Company interest and research in the circular economy and remanufacturing have increased as a means of reducing negative environmental impacts. Remanufacturing is an industrial process whereby used ...products are returned to a state of like-new. However, few products are designed for remanufacturing, and further research and industrial efforts are needed to facilitate more widespread use of design for remanufacturing. One crucial factor facilitating design for remanufacturing is the integration of feedback in the product design process. Thus, the objective of this paper is to analyse feedback flows from remanufacturing to product design. Hence, a literature study and multiple case studies were conducted at three companies that design, manufacture and remanufacture different kinds of products. The cross-case analysis revealed the five barriers of the lack of internal awareness, lack of knowledge, lack of incentives, lack of feedback channels and non-supportive organisational structures, and the five enablers of business opportunities, integrated design processes, customers’ demand, laws, regulations and standards, and new technologies. To establish improved feedback from remanufacturing to product design, the barriers need to be addressed and the enablers explored. Thus, improved feedback from remanufacturing to product design will improve the design of future products suited for a more circular economy.
Abstract
Background
The established association between acute lymphoblastic leukemia (ALL) and hyperlipidemia has, in some studies, been linked to toxicities such as pancreatitis, thrombosis, and ...osteonecrosis. However, a systematic review investigating the incidence, management, and clinical implications of hyperlipidemia during childhood ALL treatment is lacking.
Objectives
Systematically assess the incidence of hyperlipidemia during ALL treatment, explore associations with risk factors and severe toxicities (osteonecrosis, thrombosis, and pancreatitis), and review prevalent management strategies.
Methods
A systematic review was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) statement. Data synthesis was descriptive, and a meta‐analysis of hypertriglyceridemia and risk of severe toxicities was performed.
Results
We included 13 studies with 3,425 patients. Hyperlipidemia incidence varied widely (6.7%‐85%) but with inconsistent definitions and screening strategies across studies. Evidence regarding risk factors was conflicting, but age (> 10 years) and treatment with asparaginase and glucocorticosteroids seem to be associated with hyperlipidemia. Hypertriglyceridemia (grade 3/4) increased the risk for osteonecrosis (odds ratio (OR): 4.27, 95% confidence interval (CI): 2.77‐6.61). No association could be established for pancreatitis (OR: 1.60, 95% CI: 0.53‐4.82) or thrombosis (OR: 2.45, 95% CI: 0.86‐7.01), but larger studies are needed to confirm this.
Conclusion
The overall evidence of this systematic review is limited by the small number of studies and risk of bias. Our review suggests that hypertriglyceridemia increases the risk for osteonecrosis. However, larger studies are needed to explore the clinical implications of hyperlipidemia and randomized trials investigating hyperlipidemia management and its impact on severe toxicities.
Research suggests that physical education (PE) needs to adapt to meet societies' changing needs and increased diversity amongst pupils. However, despite growing pressure from often competing sectoral ...interests, educational reforms, and new curricula directed at PE to bring about such changes, research has not seen a more profound impact. Many policy initiatives often impact PE teachers, which means they are responsible for implementing desired changes. Therefore, it is somewhat surprising how research has paid limited attention to PE teachers' decision-making processes regarding the envisaged change. To address this shortfall of understanding, this study's aim is to explore PE teachers' decision-making processes and how they relate to external pressures, interests, and reforms. To meet this aim, this article draws on an institutional logics perspective and uses data collected from semi-structured interviews with 16 PE teachers. Findings show how four institutional logics guide PE teachers' decision-making processes: (a) a democracy logic, (b) an investment logic, (c) a professional logic, and (d) a bureaucracy logic. The results also show that, beyond the fact that logics legitimise certain decisions, they delegitimise other decisions, which requires PE teachers to navigate between logics in their decision-making processes. This navigating process requires PE teachers to handle multiple and incompatible ideas about what good PE is and how to conduct it. This knowledge, if utilised, can increase alignment between policy content and implementers' interpretations, which may mitigate resistance to policy reforms and stimulate intended implementation.
Previous research has addressed how societal demands shape ideas about appropriate practices in physical education (PE) and the consequences for those involved and for society at large. It has also ...highlighted the influential role of groups and organisations, including PE teachers, in shaping PE practices. However, the significance of school leaders in driving change in PE practices has been largely overlooked, despite their crucial responsibilities in decision-making, division of labour, and resource allocation. To address this gap, this study answers the following research question: what types of institutional work do Swedish school leaders engage in as they navigate government-initiated policy? Guided by the institutional work perspective and data collected in semi-structured interviews with 13 school leaders, the thematic analysis reveals that school leaders engage in structural work, operational work, conceptual work, and relational work when navigating government-initiated policy. In more empirical terms, the results indicate that most of the power to shape the implementation process is passed on to PE teachers. This suggests that although school leaders have substantial control over strategic resources and wield other forms of power, they do not necessarily significantly influence practices and beliefs in PE. The theoretical significance of these findings lies in their ability to shed light on how changes occur and explain how such changes impact widely accepted norms, rules, and structures. In practice, knowledge of how ideas and practices guide future decisions can be used in efforts to support those working in, working with, or striving to develop PE, including decision-makers, school leaders, and PE teachers.
Little is known about how PE teachers respond to the particularities of certain institutional pressures. Such knowledge is needed to start a discussion on how external expectations are managed by PE ...teachers, who in turn make internal adaptions (e.g. change in teaching elements, schedules, feedback models, work teams) that create organisational principles. Such insights might ultimately help shed new light on the origin of unintended consequences arising from policy transformation. In this study, I explored how PE teachers respond to institutional pressures embedded in policy implementation by answering the following research question: What types of responses to multiple institutional logics can be interpreted from PE teachers' narratives about policy implementation? I utilised an institutional logics approach to analyse the data collected from 16 semistructured interviews with Swedish PE teachers. The results showed that PE teachers respond in four ways: (a) compliance, (b) defiance, (c) compartmentalisation, and (d) combination. In addition, I discuss how PE teachers negotiate competing institutional pressures and point to aspects in the organisation of teaching that are direct consequences of this process.
Remanufacturing is an industrial process turning used products into a condition of like new or better. Remanufacturing is also one strategy that salvages the value put into products during ...manufacturing and thus reduces the environmental impact of products over the life-cycle. However, not many products are designed for remanufacturing, and there is rarely any feedback from remanufacturing to design. Since design for remanufacturing is not applied at most manufacturing companies, there is a need to support companies, for example, by information feedback methods. By implementing feedback transfer from remanufacturing to design and employing design for remanufacturing, the remanufacturing process is more likely to be effective and efficient. The aim of this paper is to present a framework that supports design for remanufacturing by the implementation of structured feedback from remanufacturing to design. The framework aims at strategically outlining and practically implementing information feedback from remanufacturing to design. A case company where the framework has been initialised is also presented.
With a Product-Service System (PSS), the producer often has control of its products during multiple life-cycles, and thus there are more incentives for design for service and remanufacturing in ...comparison to traditional sales. The aim of this paper is to explore the role of PSS regarding information feedback transfer in the product life-cycle including remanufacturing. The paper explores two industrial cases where PSS does not yet act as a facilitator for transferring information feedback from remanufacturing to product designers. However, the full potential of PSS is not yet utilized at the companies, and their products are neither designed for PSS nor remanufacturing.
In order to achieve a sustainable development, circular economy approaches and circular material flows are explored in industry. However, circular information flows remain essentially unestablished. ...The aim of this paper is to: 1) explore categories and types of product life-cycle information available for remanufacturing; 2) identify constraints for efficient product life-cycle information flow via remanufacturing; and 3) propose initiatives to facilitate product life-cycle information flow via remanufacturing.
Data was collected through workshops and interviews at five remanufacturing companies. An accumulated Sankey diagram illustrates product life-cycle information flow, losses and bottleneck. Based on the analysis, possible initiatives to facilitate efficient product life-cycle information flow via remanufacturing are presented.
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