In Lean Production: Semantics Matters

Manufacturing, Planning, and Control (MPC) systems are commonly categorized as either push or pull production systems. The most common example of a push system ref erred to is a MRP system, while the example of a pull system most commonly ref erred to is JIT, or more specifically a Kanban system (Sawaya et al, 1992). We have found that the use of this terminology regarding different forms of MPC systems can be confusing to the novice as well as the more experienced management practitioner or researcher. In this paper, we make an argument for the importance of using more precise MPC terms and concepts to foster a more universally consistent understanding of MPC systems. In response to inconsistencies of definitions, explanations, and examples, we provide a framework for classifying MPC systems; a brief discussion of the types of performance measures to monitor or control for effective performance and continuous improvement in either a push or pull system

Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative study

Objectives Patients with colorectal cancer undergoing palliative treatment receive extensive treatment-related information throughout their disease trajectory. We aimed to explore the experiences of patients with incurable colorectal cancer while in palliative care and their reflections on the information provided by physicians and nurses. Our main focus was the patients’ thoughts about how information about disease status and life expectancy was communicated, from the first time that they were informed about the incurable nature of their disease through to postsurgery palliative treatment. Settings Patients with colorectal cancer receiving palliative chemotherapy. Research design We used a qualitative approach, and the data were analysed by qualitative content analysis. Participants 20 patients (34–75 years of age) were included in the study; 12 received first-line chemotherapy and 8 received second-line chemotherapy. Eleven patients were treated by oncologists, and nine were treated by junior physicians. Results Data-driven empirical analysis identified three themes: (1) inadequate information during the initial phase of the disease trajectory; (2) hope and information further into the disease trajectory and (3) personal, professional and organisational factors that influenced information and communication throughout the disease trajectory. Conclusion The participants’ experience of being told for the first time that they had an incurable disease was perceived as inadequate, while postsurgery palliative chemotherapy, physicians and nurses offered hope. The participants preferred customised information about their treatment and likely future prospects and physicians and nurses who took a holistic and compassionate approach focusing on their lifeworld. To be a sensitive, holistic and compassionate physician or nurse requires knowledge and confidence. To achieve this requires training and guidance at universities and in hospitals.Reflections on communication of disease prognosis and life expectancy by patients with colorectal cancer undergoing palliative care: a qualitative studypublishedVersio

Avgiftsreglene for utleie av næringsbygg, med hovedvekt på justeringsreglene

MasteroppgaveJUS399MAJUR-2MAJU

Stien i endring

The trail is the most important helping measure in friluftsliv (i.e. outdoor recreation or OR), mainly since walking in the neighborhood or local forest is the most frequent friluftsliv activity. Historically, trails were linear structures through the landscape to help people move from A to B for various purposes, and generally a trail was the result of systematic trampling along a preferred durable route. In OR, the activity and the experiences along the trail are often regarded as more important than moving from A to B. Preference studies in Norway have shown that a narrow, simple, dirt trail through an open, mature forest is the most attractive type of trail. Developed, graveled and broader trails are visually less attractive, likewise for wooden boardwalks. Today, new trails and restored trails seem to be systematically developed, broadened and hardened with gravel, wooden boardwalks or a stone surface. And there are many good reasons for this, like limiting erosion and ground impact, stimulating OR volume and thereby public health, helping disabled persons to access nature, building attractions for tourists, stimulating new activities (like biking), maintaining OR access in built-up areas, etc. A new “trail normality” is on the way, and I see (potential) losses: The friluftsliv culture and human–nature relation are changing, and a “graveled nature” is likely to be less attractive for children. Constant trail maintenance is needed, which takes the attention away from high quality friluftsliv landscape and replaces it with friluftsliv infrastructure. A heavy responsibility rests on the responsible OR management authorities in balancing various OR and trail measures. outdoor recreation culture, friluftsliv, dirt trail, developed trail, trail preference, public health, trail impacts and management, children and nature, trail tourism, trail maintenancepublishedVersio

Nurse-led consultations reinforced with eHealth technology: a qualitative study of the experiences of patients with gynecological cancer

publishedVersio

What you should know about tumorreductive surgery in advanced ovarian cancer –Clinical recommendations from a patient perspective

Poster presentert på 21st European Congress on Gynaecological Oncology, 2.-5. november 2019 i Aten, Hellas

Significant increase in negative impacts on vegetation and soils at informal campsites in a Norwegian national park in the period 1988–2020

publishedVersio

Preferences for follow up in long-term survivors after cervical cancer

Introduction An increasing number of cervical cancer survivors combined with lack of data on the efficacy of long-term surveillance, challenges existing follow-up models. However, before introducing new follow-up models, cervical cancer survivors’ own views on follow up are important. We aimed to explore preferences for follow up in long-term cervical cancer survivors and their associations with self-reported late-effects. Material and methods In 2013, we mailed 974 Norwegian long-term cervical cancer survivors treated during 2000-2007 a questionnaire with items covering preferences for follow up after treatment, clinical variables and validated questionnaires covering anxiety, neuroticism and depression. Results We included 471 cervical cancer survivors (response rate 57%) with a median follow up of 11 years. In all, 77% had FIGO stage I disease, and 35% were attending a follow-up program at the time of survey. Of the patients, 55% preferred more than 5 years of follow up. This was also preferred by 57% of cervical cancer survivors who were treated with conization only. In multivariable analyses, chemo-radiotherapy or surgery with radiation and/or chemotherapy (heavy treatment) and younger age were significantly associated with a preference for more than 5 years’ follow up. Late effects were reported by more than 70% of the cervical cancer survivors who had undergone heavy treatment. Conclusions Our study reveals the need for targeted patient education about the benefits and limitations of follow up. To meet increasing costs of cancer care, individualized follow-up procedures adjusted to risk of recurrence and late-effects in cervical cancer survivors are warranted.publishedVersio

The association between intrapartum opioid fentanyl and early breastfeeding: A prospective observational study

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