End Of Life Options Research Articles

Integration of dismantling operations into a value recovery plan for circular economy

Traditional linear production mode “take-make-dispose” has brought about increasing resource scarcity, great environmental cost and endangered human health. To address the problem, the concept of circular economy has been introduced and accepted as a solution. In a circular economy, end-of-life (EOL) products can be introduced into multiple life cycles, which maximize the utility and value of components and materials. The economic viability of value recovery from an EOL product is greatly affected by the plan and technologies used for dismantling that product. This paper presents an approach to find a profitable EOL strategy, which includes a method for generating a dismantling transition matrix and making decisions on the best dismantling sequence, level, and EOL options for components/parts. A preservative disassembly transition matrix is a description of possible ways to disassemble a product into individual parts without any damage. A guideline is created to include destructive and automated operations in order to expand a preservative disassembly matrix into a dismantling transition matrix, because dismantling EOL products might produce more profit than pure preservative disassembly. Based on the dismantling transition matrix, binary integer programming is used to formulate EOL product value recovery while considering possible options for components/subassemblies as well as the transition cost between dismantling operations, tools costs, and recycling regulations or goals. A hard disk drive (HDD) is used as a case study to demonstrate the approach.

Product Redesign for Improved Value Recovery via Disassembly Bottleneck Identification and Removal

Making progress towards a circular economy requires the reuse of material/components to realize their maximum utility. Integrating end-of-life (EOL) considerations into the design of products will greatly facilitate the recovery of material/components at EOL, and enable their reintroduction into new product life cycles. Past research has largely employed qualitative or single objective oriented approaches for environmental product design. This paper presents a quantitative method for value recovery, in which disassembly bottlenecks are identified and removed by improving upon an existing design. The approach determines the value that can be recovered from EOL products through different EOL options. For a given EOL scenario, major bottlenecks are generally associated with joints, material incompatibility, and product architecture. Once the bottlenecks to rapid, cost effective dismantling of EOL products are identified, different design changes are considered to reduce the time/cost required to recover components/materials. To demonstrate the effectiveness of the method, a hard disk drive is used as a case study.

Application of grey relational analysis for material and end of life strategy selection with multiple criteria

Material selection is a vital phase in product development as it considers several criteria and solves trade-offs that exist among the criteria. Also, the environmental considerations are gaining importance. This article deals with the material selection process with reference to the application of an automotive component. The study presents an integrated approach for material selection coupled with the end of life (EoL) strategy. Grey relational analysis (GRA) was used to provide the solution by ranking materials considering cost, material properties and environmental impacts. EoL and strategy of the materials were also considered in ranking. The combinations were ranked using GRA in the order: SL-REU, SL-REP, SL-REN, SL-REC, SL-REM, AL-REU, AL-REC, AL-REM, AL-REP, PP-REU, ABS-REU, ABS-REC, PP-REC. The ranking configured that steel with reuse strategy as the most favourable material, considering repair, reconditioning, recycle and remanufacturing EoL options for steel. The approach combining material properties with EoL strategy will enable the selection of suitable material. The results of the study indicated the feasibility of evaluating material options using the developed multi-criteria approach.

Application of grey relational analysis for material and end of life strategy selection with multiple criteria

Material selection is a vital phase in product development as it considers several criteria and solves trade-offs that exist among the criteria. Also, the environmental considerations are gaining importance. This article deals with the material selection process with reference to the application of an automotive component. The study presents an integrated approach for material selection coupled with the end of life (EoL) strategy. Grey relational analysis (GRA) was used to provide the solution by ranking materials considering cost, material properties and environmental impacts. EoL and strategy of the materials were also considered in ranking. The combinations were ranked using GRA in the order: SL-REU, SL-REP, SL-REN, SL-REC, SL-REM, AL-REU, AL-REC, AL-REM, AL-REP, PP-REU, ABS-REU, ABS-REC, PP-REC. The ranking configured that steel with reuse strategy as the most favourable material, considering repair, reconditioning, recycle and remanufacturing EoL options for steel. The approach combining material properties with EoL strategy will enable the selection of suitable material. The results of the study indicated the feasibility of evaluating material options using the developed multi-criteria approach.

Abstract 11925: Differences in End-of-Life Preferences and Planning by Prognosis in Patients Hospitalized With Acute Decompensated Heart Failure

Introduction: In patients with heart failure, preferences for end-of-life (EOL) care and involvement in advance care planning can vary over their illness trajectory. The aim of this study was to compare EOL preferences by prognosis, assessed using the validated Meta-analysis Global Group in Chronic Heart Failure (MAGGIC) risk score, in patients hospitalized with acute decompensated heart failure (ADHF). Hypothesis: EOL preferences and planning vary by prognosis. Methods: Between January 2014 and January 2016, Southeastern Minnesota residents hospitalized with ADHF at Mayo Clinic hospitals in Rochester, MN were prospectively recruited into an observational cohort study. Information on EOL preferences and advance care planning were assessed by patient questionnaire. MAGGIC risk scores and associated 1-year mortality estimates were calculated using patient characteristics at the time of hospital admission and stratified by quartile. The associations of EOL preferences/ planning and prognosis were examined using two sample t-tests and linear regression. Results: Among 400 patients (mean age 77.7 years, 46% female), predicted 1-year mortality ranged from 3.9-72.5% (median 22.5%). Patients with higher estimated mortality (worse prognosis) more often elected Do Not Resuscitate (DNR) status (p=0.001) and more often had an advanced directive (p<0.001, Table). No other differences in EOL preferences or planning by prognosis were observed. Conclusions: In community patients hospitalized with ADHF, resuscitation preferences and rates of completion of advance care planning documents varied with prognosis, though patient-clinician EOL discussions and awareness and attitudes about EOL options did not.

Abstract 11924: Prevalence and Predictors of End-of-Life Discussions in Patients Hospitalized With Acute Decompensated Heart Failure

Introduction: Although national guidelines call on physicians to conduct regular conversations about end-of-life (EOL) care and planning with patients with heart failure (HF), research suggests that physicians often avoid these discussions. The aim of this study was to evaluate whether patients hospitalized with acute decompensated HF (ADHF) reported ever discussing their preferences for EOL care with their physicians. Methods: Between January 2014 and January 2016, Southeastern Minnesota residents hospitalized with ADHF at Mayo Clinic hospitals in Rochester, MN were prospectively recruited into an observational cohort study that included the administration of face-to-face questionnaires. Patients were asked questions regarding details of EOL discussions with their physicians, their preference for prognostic information, whether they had an advanced directive, attitudes about dying and hospice, and familiarity with palliative care and hospice. Results: Among 400 patients (mean age 77.7 years, 46% female, 48% preserved ejection fraction), only 68 (17.5%) reported previously discussing EOL wishes with their physician. Most patients (62.2%) indicated a preference to discuss their prognosis with their physician. Patients reporting prior EOL discussions were more often anemic (82.6% vs. 68.9%, p=0.022), hyponatremic (28.6% vs. 12.5%, p=0.002), and married (68.1% vs. 51.5%, p=0.012). They more often recognized the term ‘hospice’ (95.7% vs. 87.3%, p=0.045), had more favorable attitudes of dying and hospice (p=0.030), and more often had an advanced directive (83.6% vs. 67.7%, p=0.010). No other differences in demographics, comorbidity burden, HF characteristics, or in-hospital and 30-day outcomes were observed. Conclusions: Only 17.5% of patients hospitalized with ADHF reported previously discussing their preferences for EOL care with their physician. Patients reporting EOL discussions were more knowledgeable about EOL options and more likely to have completed advance care planning documents. Despite increasing recognition of the importance of these conversations, they are still occurring infrequently, and represent an important modifiable gap in the optimal longitudinal care of patients with HF.

The End of Life Option Act: A Minor Adjustment for Alzheimer's Sufferers

There are two primary issues to resolve before the Act can cover Alzheimer’s: capacity and time. This comment seeks to resolve the capacity issue only, especially with regard to mild to moderate Alzheimer’s sufferers with questionable decision-making capacity. There are many issues with allowing individuals to have access to the End of Life Option Act when they suffer from Alzheimer’s. However, respect for a person’s autonomy during their time of competency needs to be a priority. With careful consideration of the person’s medical preferences and a detailed advance directive describing their wishes, access to the End of Life Option Act may be possible. Qualifying individuals who have questionable decision-making capacity would be a giant step towards helping individuals who are suffering from Alzheimer’s gain access to the End of Life Option Act.

Simultaneous Evaluation of Environmental Impact and Incurred Cost on Selection of End-Of-Life Products Recovery Options

Conventional production and consumption systems, in which industrial products are manufactured, consumed, and then finally disposed, have significant environmental impacts. Reusing and recycling product components in the manufacture of industrial products has recently become popular as an effective way of conserving natural resources. In this study, we propose a method to assign each product component a reasonable end-of-life (EOL) option (reuse, recycling, and disposal) in the product design phase. We develop a method, in which a product tree is generated by a multi-agent system, to determine EOL options considering component combinations based on environmental impact and incurred cost. In addition, we optimize the disassembly level for better reuse and recycling. The proposed determination method of EOL options for components in a product is justified by numerical examples using an inkjet printer.

Heuristic algorithms for maximising the total profit of end-of-life computer remanufacturing

Recently the optimisation of end-of-life (EOL) computer remanufacturing has been highlighted since a big amount of used computers have been disposed of every year. Each part inspected after disassembling EOL computers can have various EOL options such as reuse, repair, reconditioning and so on. Depending on EOL options, recovered values and costs of parts will be different. Hence, in order to maximise the profit of remanufactured computers, it is important to develop the method as to how to decide the EOL options of computer parts. To this end, this study deals with a decision-making problem to select the best EOL option policy of the computer parts for maximising the total profit of computer remanufacturing considering its incurred costs and demand of remanufactured computers during multiple production periods. In particular, to maximise the total profit, the conditional repair option is newly proposed. To resolve the problem, a genetic search algorithm and an ant colony search algorithm have been developed. Computational experiments have carried out to evaluate the algorithms and the proposed conditional repair option.

Approach to the companion animal cancer patient part 1: an overview

Cancer is a common diagnosis, affecting most species of animals. This is the first in a series of articles looking at how cancer affects companion animals and their owners, and what best practice means in the veterinary profession today. This first article gives an overview of cancer in companion animal species, documenting the most common cancers seen in various species, clinical presentation and the importance of early and accurate diagnosis with staging. The reference list includes review articles, scientific papers and open access options for further reading. Future articles will look at cancer treatment, palliative care and end of life options.

Sustainable fabric choice for regularly laundered healthcare uniforms

It is well known that blended fabrics dominate the healthcare uniform market for comfort and durability performance. These fabrics present problems for end of life (EOL) management by not being easily recyclable and concerns of cross-infection lead to disposal through incineration or landfill waste. Comfort of fabrics used in healthcare uniforms is important to the wearer to enable them to carry out their duties and therefore, choice of fibre is paramount to achieve this. The use of 100% polyester has the potential to provide a sustainable alternative to polyester/cotton-blended fabrics, creating a recyclable EOL option. This paper demonstrates that fabrics using a variety of polyester yarn types show different comfort performances. The selection of appropriate polyester yarns and fabric with good comfort properties could lead to a sustainable future choice for the healthcare market.

Abstract TP410: Utilizing the Stroke Team Coordinator to Improve End of Life Discussions

Background and purpose: End of life decision making is becoming an ever increasing focus for stroke patients and their care-givers. The American Heart Association recognized the importance of this process and the need for study in this area in a 2014 scientific statement. This remains a difficult discussion for many providers to engage in given the often difficult prognostication involved in this population. We hypothesize that including the stroke coordinator in end of life discussions will facilitate a consistent message for both families and providers, allowing less opportunity for the passage of conflicting information. Methods and Results: The stroke coordinator cross trained and joined the palliative care committee, and the palliative care nurse joined the stroke team, to ensure ease of communication and collaboration. Additionally, the stroke team coordinator now participates in family care conferences in which end of life options are being discussed. The stroke team coordinator convenes with all providers prior to the family care conference to evaluate co-morbidities as well as stroke severity, thus allowing a holistic discussion with the family. Outcomes: The stroke team coordinator brings a unique perspective to end of life conversations. While physicians provide clinical data around stroke severity and co-morbidities the stroke coordinator discusses outcomes and quality of life. By exploring with families what a loved one would consider an acceptable quality of life we are able to more fully assist the family to make difficult decisions. Expertise in palliative care assists in those conversations and allows family to feel comfortable understanding the options available. Most importantly, a frank discussion around feeding issues is essential to assure families that withholding tube feedings will not cause the patient distress. Conclusion: The stroke team coordinator is in a unique position to provide leadership and guidance through often difficult and murky end of life discussions proving to be a valuable resource for this process.

Framing Effects on End-of-Life Preferences Among Latino Elders

This study compared how the presentation of end-of-life (EOL) choices influences responses by Latino and White older adults relative to resuscitation preferences. The authors apply prospect theory, which deals with decision making based on how choices are framed. Participants were presented with differently ordered questions framing a resuscitation scenario and asked to rate their preferences. Results show that Latino participants were significantly influenced by the framing order of treatment options with regard to resuscitation while Whites were not. Health professionals need to be aware that the ways they present EOL options are likely to affect the choices of Latino older adults. Further research is needed with Latino subgroups.

A fuzzy logic-based approach to determine product component end-of-life option from the views of sustainability and designer's perception

In our time, an increasing awareness of short and long-term environmental impacts is driving manufacturers to reconsider the product design process with a view toward sustainability. Manufacturers have begun to consider the need for responsible resource use and management during the product life cycle, particularly during the product retirement phase. The determination of appropriate end-of-life (EOL) options for retired product components is a crucial issue relative to most manufactured products. To address it, the product design process must be modified to consider sustainability in a comprehensive manner. At present, only limited existing research integrates social sustainability into EOL option determinations; that gap, in part, stimulates this study. We also recognize that a product designer's background and experience will directly affect the EOL strategy selection. Therefore, incorporating the designer's perception along with sustainability dimensions into an EOL strategy determination is essential and also motivates this investigation. In our proposed approach, quantitative indicators are used to assess sustainability dimensions — economic (residual value), environmental (Eco-indicator) and social impact (job creation, human toxic potential and land use) — for each EOL option. The primary merit of this approach is transferring the essential but not directly relevant design preferences into sustainability analysis through fuzzy logic-based transformation equations. An expected value is derived to represent the sustainability value of each EOL option. An automobile gasoline engine is used as a case study to illustrate the methodology.

Leaving a Legacy: Adolescent and Young Adult End-of-Life Care Planning

Leaving a Legacy: Adolescent and Young Adult End-of-Life Care Planning

A tool to evaluate the impacts of an innovation on a product's recyclability rate by adopting a modular approach: automotive sector application

While the European regulation on the end–of–life (EoL) vehicle is more and more strict, the introduction of innovations makes the material composition of vehicles evolve and can lead to a risk for approval on the recoverability of the vehicle. We set up a preventive tool named OSIRIS to evaluate the impact of an innovation on the recyclability rate of a vehicle. The innovation teams and the vehicle project leaders can evaluate an impact trend. It is supported: 1) by a modular approach of the vehicle; 2) by simplifying assumptions for fixing a module; 3) by management of the EoL options. By testing this approach on a hybrid motorisation, we show that the uncertainty resulting from the simplifying hypothesis is <0.20% when the initial and innovative solutions have a mass difference <40-60 kg.

SUSTAINABLE SUBSTRATES FOR PLANTS, TREES AND SHRUBS ENABLED WITH BIOFOAM®

BioFoam® is a polylactic acid based particle foam developed by Synbra Technology. It is an alternative to current foam materials, but bio-based and compostable. BioFoam® is already used in packaging applications and in construction, but now also horticultural applications are considered. To study possible horticultural applications various experiments have been conducted. Water retention curves of BioFoam® mixtures with potting soil have been determined. Various types of BioFoam® have been used for this. It was found that the water retention of the foam is not as good as e.g., peat, but it can be improved by modifying. In a large greenhouse BioFoam® has been compared with Styromull for insulation purposes and to improve light reflection during Chrysanthemums growth. Best growing results have been obtained when BioFoam® was used and besides it has better end of life options. A cultivation test in a hydro culture pot system with blackberry plants on BioFoam® and standard substrates showed that plant growth was comparable. Based on the above it is concluded that BioFoam® offers an alternative in various horticultural applications as (partial) replacement for existing substrates like peat or coconut.

Comparative life cycle assessment of smartphone reuse: repurposing vs. refurbishment

Waste management for end-of-life (EoL) smartphones is a growing problem due to their high turnover rate and concentration of toxic chemicals. The versatility of modern smartphones presents an interesting alternative waste management strategy: repurposing. This paper investigates the environmental impact of smartphone repurposing as compared to traditional refurbishing using Life Cycle Assessment (LCA). A case study of repurposing was conducted by creating a smartphone “app” that replicates the functionality of an in-car parking meter. The environmental impacts of this prototype were quantified using waste management LCA methodology. Studied systems included three waste management options: traditional refurbishment, repurposing using battery power, and repurposing using a portable solar charger. The functional unit was defined as the EoL management of a used smartphone. Consequential system expansion was employed to account for secondary functions provided; avoided impacts from displaced primary products were included. Impacts were calculated in five impact categories. Break-even displacement rates were calculated and sensitivity to standby power consumption were assessed. LCA results showed that refurbishing creates the highest environmental impacts of the three reuse routes in every impact category except ODP. High break-even displacement rates suggest that this finding is robust within a reasonable range of primary cell phone displacement. The repurposed smartphone in-car parking meter had lower impacts than the primary production parking meter. Impacts for battery-powered devices were dominated by use-phase charging electricity, whereas solar-power impacts were concentrated in manufacturing. Repurposed phones using battery power had lower impacts than those using solar power, however, standby power sensitivity analysis revealed that solar power is preferred if the battery charger is left plugged-in more than 20 % of the use period. Our analysis concludes that repurposing represents an environmentally preferable EoL option to refurbishing for used smartphones. The results suggest two generalizable findings. First, primary product displacement is a major factor affecting whether any EoL strategy is environmentally beneficial. The benefit depends not only on what is displaced, but also on how much displacement occurs; in general, repurposing allows freedom to target reuse opportunities with high “displacement potential.” Second, the notion that solar power is preferable to batteries is not always correct; here, the rank-order is sensitive to assumptions about user behavior.

Development of Multi-Criteria Decision Analysis Methodology to Determine Product End-of-Life Treatment Options

There are a number of different possible End-Of-Life (EOL) treatment scenarios for products at their EOL. The decision to select the best EOL scenario for a particular product, its subassemblies and individual components, depends on multiple criteria. The performance of a particular EOL option can be better against one criterion, but might not perform satisfactorily with respect to another. To overcome the problem generated by the conflicting criteria, a multi criteria decision analysis (MCDA) technique will be used. In this project MCDA is used to develop a system which aids users to determine the best EOL scenario of products by considering the user preferences and performance of competing EOL options with respect to different affecting criteria.

Product Resynthesis: Knowledge Discovery of the Value of End-of-Life Assemblies and Subassemblies

The trends of increasing waste and comparatively low growth of waste treatment methodologies have created the need for better utilization of the products we deem unfit for use. The options available for utilizing end-of-life (EOL) products are currently restricted to reusing, recycling, remanufacturing, and permanent disposal. In this work, the authors propose a new EOL option called resynthesis that utilizes existing waste from EOL products in a novel way through the synthesis of assemblies/subassemblies across multiple domains (i.e., consumer electronics, health care, automotive, etc.). The resynthesis of assemblies/subassemblies is achieved by quantifying their similarities (form and function) across multiple domains. A mixed-integer linear model is developed to determine the optimal EOL strategy for each component/subassembly. As a means of verifying the EOL decision, the value of the “new” resynthesized product is compared with the value that would be derived if the individual subassemblies were reused, remanufactured, recycled, or disposed. A case study involving an electronic mouse is used to validate the proposed methodology and to demonstrate its practicality as an alternate enterprise level EOL option.