Background: The end of active treatment is a period of high stress for young people with cancer, but limited literature exists about their information and support needs during this phase. This study aimed to understand the needs of young people with cancer, how these needs are currently being met, and how best to provide information and support at the end of active treatment. Methods: This was a multi-stage, mixed methods study exploring the end of treatment experience from the perspectives of young people, and the healthcare professionals caring for them. Semi-structured interviews were undertaken with healthcare professionals, which informed a survey administered nationally. Subsequently, semistructured interviews were conducted with young people. These combined results informed a co-design workshop to develop recommendations. Results: Telephone interviews were conducted with 12 healthcare professionals and 49 completed the online survey. A total of 11 young people aged 19-26 years (female = 8; 73%) were interviewed. The stakeholder workshop was attended by both healthcare professionals (n = 8) and young people (n = 3). At the end of treatment young people experience numerous ongoing physical issues including pain, fatigue and insomnia; in addition to a range of psychosocial and emotional issues including anxiety, fear of recurrence and isolation. The top three priorities for end of treatment care were: earlier provision and preparation around ongoing impact of cancer and cancer treatment; standardised and continued follow-up of young people's emotional well-being; and development of more information and resources specific to young people. Conclusion: The access and availability of appropriate information and sources of support at the end of treatment is variable and inequitable. Young people's needs would be more effectively met by timely, structured and accessible information, and support provision at the end of treatment to both prepare and enable adaptation across their transition to living with and beyond cancer. This will require both organisational and practical adjustments in care delivery, in addition to a renewed and updated understanding of what the 'end of treatment' transition process means.
With many industries changing to a just-in-time manufacturing environment, the ability to reliably meet due dates and/or determine delivery/promise dates is gaining importance. In order to achieve this, the ability to determine operating policies based on realistic production plans is paramount. For these policies to be reasonable, the uncertain nature of the process must be addressed. These uncertainties include, but are not limited to, processing time fluctuations, equipment reliability/availability, process yields, demands, and manpower changes. In this paper we present a framework for addressing uncertainty by means of Monte Carlo sampling. This framework is not limited to a specific model, but results obtained show that the need of including sufficient detail is best satisfied by a scheduling model. A number of stopping criteria are derived, and the framework is utilized to obtain operating policies for two industrially-based examples.
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