Closing the loop of products and materials in Product Service Systems (PSS) can be approached by designers in several ways. One promising strategy is to invoke a greater sense of ownership of the products and materials that are used within a PSS. To develop and evaluate a design tool in the context of PSS, our case study focused on a bicycle sharing service. The central question was whether and how designers can be supported with a design tool, based on psychological ownership, to involve users in closing the loop activities. We developed a PSS design tool based on psychological ownership literature and implemented it in a range of design iterations. This resulted in ten design proposals and two implemented design interventions. To evaluate the design tool, 42 project members were interviewed about their design process. The design interventions were evaluated through site visits, an interview with the bicycle repairer responsible, and nine users of the bicycle service. We conclude that a psychological ownership-based design tool shows potential to contribute to closing the resource loop by allowing end users and service provider of PSS to collaborate on repair and maintenance activities. Our evaluation resulted in suggestions for revising the psychological ownership design tool, including adding ‘Giving Feedback’ to the list of affordances, prioritizing ‘Enabling’ and ‘Simplification’ over others and recognize a reciprocal relationship between service provider and service user when closing the loop activities.
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IntroductionThe driving pressure (ΔP) has an independent association with outcome in patients with acute respiratory distress syndrome (ARDS). INTELLiVENT-Adaptive Support Ventilation (ASV) is a closed-loop mode of ventilation that targets the lowest work and force of breathing.AimTo compare transpulmonary and respiratory system ΔP between closed-loop ventilation and conventional pressure controlled ventilation in patients with moderate-to-severe ARDS.MethodsSingle-center randomized cross-over clinical trial in patients in the early phase of ARDS. Patients were randomly assigned to start with a 4-h period of closed-loop ventilation or conventional ventilation, after which the alternate ventilation mode was selected. The primary outcome was the transpulmonary ΔP; secondary outcomes included respiratory system ΔP, and other key parameters of ventilation.ResultsThirteen patients were included, and all had fully analyzable data sets. Compared to conventional ventilation, with closed-loop ventilation the median transpulmonary ΔP with was lower (7.0 [5.0–10.0] vs. 10.0 [8.0–11.0] cmH2O, mean difference − 2.5 [95% CI − 2.6 to − 2.1] cmH2O; P = 0.0001). Inspiratory transpulmonary pressure and the respiratory rate were also lower. Tidal volume, however, was higher with closed-loop ventilation, but stayed below generally accepted safety cutoffs in the majority of patients.ConclusionsIn this small physiological study, when compared to conventional pressure controlled ventilation INTELLiVENT-ASV reduced the transpulmonary ΔP in patients in the early phase of moderate-to-severe ARDS. This closed-loop ventilation mode also led to a lower inspiratory transpulmonary pressure and a lower respiratory rate, thereby reducing the intensity of ventilation.Trial registration Clinicaltrials.gov, NCT03211494, July 7, 2017. https://clinicaltrials.gov/ct2/show/NCT03211494?term=airdrop&draw=2&rank=1.
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Background: INTELLiVENT-adaptive support ventilation (ASV) is an automated closed-loop mode of invasive ventilation for use in critically ill patients. INTELLiVENT-ASV automatically adjusts, without the intervention of the caregiver, ventilator settings to achieve the lowest work and force of breathing. Aims: The aim of this case series is to describe the specific adjustments of INTELLiVENT-ASV in patients with acute hypoxemic respiratory failure, who were intubated for invasive ventilation. Study design: We describe three patients with severe acute respiratory distress syndrome (ARDS) because of COVID-19 who received invasive ventilation in our intensive care unit (ICU) in the first year of the COVID-19 pandemic. Results: INTELLiVENT-ASV could be used successfully, but only after certain adjustments in the settings of the ventilator. Specifically, the high oxygen targets that are automatically chosen by INTELLiVENT-ASV when the lung condition ‘ARDS’ is ticked had to be lowered, and the titration ranges for positive end expiratory pressure (PEEP) and inspired oxygen fraction (FiO2) had to be narrowed. Conclusions: The challenges taught us how to adjust the ventilator settings so that INTELLiVENT-ASV could be used in successive COVID-19 ARDS patients, and we experienced the benefits of this closed-loop ventilation in clinical practice. Relevance to clinical practice: INTELLiVENT-ASV is attractive to use in clinical practice. It is safe and effective in providing lung-protective ventilation. A closely observing user always remains needed. INTELLiVENT-ASV has a strong potential to reduce the workload associated with ventilation because of the automated adjustments.
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Single-Use Plastics (SUPs) are at the centre of European Union Agenda aiming at reducing the plastic soup with the EU Directive 2019/904. SUPs reduction is pivotal also in the Dutch Government Agenda for the transition to a Circular Economy by 2050. Worldwide the data on SUPs use and disposal are impressive: humans use around 1.2 million plastic bottles per minute; approximately 91% of plastic is not recycled (www.earthday.org/fact-sheet-single-use-plastics/). While centralised processes of waste collection, disposal, and recycling strive to cope with such intense use of SUPs, the opportunities and constraints of establishing a networked grid of facilities enacting processes of SUPs collection and recycling with the active involvement of local community has remained unexplored. The hospitality sector is characterised by a widespread capillary network of small hospitality firms nested in neighbourhoods and rural communities. Our research group works with small hospitality firms, different stakeholders, and other research groups to prompt the transition of the hospitality sector towards a Circular Economy embracing not only the environmental and economic dimensions but also the social dimension. Hence, this project explores the knowledge and network needed to build an innovative pilot allowing to close the plastic loop within a hospitality facility by combining a 3D printing process with social inclusiveness. This will mean generating key technical and legal knowledge as well as a network of strategic experts and stakeholders to be involved in an innovative pilot setting a 3D printing process in a hospitality facility and establishing an active involvement of the local community. Such active involvement of the local inhabitants will be explored as SUPs collectors and end-users of upcycled plastics items realised with the 3D printer, as well as through opportunities of vocational training and job opportunities for citizens distant from the job market.
De achtergrond van het project is het hoogwaardig recyclen van (autobanden)rubbers die het eind van de gebruiksfase hebben bereikt en worden aangemerkt als ‘afval’. In het beoogde proces van hoogwaardige recycling wordt het materiaal middels devulcanisatie zo ver mogelijk teruggebracht tot zijn oorspronkelijke vorm, waardoor de eigenschappen van de elastomeren grotendeels behouden blijven. Het doel is dat het materiaal bij hergebruik als wezenlijk deel van de samenstelling van een nieuw te vervaardigen rubbercompound kan dienen. Beoogde toepassing is terug in banden, dus een cradle-to-cradle loop. Naast het behoud van de unieke rubbereigenschappen is met name de homogeniteit van het materiaal en herverwerkbaarheid van belang. Tevens is het belangrijk dat de kosten van het devulcanisatieproces relatief laag zijn om het economisch aantrekkelijk te maken. De nieuwe methode van recycling past in het principe van de circulaire economie. Het onderhavige project beoogt de praktische vertaling van de kennis die ontwikkeld is in het PhD-onderzoeksproject ‘Closing the Loop’ van de Universiteit Twente in samenwerking met Hogeschool Windesheim naar een tweetal bestaande materiaalstromen. De kennis is opgebouwd voor een specifieke materiaalstroom van een specifieke leverancier, maar is naar verwachting breder inzetbaar voor meerdere materiaalstromen door aanpassing van de procesparameters. Onderdeel van het onderzoek is het analyseren van de kwaliteit van het gedevulcaniseerde materiaal en daarnaast het testen van de eigenschappen van het materiaal na toevoeging van een standaard vulcanisatiesysteem en het bijbehorende vulcanisatieproces. Het onderzoek wordt gedaan door deskundigen in het vakgebied die specifiek kennis en ervaring hebben met betrekking tot rubbermaterialen en -verwerking en recyclingvraagstellingen omtrent rubbers. Er zijn een tweetal MKB-bedrijven bij het project betrokken die jarenlange ervaring hebben met de recycling van rubbers. Daarnaast is RecyBEM, de uitvoeringsorganisatie van het Besluit beheer autobanden (Bba) betrokken bij dit project. RecyBEM organiseert sinds 2004 in Nederland de inzameling en recycling van gebruikte autobanden uit de vervangingsmarkt. Het beoogde projectresultaat betreft kennis over de technische en praktische mogelijkheden van het devulcanisatieproces voor rubber afvalstromen. Om de mogelijkheden van hoogwaardig hergebruik van deze rubbers nauwkeurig te bepalen en kunnen voorspellen worden de materialen tevens opnieuw gecompoundeerd en geanalyseerd. De opgedane kennis en resultaten worden gerapporteerd in een onderzoeksrapport. Tevens zal met instemming van de deelnemende bedrijven hierover een artikel worden geschreven.
The COVID19 pandemic highlighted the vulnerability in supply chain networks in the healthcare sector and the tremendous waste problem of disposable healthcare products, such as isolation gowns. Single-use disposable isolation gowns cause great ecological impact. Reusable gowns can potentially reduce climate impacts and improve the resilience of healthcare systems by ensuring a steady supply in times of high demand. However, scaling reusable, circular isolation gowns in healthcare organizations is not straightforward. It is impeded by economic barriers – such as servicing costs for each use – and logistic and hygiene barriers, as processes for transport, storage and safety need to be (re)designed. Healthcare professionals (e.g. purchasing managers) lack complete information about social, economic and ecological costs, the true cost of products, to make informed circular purchasing decisions. Additionally, the residual value of materials recovered from circular products is overlooked and should be factored into purchasing decisions. To facilitate the transition to circular procurement in healthcare, purchasing managers need more fine-grained, dynamic information on true costs. Our RAAK Publiek proposal (MODLI) addresses a problem that purchasing managers face – making purchasing decisions that factor in social, economic and ecological costs and future benefits from recovered materials. Building on an existing consortium that developed a reusable and recyclable isolation gown, we design and develop an open-source decision-support tool to inform circular procurement in healthcare organizations and simulate various purchasing options of non-circular and circular products, including products from circular cascades. Circular procurement is considered a key driver in the transition to a circular economy as it contributes to closing energy and material loops and minimizes negative impacts and waste throughout entire product lifecycles. MODLI aims to support circular procurement policies in healthcare organizations by providing dynamic information for circular procurement decision making.
