Child mental health and educational attainment: multiple observers and the measurement error problem

We examine the effect of survey measurement error on the empirical relationship between child mental health and personal and family characteristics, and between child mental health and educational progress. Our contribution is to use unique UK survey data that contain (potentially biased) assessments of each child's mental state from three observers (parent, teacher and child), together with expert (quasi-)diagnoses, using an assumption of optimal diagnostic behaviour to adjust for reporting bias. We use three alternative restrictions to identify the effect of mental disorders on educational progress. Maternal education and mental health, family income and major adverse life events are all significant in explaining child mental health, and child mental health is found to have a large influence on educational progress. Our preferred estimate is that a one-standard-deviation reduction in ?true? latent child mental health leads to a 2- to 5-month loss in educational progress. We also find a strong tendency for observers to understate the problems of older children and adolescents compared to expert diagnosi

Creativity Support in a Serious Game for Dementia Care

This paper advocates the use of computer-based serious games as a form of creativity support tool. Whilst the use of serious games has grown considerably in recent years, support for players to think creatively is often implicit in the game, and does not exploit the wide range of creativity techniques and software tools available. This paper makes the case for explicit creativity support in serious games, explores how implicit creativity support can be delivered in game play, and extends one reported model of serious game play with activities in which players deploy different forms of supported creative thinking. The model is then applied to inform 2 versions of a serious game developed to train carers in creativity techniques to deliver more person-centered care to people with dementia. Each version of the game was delivered as a prototype to support playtesting of the game and its effect on carer training

CD8+ immunodominance among Epstein-Barr virus lytic cycle antigens directly reflects the efficiency of antigen presentation in lytically infected cells

Antigen immunodominance is an unexplained feature of CD8+ T cell responses to herpesviruses, which are agents whose lytic replication involves the sequential expression of immediate early (IE), early (E), and late (L) proteins. Here, we analyze the primary CD8 response to Epstein-Barr virus (EBV) infection for reactivity to 2 IE proteins, 11 representative E proteins, and 10 representative L proteins, across a range of HLA backgrounds. Responses were consistently skewed toward epitopes in IE and a subset of E proteins, with only occasional responses to novel epitopes in L proteins. CD8+ T cell clones to representative IE, E, and L epitopes were assayed against EBV-transformed lymphoblastoid cell lines (LCLs) containing lytically infected cells. This showed direct recognition of lytically infected cells by all three sets of effectors but at markedly different levels, in the order IE > E ≫ L, indicating that the efficiency of epitope presentation falls dramatically with progress of the lytic cycle. Thus, EBV lytic cycle antigens display a hierarchy of immunodominance that directly reflects the efficiency of their presentation in lytically infected cells; the CD8+ T cell response thereby focuses on targets whose recognition leads to maximal biologic effect

Tourists’ expenditure behaviour: the influence of satisfaction and the dependence of spending categories.

A review of the literature shows that the relationship between satisfaction and tourism expenditure, as well as the dependence among different tourist expenditure categories, are under-researched topics. The aim of this study is twofold: first, to investigate the influence on tourism expenditure of tourists’ satisfaction with the destination, correcting for the effect of some socio-demographic and trip-related variables; second, to study the dependence among tourist expenditure on the different tourist categories that create the overall expenditure for the trip. This study focuses on an analysis of the expenditure behaviour of a sample of international visitors who travelled in an area around the Dolomites in Northern Italy, adopting the doublehurdle model with the Heien and Wessells estimator. In discussing the results, policy implications and managerial issues for tourism destinations are presented

Pearling: stroke segmentation with crusted pearl strings

We introduce a novel segmentation technique, called Pearling, for the semi-automatic extraction of idealized models of networks of strokes (variable width curves) in images. These networks may for example represent roads in an aerial photograph, vessels in a medical scan, or strokes in a drawing. The operator seeds the process by selecting representative areas of good (stroke interior) and bad colors. Then, the operator may either provide a rough trace through a particular path in the stroke graph or simply pick a starting point (seed) on a stroke and a direction of growth. Pearling computes in realtime the centerlines of the strokes, the bifurcations, and the thickness function along each stroke, hence producing a purified medial axis transform of a desired portion of the stroke graph. No prior segmentation or thresholding is required. Simple gestures may be used to trim or extend the selection or to add branches. The realtime performance and reliability of Pearling results from a novel disk-sampling approach, which traces the strokes by optimizing the positions and radii of a discrete series of disks (pearls) along the stroke. A continuous model is defined through subdivision. By design, the idealized pearl string model is slightly wider than necessary to ensure that it contains the stroke boundary. A narrower core model that fits inside the stroke is computed simultaneously. The difference between the pearl string and its core contains the boundary of the stroke and may be used to capture, compress, visualize, or analyze the raw image data along the stroke boundary

Evaluating the Use of Daily Care Notes Software for Older People with Dementia

There has been little research to investigate the impact of software to support the care for older people with dementia care. This article reports the evaluation of software adapted to support one key person-centered task for the care of older residents with dementia – recording and sharing daily care notes. The evaluation on the dementia wing of 1 residential home for over 6 months revealed that use of the software on mobile devices carried by the carers increased the number and volume of daily care notes recorded, but only for the types of content that were already being recorded by carers. Carers reported more advantages that resulted from daily care notes once in digital form than from the documenting task, as well as barriers to the use of mobile digital software to record daily care notes

EQ-5D-5L versus 3L: the impact on cost-effectiveness

Objectives To model the relationship between EQ-5D-3L and EQ-5D-5L and examine how differences impact on cost-effectiveness in case studies. Methods We used two datasets that included both EQ-5D-3L and EQ-5D-3L from the same respondents. The EuroQoL dataset (n=3551) included patients with different diseases and a healthy cohort. The National Databank (NDB) dataset included patients with rheumatoid disease (n=5205). We estimated a system of ordinal regressions in each dataset using copula models, to link responses to the 3L instrument to 5L and its tariff, and vice versa. Results were applied to nine cost-effectiveness studies. Results Best-fitting models differed between EuroQoL and NDB datasets in terms of the explanatory variables, copulas and coefficients. In both cases the coefficients of the covariates and latent factor between -3L and -5L were significantly different, indicating that the two instruments are not a uniform realignment of the response levels for most dimensions. In the case studies, moving from 3L to 5L caused a decrease of up to 87% in incremental QALYs gained from effective technologies in almost all cases. ICERs increased, often substantially. Conversely, one technology with a significant mortality gain saw increased incremental QALYs. Conclusion 5L shifts mean utility scores up the utility scale towards full health and compresses them into a smaller range, compared to -3L. Improvements in quality of life are valued less using 5L than with 3L. 3L and 5L can produce substantially different estimates of cost effectiveness. There is no simple proportional adjustment that can be made to reconcile these differences

Coupled Motions Direct Electrons along Human Microsomal P450 Chains

Directional electron transfer through biological redox chains can be achieved by coupling reaction chemistry to conformational changes in individual redox enzymes

Brillouin microscopy for the evaluation of hair micromechanics and effect of bleaching

This is the author accepted manuscript. The final version is available from Wiley via the DOI in this recordBrillouin microscopy is a new form of optical elastography and an emerging technique in mechanobiology and biomedical physics. It was applied here to map the viscoelastic properties of human hair and to determine the effect of bleaching on hair properties. For hair samples, longitudinal measurements (i.e. along the fibre axis) revealed peaks at 18.7 GHz and 20.7 GHz at the location of the cuticle and cortex, respectively. For hair treated with a bleaching agent, the frequency shifts for the cuticle and cortex were 19.7 GHz and 21.0 GHz, respectively, suggesting that bleaching increases the cuticle modulus and - to a minor extent - the cortex modulus. These results demonstrate the capability of Brillouin spectroscopy to address questions on micromechanical properties of hair and to validate the effect of applied treatments.Engineering and Physical Sciences Research Council (EPSRC)UnileverCancer Research UKEuropean Unio