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Aim To explore cancer survivors’ experiences of living with chronic pain after curative cancer treatment in England, UK. Methods A qualitative study using telephone interviews with adult cancer survivors experiencing chronic pain after curative cancer treatment. Interview data was analysed using a reflexive thematic approach [1–3]. Findings Nineteen participants: 14 female, 5 male, mean age 62.4 years, 1.5–48 years since cancer diagnosis, eight tumour groups represented. Six participants (31.6%) developed chronic pain more than ten years after completing cancer treatment (range 0–25 years). Five themes were generated which highlighted the experience of chronic pain after cancer treatment for cancer survivors: 1) ‘Hear me… believe me…. Please’. Survivors felt that they had not been listened to when they tried to talk about their chronic pain after cancer treatment, nor at times, believed. 2) ‘Expectation versus reality’. Survivors had anticipated returning to pre cancer quality of life yet living in chronic pain prevented them from doing so. 3) ‘They don’t understand…. We don’t understand’. Cancer survivors did not feel informed or prepared for the risk or reality of chronic pain after cancer treatment and this compounded the difficulties of coping with and managing their pain. They felt health care professionals lacked knowledge and understanding of chronic pain after cancer. 4) ‘Negotiating the maze’. Cancer survivors encountered unclear and limited pathways for support, often bouncing from one support team to another. Identifying and accessing services was a challenge, and the responsibility of this was often left to the survivor. 5) ‘Validate my pain, validate me’. Palpable relief and benefit was felt when health care professionals diagnosed and acknowledged their chronic pain after cancer treatment. Conclusions Cancer survivors can feel ill prepared for the risk of chronic pain after cancer treatment and can experience challenges accessing support from healthcare professionals and clinical services.

The global positioning system (GPS) has motivated rapid advances in mobility data collection. A massive amount of spatio-temporal information has made it possible to know where a person was and when, but not how and why (s)he travelled, creating the need for inference models. Compared with mode detection, purpose imputation has been insufficiently studied. However, the relative lack of attention to purpose identification does not mean that this field has not emerged. For this paper, which is the first review dedicated to inferring trip purposes from GPS data, 1162 non-duplicate papers from four databases (Scopus, Web of Science, ScienceDirect and TRID) were screened, and a corpus of 25 publications was selected for examination. Based on these papers, the purpose imputation problem is defined in the contexts of the evolution of GPS-based travel surveys and two research domains, transportation science (TS) and human geography (HG). Subsequently, three steps of the purpose detection process, namely trip end detection, input feature selection and main algorithms and validation, are surveyed. During these procedures, the differences between studies in TS and those in HG are highlighted. Finally, unresolved issues related to data and feature selection, algorithms and assessment are discussed substantially to provide potential research directions. This review may be an informative reference for those newly accessing the GPS-based purpose imputation field and/or intending to develop solutions to this problem.

The Faculty of Agriculture (FoA) (University of Mauritius) is the only tertiary Education Institution in the country providing graduate training in Agriculture with an annual enrolment of about 100-125 students. Although the relative contribution of the Agricultural sector to the economy has declined over the past decade--share to GDP: 3.0% in 2014 as compared to 6.4% in 2004[1] the introduction of new schemes in support of Bio- Farming, food processing and value-addition will attract new entrepreneurs to Agriculture. This transformation in the Agriculture sector will create new job opportunities, but has to leverage on skilled human capital. Graduates with good employability skills are of strategic importance to the FoA, in line with the government's vision to develop a knowledge-based economy. This study aimed at mapping out the set of skills, understandings and personal attributes that will increase the job prospects of the fresh graduate from FoA in Agriculture. The main research question centred on the perceptions of employers, alumni and students of the FoA, concerning the most relevant competences for the Subject Area (key general and key subject specific competences), understandings and personal attributes, which enhance the employability of graduates in Agriculture. Using semi-structured interviews, the study explored and triangulated the perceptions from four key stakeholders' perspectives, namely: a range of employers, Industry Placement Supervisors, alumni of the FoA and current students. Both quantitative and qualitative insights of the perceptions on the employability skills of FoA undergraduates were obtained from a wide range of employers from the private and public sector. An analysis of data from the interviews and responses was carried out using SPSS. The key attributes that were valued by the key stakeholders have been used to inform the 'Employability Skills Subject Area Framework', and the 'Curriculum Mapping', proposed for the degree of BSc (Hons) Agriscience and Technology of the FoA.

Recently, there has been an increasing interest in targeting the safety of bus operations worldwide; however, little is known about the determinants of the bus crash severity in developing countries. By estimating an ordered logit model using the bus-involved collision data in Hanoi (Vietnam), spanning the period from 2015 to 2019, this study investigates various factors associated with the crash severity. The results reveal that the severity risk increases for (1) large buses, (2) raining conditions, (3) evening or night, (4) sparse traffic, (5) non-urban areas, (6) roads with at least three lanes, (7) curved roads, (8) two-way roads without a physical barrier, (9) head-on collision, and (10) pedestrian-related crashes. Aside from confirming the crucial roles of a wide range of factors, this research has examined the effects of two determinants (traffic density and crash area) that have not been considered for the cases of developing countries previously. Based on the findings on the impacts of factors, a series of policy recommendations regarding improving road conditions in non-urban areas, promoting walking infrastructure, reminders of high-risk situations for drivers, safety notes when improving bus service quality, and recording bus-related crashes are proposed.

The Faculty of Agriculture (FoA) (University of Mauritius) is the only tertiary Education Institution in the country providing graduate training in Agriculture with an annual enrolment of about 100-125 students. Although the relative contribution of the Agricultural sector to the economy has declined over the past decade — share to GDP: 3.0% in 2014 as compared to 6.4% in 2004[1] the introduction of new schemes in support of Bio- Farming, food processing and value-addition will attract new entrepreneurs to Agriculture. This transformation in the Agriculture sector will create new job opportunities, but has to leverage on skilled human capital. Graduates with good employability skills are of strategic importance to the FoA, in line with the government’s vision to develop a knowledge-based economy. This study aimed at mapping out the set of skills, understandings and personal attributes that will increase the job prospects of the fresh graduate from FoA in Agriculture. The main research question centred on the perceptions of employers, alumni and students of the FoA, concerning the most relevant competences for the Subject Area (key general and key subject specific competences), understandings and personal attributes, which enhance the employability of graduates in Agriculture. Using semi-structured interviews, the study explored and triangulated the perceptions from four key stakeholders’ perspectives, namely: a range of employers, Industry Placement Supervisors, alumni of the FoA and current students. Both quantitative and qualitative insights of the perceptions on the employability skills of FoA undergraduates were obtained from a wide range of employers from the private and public sector. An analysis of data from the interviews and responses was carried out using SPSS. The key attributes that were valued by the key stakeholders have been used to inform the ‘Employability Skills Subject Area Framework’, and the ‘Curriculum Mapping’, proposed for the degree of BSc (Hons) Agriscience and Technology of the FoA.[1] “Digest of Agricultural Statistics Mauritius,” Ministry of Finance and Economic Development, http://statsmauritius.govmu.org/English/StatsbySubj/Documents/Digest/Digest%20of%20Agricultural%20Statistics%202014.pdf.

Purpose : We present a framework, in which we compare a conventional standard dose of 50 Gy in 25 fractions with accelerated partial breast irradiation (APBI) using electronic brachytherapy (eBT). We discuss how radiobiological modelling enables us to establish a framework, within which we can compare external beam radiotherapy (EBRT). This leads to a determination of the shell of isoeffect in breast tissue, at which very low kV eBT can be considered to be clinically equivalent to standard EBRT. Material and methods : To estimate relative biological effectiveness (RBE) values as a function of dose and irradiation time, we used a modified linear quadratic (LQ) approach, taking into account the ability of this new device, to deliver 20 Gy at the surface of a 40 mm diameter rigid, hollow spherical applicator in less than 2 minutes. In this study, we considered the radiobiological effectiveness of the Papillon+™ X-ray brachytherapy device operating at 30 kV, 0.3 mA producing dose rates in excess of 14 Gy/min. Results : Calculated clinical RBEs ranged from 1.154 at the surface of a 40 mm diameter applicator to 1.100 at 35 mm from the applicator surface for the Papillon+ device. The absolute physical dose D (abs) 30 kV ranged from 20.00 Gy at the applicator surface to 1.20 at 35 mm distant. The product of the isoeffective single dose of 60Co reference radiation – (RBE)60Co, and the RBE corrected standard 2 Gy equivalent dose fractions (EQD2) doses, EQD2(30 kV) * (RBE)60Co ranged from 98.62 Gy at the applicator surface to 1.13 at 35 mm. The ‘shell of isoeffect’, the value on the X-axis where the EQD2(30 kV) * (RBE)60Co line crosses the 50 Gy mark on the Y-axis, was found to be approximately 3.5 mm beyond the applicator surface. Conclusions : The ‘shell of isoeffect’ can serve as a useful metric with which to compare the radiobiological effectiveness of low kV eBT with various regimes of conventional EBRT.

The education system in Mauritius bears the influence of British education. Preprimary education is fee paying. Primary schooling is free and covers 6 years. This leads to a highly selective Certificate of Primary Education (CPE) which opens the doors of secondary schooling. Since 1991, secondary education is also free and compulsory. But 80% of secondary schools are in the private sector. Secondary schooling leads to the School Certificate after 5 years of study, and the Higher School Certificate after two additional years of study. Technical education provided by two polytechnic schools and higher education, provided by the institutes, are also free. The historical overview of the evolution of education in Mauritius indicates that education reform and policy have often been the result of crises, and rarely an attempt to plan the long-term development of education in a consistent and coherent manner. There was consensus among all the actors at national level that the time had come for a comprehensive review of the education system, particularly as a plausible education strategy was one of the prerequisites for international financing. This article describes the successful experience of Mauritius in the preparation and implementation of its Master Plan for Education. The plan was presented in 1991 after national consultations to provide short-, medium- and long-term strategies for educational development. The plan has not only been of use to Mauritius, but has also served as a model in many developing countries. (Contains 6 notes and 26 resources.)

ContexteAlors que la population âgée de 60 ans et plus constituera un tiers de la population française en 2060 (Blanpain et Chardon, 2010), la part de personnes qui rencontrent des situations de handicap risque d’augmenter ces prochaines années. En effet, avec l’âge, des déficiences tant motrices, visuelles que psychologiques peuvent apparaître et restreindre les activités et la mobilité.MéthodeIci, les différences de mobilité selon l’âge et la gêne ressentie au cours du déplacement sont analysées au moyen de l’Enquête nationale transports et déplacements (ENTD) de 2007-2008. La gêne dans les déplacements s’avère être un bon indicateur de la situation de handicap, reflétant principalement les difficultés liées à des déficiences physiques. Afin de pallier l’insuffisance des informations contenues dans les indicateurs, telles que le nombre de déplacement, la distance parcourue et la durée des déplacements, généralement utilisées dans l’étude de la mobilité par les déplacements, les données sur les motifs, le mode de déplacement ou encore l’heure de départ puis sur la perception que l’individu a au cours du déplacement sont ajoutées, permettant ainsi d’ouvrir la voie à une approche basée sur les activités.RésultatsLes personnes gênées lors des déplacements représentent environ 10 % de la population française, avec des degrés divers : tandis que la moitié d’entre elles peuvent se déplacer sur tout itinéraire, un quart d’entre elles ne peuvent pas se déplacer seules sans aide. Leur moyenne d’âge de 67 ans, contre 44 ans parmi les autres personnes de 15 ans et plus, atteste le lien étroit entre la gêne dans les déplacements et l’âge. Parmi les personnes de 75 ans et plus, c’est une personne sur deux qui se dit gênée lors des déplacements. Alors que les personnes non gênées réalisent 3,3 déplacements par jour, les personnes gênées n’en réalisent que 1,8 notamment à cause d’une forte immobilité parmi elles. Leurs horaires de déplacements sont davantage restreints, excluant les heures de forte affluence. À partir de 65 ans, avec l’âge et la gêne dans les déplacements, la marche et la voiture – en tant que passager – sont de plus en plus utilisées au détriment de la conduite et des transports en commun. Enfin les personnes gênées dans les déplacements font davantage attention à l’agrément du déplacement, à réaliser des activités ou éprouver des sensations au cours du déplacement.

Uncertainty on traffic forecasts may have an impact on reimbursement scheduling for investment, as well as for scenarios for operating costs. Even the best projections are based on models and assumptions, thus raising the question of their accuracy. Indeed, long term investments are risky and it is important to cope with uncertainty. This paper deals with the uncertainty on a long term projection with an Age-Cohort approach. We used the jackknife technique to estimate confidence intervals and observe that the demographic approach outlines the structural determinants for long term trends of mobility.

Healthcare professionals are vital in preparing people living with and beyond cancer about the risks of chronic pain after cancer treatment. To do so, healthcare professionals need to be knowledgeable and confident about chronic pain after cancer treatment, yet little is known about their understanding or confidence of this common long-term and late side effect of cancer treatment. To identify healthcare professionals' knowledge and understanding of chronic pain after cancer treatment and consider how confident they are to inform, listen and signpost people living with and beyond cancer to appropriate information and support. A cross sectional online survey was distributed to healthcare professionals in the UK via cancer and primary care networks, cancer alliances and social media. The survey consisted of four domains: 1) knowledge and understanding, 2) information and support, 3) confidence and 4) barriers. Quantitative data were analysed with descriptive statistics and free text comments were analysed using qualitative content analysis. Healthcare professionals reported limited knowledge and understanding of chronic pain after cancer treatment. Healthcare professionals lacked confidence to talk to people about chronic pain after cancer treatment and viewed their lack of knowledge as a barrier. Additional barriers included 'Limited service provision', 'Conflict between services', 'Not my role' and 'Challenges in diagnosing chronic pain in cancer survivors'. Chronic pain after cancer can be a significant issue for those living with and beyond cancer, yet healthcare professionals report limited knowledge of it or understanding of the impact. More education is needed to increase healthcare professionals' knowledge and confidence in chronic pain after cancer treatment. • UK healthcare professionals report limited knowledge and understanding of chronic pain after cancer treatment. • They lack confidence to talk about chronic pain after cancer treatment and view their lack of knowledge as a barrier. • More education is needed to increase their knowledge, understanding and confidence of chronic pain after cancer treatment. [ABSTRACT FROM AUTHOR]

Abstract Background Intraoperative Radiotherapy (IORT) is a method by which a critical radiation dose is delivered to the tumour bed immediately after surgical excision. It is being investigated whether a single high dose of radiation will impart the same clinical benefit as a standard course of external beam therapy. Our centre has four Photon Radiosurgery Systems (PRS) currently used to irradiate breast and neurological sites. Materials and methods The PRS comprises an x-ray generator, control console, quality assurance tools and a mobile gantry. We investigated the dosimetric characteristics of each source and its performance stability over a period of time. We investigated half value layer, output diminution factor, internal radiation monitor (IRM) reproducibility and depth-doses in water. The half value layer was determined in air by the broad beam method, using high purity aluminium attenuators. To quantify beam hardening at clinical depths, solid water attenuators of 5 and 10 mm were placed between the x-ray probe and attenuators. The ion chamber current was monitored over 30 minutes to deduce an output diminution factor. IRM reproducibility was investigated under various exposures. Depth-dose curves in water were obtained at distances up to 35 mm from the probe. Results The mean energies for the beam attenuated by 5 and 10 mm of solid water were derived from ICRU Report 17 and found to be 18 and 24 keV. The average output level over a period of 30 minutes was found to be 99.12%. The average difference between the preset IRM limit and the total IRM count was less than 0.5%. For three x-ray sources, the average difference between the calculated and actual treatment times was found to be 0.62% (n = 30). The beam attenuation in water varied by approximately 1/r3. Conclusion The x-ray sources are stable over time. Most measurements were found to lie within the manufacturer's tolerances and an intercomparison of these checks suggests that the four x-ray sources have similar performance characteristics.

Summary Background The number of men diagnosed with prostate cancer is increasing and internationally there are high incidence rates. It is important that nurses and healthcare professionals are enabled to provide appropriate care to those men affected by prostate cancer and their families. Despite this need, there is recognition that many professionals feel ill prepared and lack knowledge in a number of areas. This paper presents the development of a Virtual Patient (VP) online resource to support practitioner learning. Aim To develop five online VP simulation scenarios to meet the learning needs of nurses and health-care professionals caring for men with prostate cancer. Method Topic areas for the VPs were taken from previous work exploring the needs of health care professionals working with men with prostate cancer. An initial scoping exercise involving nursing practitioners, students and a prostate cancer charity confirmed the focus of the case study scenarios. Service users and specialist practitioners reviewed an outline of each case study to ensure fidelity of the simulations scenarios. Cases were entered into UChoose, a web based interactive VP player and authoring tool. The final case studies were reviewed by a sample of both registered and non-registered nurses and nursing students. Results The majority of respondents reported an increase in knowledge and suggested that they would recommend the resource to others. A number of positive aspects of the resource were highlighted. Respondents also commented about areas of weakness, a number of which have been addressed subsequently. Conclusions The VP case studies provided an opportunity to develop knowledge and confidence in caring for men with prostate cancer. The mode of delivery and the content was acceptable for less experienced and knowledgeable staff. [ABSTRACT FROM AUTHOR]

We present a multicenter validation of a modified Manchester Triage System (MTS) flowchart for pediatric patients who present with headache to the emergency department. A prospective observational study was conducted across 5 European pediatric emergency departments. The standard MTS headache flowchart and a modified MTS headache flowchart were tested in the participating centers, and results were compared with triage categories identified by either the physician at the end of the clinical examination or the reference classification matrix (RCM). Fifty-three patients were enrolled in the preimplementation phase and 112 in the postimplementation phase. When compared with physician's triage and RCM, the modified MTS flowchart demonstrated good sensitivity (79% and 70%, respectively), specificity (77% and 76%, respectively), and a high positive likelihood ratio (9.14 and 16.75, respectively) for the identification of low-risk children. Conclusions: Our modified headache flowchart is safe and reliable in pediatric emergency settings, especially for lower classes of urgency. [ABSTRACT FROM AUTHOR]

Objective As few data are available on the causes of fever in children returning from international travel, the authors studied children presenting to a French tertiary care centre with fever. Methods Children presenting to the emergency department of the Robert Debré Paediatric Hospital, Paris, France between July and December 2007 with fever that occurred within 3 months of a stay abroad were included in this retrospective study. Results The children (n=538) had most commonly visited North Africa (NA) (n=214), sub-Saharan Africa (SSA) (n=185) and Europe (n=67). Their median age was 2.8 years (IQR 1.4-5.8). The median time between their return to France and the onset of fever was 5 days (IQR 0-18). Cosmopolitan infections represented 85% of the established diagnoses (97.8% and 63.9% in the children returning from NA and SSA, respectively). Fever of unknown origin accounted for 19.3% of cases. Malaria was the leading tropical infection. Excluding malaria, diarrhoeal diseases were more frequent in the children returning from NA (38.5%) than in those returning from SSA (24.5%). Malaria was associated with stays in endemic countries that exceeded 30 days (OR 3.13, 95% CI 1.02 to 9.59). Conclusion Cosmopolitan infections are the leading cause of fever in French children returning from tropical and subtropical areas. However, all febrile children who have returned from an endemic area should be tested for malaria. [ABSTRACT FROM AUTHOR]

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