We have studied the impacts of polypropylene (PP) and poly lactic acid (PLA) to quantify the differences between fossil-based and first generation biosourced plastics. Preliminary results on impact assessment from manufacturing stages suggested that the smaller the lot size and part weight of each injection molded plastic material, the higher the economic and environmental impacts. When lot size and part weight were equal, PLA performed better than PP. In three regional development scenarios, we have studied the impacts of end-of-life (EOL) options for smaller-sized and potentially landfilled single-use food packaging materials in town (population &amp;lt;10 k), city (population 30–250 k), and province (population &amp;gt;1 M) regional scales. The impacts of the change from PP to PLA as well as landfill (L) and open incineration (OI) to other EOL options, such as recycling (R), composting (CP), and incineration with energy recovery (IwE), were studied. Impacts of toxic damages are calculated as their impact on the healthcare sector. Thus, microplastics (MP) as a vector of bioaccumulation of toxins, such as dioxins, resulted in 16,5 $/kg MP on a province scale. In the Province scenario, where L PP (90%), a mix of R and OI PP was changed to a mix of R and CP PLA resulting in 63% economic gain and 39% lower global warming potential (GWP). In the City scenario, where L PP was changed to a mix of R PP (50%), IwE PP (25%), and IwE PLA (25%) resulting in 22% economic gain and 26% lower GWP. However, the higher the waste management activities such as sorting and waste processing, the higher the high-carcinogens (+137%), high non-carcinogens (+456%), and toxic release for total air (+9%) emissions. Future work should be done to study the impacts of other toxic compounds such as food contact chemicals to compare different food packaging materials to obtain more comprehensive results.

Environmental Impacts of End-of-Life Options of Biobased and Fossil-Based Polyethylene Terephthalate and High-Density Polyethylene Packaging

Plastic waste production increasingly causes environmental pollution. However, end-of-life (EoL) research often lacks detail and timeliness and fails to integrate the end-of-life option into a product’s life cycle in a systemic perspective. This study addresses these knowledge gaps, by applying an improved anticipatory consequential life cycle assessment (LCA) approach. Reuse, mechanical and chemical recycling options were compared for (biobased and fossil-based) high-density polyethylene (HDPE) and polyethylene terephthalate (PET) plastic shampoo bottles in the European context using three types of impact categories: climate change, fossil resource scarcity and mineral resources scarcity. The completeness and detail of EoL were increased by modelling the polymer reprocessing within the collection system including all transport distances, while timeliness was improved by implementing the data applicable for the time of implementation of EoL options in the future. The results show that the reuse option has the largest benefits on climate change impact, and on fossil and mineral resource scarcity for both HDPE and PET, for both biobased and fossil plastics. Furthermore, all EoL options cause a net reduction in all climate change, fossil and mineral resource scarcity thanks to the avoided impact of virgin plastic. Finally, the improved LCA approach, utilized in this study, includes plastic production, use and EoL in one assessment, and thus can provide valuable information for adjusting policy and regulations for plastic manufacturers in their production of new virgin plastic polymer, as it requires alignment with its use and EoL options.

Building Sector Issues in about 100 Years: End-Of-Life Scenarios of Carbon-Reinforced Concrete Presented in the Context of a Life Cycle Assessment, Focusing the Carbon Footprint

Carbon-reinforced concrete (CRC) has the potential to play a pivotal role in optimizing the built environment and has therefore been experiencing a wave of research and development in the construction industry in recent years. The production of carbon fibers for CRC is energy-intensive, prompting the need to explore circular economy approaches (e.g., recycling at the End-of-Life (EoL)) to optimize the environmental performance of this material. Underdeveloped processes and a resulting lack of primary data regarding the recycling of CRC have hampered a comprehensive sustainability assessment of the novel composite building material. The novelty of this article is the detailed presentation of possible EoL scenarios for CRC and the detailed determination of the respective environmental impacts. This study aims to model EoL options within a Life Cycle Assessment (LCA), focusing on the EoL stage based on ISO 14040/44 using the GaBi ts 10.5.1.124 software and the CML2001 (2016) methodology. The practical relevance of the study lies in the early consideration of the entire life cycle of new materials, such as CRC, already in the design phase. Furthermore, the EoL can have relevant impacts on the environment, and due to an increasing significance of sustainability aspects, this LCA clarifies first approaches for the future of the construction sector in quantitative statements (e.g., CO2 emissions). All data are literature-based and are explained in detail and calculated for our case study with the functional unit of one kilogram of re-usable material (reusable and fully usable “raw” material for further use/ development) from a double wall. The impact assessment was calculated for 11 midpoint categories and related indicators, although the main focus was on Global Warming Potential (GWP). It was found that the highest-quality recycled options for CRC arise when the individual fractions (concrete matrix and carbon fibers) are first broken up, separated and then individually processed. This study focused mainly on the processing of the carbon fibers contained in CRC, for which pyrolysis and mechanical recycling have the strongest potential for industrial application. For the demolition and separation of both the concrete and the carbon fiber fractions, the conventional transport from the demolition site to the stationary processing plant proved to be the main driver of the GWP (1.4 × 10−3 kg CO2e). In the subsequent processing of the carbon fibers, pyrolysis showed a higher GWP (9.7 × 10−3 kg CO2e) than mechanical recycling (3.1 × 10−4 kg CO2e). In addition, the production of one m³ of concrete (C30/37) was compared to a primary raw material concrete fraction. Concrete can be successfully used as a substitute material for the gravel present in the C30/37 concrete. The use of recycled parts in concrete (originating from the concrete used in carbon-reinforced concrete) as a substitute for primary gravel showed a savings of 6.9 kg CO2e per m³ of primary concrete, corresponding to a reduction of 22.5%. The results show that the mechanical recycling of carbon fibers is overall the route with the lowest energy input and emissions. However, compared to pyrolysis, the recycled carbon fibers from mechanical recycling have a lower quality. Therefore, despite the higher energy input, pyrolysis is a more promising approach to close the material cycle. Furthermore, recycled aggregate concrete can reduce emissions by a quarter compared to primary concrete. Finally, this work aimed to provide a basis for further life cycle optimization in the construction sector. In subsequent studies, the EoL must be combined with the production and use stages to depict the entire life cycle, identify possible trade-offs and compare the results with conventional construction methods or materials such as steel-reinforced concrete.

A mini-review of end-of-life management of wind turbines: Current practices and closing the circular economy gap.

Renewable energy generation and increased electrification are pivotal to reducing greenhouse gas emissions and mitigating climate change. Consequently, global deployment of wind turbines has soared, and the trend is expected to continue. Installed turbines have only recently started reaching the end of their design lives, and waste volumes are projected to escalate rapidly. Approximately 94% of a wind turbine (by mass) is recyclable, but the waste polymer composite blades are most commonly landfilled. This mini-review aims to review current end-of-life (EoL) management practices in the large-scale wind industry for countries with established EoL standards as well as those with less mature regulations. Data on current EoL management practices, initiatives and regulations in industry was sourced primarily from literature reviews and publicly available internet information. Additional insights and perspectives were gained from WindEurope's EoL Issues and Strategies 2020 seminar and through communication with select individuals from various sectors such as wind energy development and operations, government, industry associations, academia and research organizations. The results show that the decision on EoL options is dictated by the remaining useful life (RUL) of the wind turbines, prevailing policies and electricity prices. The contribution of this article is, firstly, identifying a number of key technical, economic and regulatory questions that must be asked before deciding on the most appropriate EoL option. Secondly, the article identifies factors that impede current EoL management efforts to close the circular economy gap and those that can support sustainable technology deployment. Finally, the article considers the way that countries with a young fleet of wind farms may learn from more experienced nations. There are few proven business cases, and barriers to the profitability and effectiveness of EoL strategies include uncertainty about the assets' RUL, collection logistics, the size of wind farm operation margins, low waste feedstock and limited markets for recycled products. Designing for circularity, stakeholder collaboration, circular business models and technology-specific regulations can improve EoL sustainability. The research found that wind turbine EoL management is dynamic and complex and needs to consider multiple, often conflicting factors. However, it is necessary and has immense environmental, technical and economic potential as the industry matures and business cases are proven.

Design for Recycling Strategies Based on the Life Cycle Assessment and End of Life Options of Plastics in a Circular Economy

AbstractThe plastic economy, despite offering unique properties in fulfilling the functions of products in different industrial sectors over decades, has so far been mainly linear, that is, “take‐make and dispose” with only a small fraction of plastics being recycled worldwide. With ever‐increasing circular economy initiatives and the urge to conserve resources and prevent plastic pollution from affecting ecosystems, more emphasis on the resource recovery of plastic products after its use has been made over the last few years. It is necessary for manufacturers to understand the value chain as early as the design phase while manufacturing and distributing plastic products across the world. The current study provides an overview of the status quo of plastic waste management and analyzes the Life Cycle Assessment (LCA) studies of different End‐of‐Life (EoL) options for plastics. Based on the LCA studies, a preliminary, country‐specific Circular Footprint (CF) is calculated and Design for Recycling (DfR) strategies are identified. Results show that the environmental impacts of different EoL options differ significantly for different plastics. The CF highlights the lack of data regarding the composition and recovery of plastics in different countries thus showing the necessity to consider the whole lifecycle when quantifying the environmental impacts of plastics.

Bio-Based Plastics Production, Impact and End of Life: A Literature Review and Content Analysis

The accumulation of plastic wastes is one of the most widely spread problems affecting the environment. The reality that plastics can be made from renewable resources and degrade naturally has prompted academics to think outside the box to develop “better for the environment” items. In this paper, a bibliometric analysis of the scholarly publications related to bio-based plastics within the last 20 years is presented. Annual progression, geographic and research area distribution, and keyword co-occurrence were all examined. Six distinct clusters emerged from keyword analysis, which were further categorized into three directions: production to marketing; impact on the environment, economy, and society; and end-of-life (EoL) options. The major focus was on how to counter the weaknesses and challenges of bio-based plastics and take opportunities using the inherent advantages of bio-based plastics. Comprehensive studies regarding the impact of bio-based plastics on the environment, economy and social sustainability are still deficient. Although there are many promising innovations in this area, most of them are at the research stage. The benefits of bio-based plastics and better EoL options can be enjoyed only after increased production.

The ethics of euthanasia in dementia: A qualitative content analysis of case summaries (2012-2020).

BackgroundThe practice of euthanasia in dementia has thus far been described both in terms of its empirical patient characteristics and its ethical questions. However, 40 new cases have been published since the last study.MethodsA qualitative content analysis of all 111 Dutch case summaries of euthanasia in dementia patients between 2012 and 2020, selected from the total of 1117 cases published by the Regional Euthanasia Review Committees (RTE). Our initial analytical framework consists of six due care criteria and five ethical principles.Results111 case summaries were analyzed, from which we distilled seven recurring ethical questions: (1) How voluntary is a request? (2) Can an incapacitated patient make well‐considered requests? (3) What constitutes “unbearable suffering”? (4) What if the unbearableness of suffering solely consists of “the absence of any prospect of improvement”? (5) What if a euthanasia request is meant to prevent future suffering (now for then)? (6) How (well) can a patient with cognitive limitations be informed? (7) What are “reasonable alternatives” and what if patients decline available alternatives?ConclusionsBeyond these questions, however, we also see some serious challenges for the future: (a) narrowing the gap between perceived and real nursing home quality, since many advance euthanasia directives refer to nursing homes as sources of unbearable suffering; (b) making information to incompetent patients and their relatives about end of life options more tailor made, since it is questionable whether patients with dementia currently understand all of the euthanasia procedure; (c) involving patients' own physician as long as possible in a euthanasia request. Training may help physicians to deal better with euthanasia requests by patients suffering from dementia; (d) longitudinal research is required that encompasses all dementia euthanasia cases, not only those selected by the RTE.

Wind turbine blade end-of-life options: An economic comparison

Global wind energy is developing rapidly, with total installed capacity having increased from 24,332 MW in 2001 to 650,758 MW in 2019. Environmental concerns have been raised over the large volumes of waste that will be generated as these wind turbine blades are decommissioned over the coming decades. Although wind turbines are largely clean during operation, in manufacture and end-of-life stages they release emissions and consume significant energy. Wind turbine blades are mainly made from lightweight thermoset composites (glass fibre/carbon fibre), which are economically challenging to recycle. This study aims to understand the economic feasibilities of recycling technology options for blade waste management. We have used a quantitative method, first building a financial performance model for wind turbine blade end of life, then evaluating and comparing the financial performance for all available end of life options, and finally performing a sensitivity analysis. We found that mechanical recycling and fluidised-bed recycling are the optimal options of the ready-to-go technologies, and chemical recycling is the optimal option for technologies currently available only at lab scale.

Abstract PO-124: Should place of death be added to the index of disparities between Black and White breast cancer patients?

Abstract Background: Compared to their white counterparts, Black women with breast cancer suffer from earlier onset of diagnosis, more aggressive histology, higher mortality rates, and are at risk of racial bias from healthcare providers and treatment plans that do not align with the standard of care. Place of death can be considered a metric for high quality end-of-life care as hospital death is associated with both physical and emotional distress. Given Black patients' particular vulnerability, the purpose of this study was to investigate place of death as a surrogate for end-of-life healthcare disparities. Methods: The National Center for Health Statistics database was used to determine the place of death for all US women with primary-breast cancer death from 1999-2019. Place of death (home, hospital, and hospice) and race (white and Black) were considered; the subset of women who died &amp;lt;40 were also analysed. Trends in place of death in the 20-year period were evaluated via linear regression with comparisons by Chi-square test. Results: From 1999 to 2019, there were 867, 213 women who died due to breast cancer; 718,437 (82.8%) were white and 125,040 (14.4%) were Black women. Home death increased an absolute 5.7% (38.4 to 44.1%) in white women and 6.2% (29.3 to 35.5%) in Black women, p&amp;lt;0.0001 trend for both. Hospital deaths decreased -11.4% (31.9 to 20.5%) in white women and -14.4 (48.2 to 33.8%) in Black women, p&amp;lt;0.0001 trend for both. Hospice death was introduced as a database category in 2003; from 2003-2019, hospice death increased similarly in both white (0.6 to 14.5%) and Black patient populations (0.5 to 14.2%), p&amp;lt;0.0001 trend for both. In 2019, white women with breast cancer are 1.24x more likely to die at home than Black women (44.1 vs 35.5%, p&amp;lt;0.0001) and Black women with breast cancer are 1.65x more likely to die in the hospital (33.8 vs 20.5%, p&amp;lt;0.0001). Hospice deaths are more closely proportional between racial groups with white women with breast cancer only 1.02x more likely to die in hospice than Black women (p=NS). For women &amp;lt;40 from 1999 to 2019, home deaths decreased 4.6% (40.0 to 35.4%, p=0.016) for white women without significant changes in home deaths (26.9 to 25.2%, p=NS) in Black women. In 2019, white women &amp;lt;40 were 1.40x more likely to die at home than Black women with breast cancer (35.4 vs 25.2%, p = 0.0009). Conclusions: Despite improvements in home deaths over time, racial place of death disparities persist with Black women facing disproportionately higher hospital deaths and lower home deaths than white women with breast cancer. These differences may be due to cultural preference, poor physician communication about end of life options, or even inaccurate prognosis resulting in limited integration of palliative care (particularly for young patients). As home death has been associated with more favorable outcomes for patients including symptom control and autonomy, further research is needed to develop targeted interventions to improve communication and culturally competent end-of-life care. Citation Format: Sarah Marion, Fumiko Chino. Should place of death be added to the index of disparities between Black and White breast cancer patients? [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-124.

Unveiling a novel model for promoting mobile phone waste management with a social media data analytical approach

With the enormous growth of the population, the intense improvement of the electronic industry, and the ever-incrementing use of mobile phones in today's life, the proper disposal of waste mobile phones has been of paramount importance. Consequently, the tremendous volume of end-of-life (EOL) mobile phones worldwide calls for a sustainable management system to decide on waste mobile phone recovery to minimize the cost and environmental impact. This paper presented a decision problem, namely, EOL option determination, to decrease mobile phone waste. Thus, this study suggests a decision support system (DSS) for the iPhone mobile phone (a subset of the electronics industry) in the EOL phase. Customers’ pervading use of social media has led to these platforms being used as a rich data source to extract information. Thus, the proposed DSS analyzes the Twitter databases, collecting mobile phone defect information from the customers. We suggest an ontology-based text mining and a data mining-based technique through the self-organizing map (SOM) for information discovery from the Twitter data. Finally, a multi-objective mathematical model based on sustainability dimensions is developed to correct EOL decisions based on the defective mobile phone components analyzed from Twitter data. The proposed DSS helps manufacturers when a product is returned and decide for proper EOL processes. This study provides a novel insight and can serve as a valuable reference for solving waste management problems using social media data.

Experience of African American Surrogate Decision Makers of Patients With Dementia.

Dementia cases are expected to grow for African Americans and surrogate decision makers (SDMs) will have a significant role at the end of life (EOL). This qualitative exploratory case study used Cognitive Task Analysis and an integrated conceptual framework to understand the EOL decision experience of African American SDMs for patients with advanced dementia. Using a holistic multiple-case design, 8 African American SDMs were interviewed about their experiences with the decision-making process, including role acceptance, role enactment, and emotional outcomes of decision making. Thirteen themes germane to understanding the EOL decision experience of African American SDMs were identified. Findings suggest African American SDMs often lack sufficient knowledge of disease prognosis and intervention options to make informed treatment choices at EOL. In particular, African Americans extend the caregiver role to SDM for patients with dementia at EOL without being fully aware of the role and decision-making responsibilities. Surrogates lacked a general understanding of EOL options resulting in underutilization of hospice and palliative care and subsequent regret, and few interventions exist to improve the uptake of EOL care services. There is a need to develop culturally appropriate role preparation, education, and decision support to improve EOL treatment decisions and emotional adjustment of surrogates of patients with advanced dementia, which should be rendered early and throughout the illness trajectory.

Proposed Methodology for End-of-Life Option using Multi Criteria Decision Analysis: A Study for General Paper Product

Over the years, the world population has been growing exponentially. This population growth affects the number of waste products due to the increased production, which leads to greater environmental impact and other problems. There are different numbers of product end-of-life (EOL) options to handle waste based on product characteristics. This research is designed to develop a methodology to determine the best EOL option for a paper product using the analytical hierarchy process (AHP). AHP is one of the multi-criteria decision analysis (MCDA) methods employed to select the best option by considering the user’s preferences and output of competing EOL options related to different product criteria. A graphical user interface (GUI) called AHP-based software was developed using Microsoft Excel through the programming function of Visual Basic for Applications as a user facilitating tool when conducting the analysis. The case study technique is applied to five different types of paper products to assess the capability of the proposed AHP-based software. Results from the AHP-based software reveal that recycling is the most suitable EOL technique for most paper products compared to other techniques. However, polluted products with ink or food waste and coating may not be suitable for this method. The research assists the users to identify the most sustainable ways to handle paper product waste based on the product condition.

Integration of BIM and advanced digital technologies to the end of life decision-making process: a paradigm of future opportunities

PurposeAt the end of a building’s lifecycle, there are several limitations to the decision-making process (DMP). There is a lack of data available from the building’s history, the difficulty in assessing the condition of a building and the variety of stakeholders’ needs that have to be satisfied. The purpose of this paper is to answer the question: how would end-of-life (EOL) DMP change when buildings will have been digitally built? The answer will be illustrated through a conceptual framework.Design/methodology/approachA qualitative analysis of the existing literature has been performed to identify the elements within building information modelling (BIM) and advanced digital technologies that could be of support to the DMP. The findings have been collected and summarised in a conceptual framework that has been validated and enhanced through online interviews with industry experts.FindingsThe enhanced framework has identified that BIM technology would bring the benefit of providing the initial digital data source, from which machine learning and data analytics would then extract the relevant data needed to measure accurately the criteria during the analysis of the EOL options put on the table.Originality/valueThe findings of this research could contribute to developing the software modules making the bridge between BIM and machine learning technologies, to implement them in the EOL DMP.