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Background: MOG-IgG is associated with non-MS demyelinating disease of the optic nerves, spinal cord and brain. Specificity has been issue so we validated the live and fixed MOG-IgG CBAs against the Oxford Autoimmune Neurology Diagnostic Laboratory (OANG) live CBA as a comparator with high specificity. Methods: At BC Neuroimmunology lab (BCNI), 54 MOG-IgG serum samples previously positive by live-CBA at OANG and BCNI were blindly tested by commercial fixed CBA. All 54 MOG IgG positives came from MOG-IgG positive patients. In addition, 256 samples from healthy people and other neurolgic disease were tested. Results: The live MOG-IgG CBA performed at BCNI was 100% concordant (54/54) with OANG live CBA. In contrast, only 49/54 samples were found seropositive by the commercial fixed CBA. The BCNI live-CBA identified 3/256 control samples as positive while 6/256 controls were positive on the fixed commercial CBA. On this cohort the live CBA is 100% sensitive, 98.8% specific and has PPV of 95%. The commercial fixed MOG test is 91% sensitive, 97.6% specific and has PPV of 87.5%. Conclusions: BCNI live MOG-IgG CBAs are in 100% agreement with MOG-IgG. Three positive results in non-MOGAD associated clinical phenotype require further investigation. These data confirm the superiority of the live MOG CBA.

Toxocariasis, one of a group of parasitic diseases known as neglected parasitic infections, is a disease caused by the larvae of two species of Toxocara roundworms, Toxocara canis, from dogs, and less commonly Toxocara cati, from cats. Although most infected individuals are asymptomatic, clinical manifestations may include fever, fatigue, coughing, wheezing, or abdominal pain (visceral toxocariasis) or vision loss, retina damage, or eye inflammation (ocular toxocariasis). To assess U.S. pediatrician knowledge of toxocariasis, we conducted an electronic survey of American Academy of Pediatrics members. Of the 2,684 respondents, 1,120 (47%) pediatricians correctly selected toxocariasis as the diagnosis in an unknown case presentation with findings typical for toxocariasis; overall 1,695 (85%) stated they were not confident that their knowledge of toxocariasis was current. This knowledge gap suggests a need for improved toxocariasis awareness and education for U.S. pediatricians, especially those caring for children at risk for infection.

Baylisascaris procyonis roundworms can cause potentially fatal neural larva migrans in many species, including humans. However, the clinical spectrum of baylisascariasis is not completely understood. We tested 347 asymptomatic adult wildlife rehabilitators for B. procyonis antibodies; 24 were positive, suggesting that subclinical baylisascariasis is occurring among this population.

Objective: To optimize sensitivity and disease specificity of a myelin oligodendrocyte glycoprotein (MOG) antibody assay. Methods: Consecutive sera (n 5 1,109) sent for aquaporin-4 (AQP4) antibody testing were screened for MOG antibodies (Abs) by cell-based assays using either full-length human MOG (FL-MOG) or the short-length form (SL-MOG). The Abs were initially detected by Alexa Fluor goat anti-human IgG (H 1 L) and subsequently by Alexa Fluor mouse antibodies to human IgG1. Results: When tested at 1:20 dilution, 40/1,109 sera were positive for AQP4-Abs, 21 for SLMOG, and 180 for FL-MOG. Only one of the 40 AQP4-Ab–positive sera was positive for SLMOG-Abs, but 10 (25%) were positive for FL-MOG-Abs (p 5 0.0069). Of equal concern, 48% (42/88) of sera from controls (patients with epilepsy) were positive by FL-MOG assay. However, using an IgG1-specific secondary antibody, only 65/1,109 (5.8%) sera were positive on FL-MOG, and AQP4-Ab– positive and control sera were negative. IgM reactivity accounted for the remaining anti-human IgG (H 1 L) positivity toward FL-MOG. The clinical diagnoses were obtained in 33 FL-MOG–positive patients, blinded to the antibody data. IgG1-Abs to FL-MOG were associated with optic neuritis (n 5 11), AQP4-seronegative neuromyelitis optica spectrum disorder (n 5 4), and acute disseminated encephalomyelitis (n 5 1). All 7 patients with probable multiple sclerosis (MS) were MOG-IgG1 negative. Conclusions: The limited disease specificity of FL-MOG-Abs identified using Alexa Fluor goat antihuman IgG (H 1 L) is due in part to detection of IgM-Abs. Use of the FL-MOG and restricting to IgG1-Abs substantially improves specificity for non-MS demyelinating diseases. Classification of evidence: This study provides Class II evidence that the presence of serum IgG1- MOG-Abs in AQP4-Ab–negative patients distinguishes non-MS CNS demyelinating disorders from MS (sensitivity 24%, 95% confidence interval [CI] 9%–45%; specificity 100%, 95% CI 88%–100%). Neurol Neuroimmunol Neuroinflamm 2015;2:e89; doi: 10.1212/ NXI.0000000000000089

A multidisciplinary experiment for advanced undergraduate students has been developed in the context of extractive metallurgy. The experiment serves as a model of an important modern industrial process that combines aspects of organic/inorganic synthesis and analysis. Students are tasked to prepare a salicylaldoxime ligand and samples of the corresponding copper and nickel complexes, before performing test extractions and UV–vis spectroscopic analysis. The oxime ligand demonstrates a clear preference for extraction of Cu2+ in the presence of Ni2+ from aqueous solution under the conditions described. It is also possible to demonstrate that the ligand can be recovered and reused. The experiment has successfully been employed in a final year project-based laboratory course involving small groups of students.

Objective—To describe the epizootiological investigation of an outbreak of Q fever (Coxiella burnetii infection). Design—Epidemiological study. Animals—17 goat herds in Washington, Montana, and Oregon. Procedures—In April 2011, an abortion storm at a commercial goat farm in Washington was determined to be caused by C burnetii. A joint epidemiological investigation by public health and veterinary professionals was subsequently performed to assess the extent of the outbreak by performing a trace-forward of goats sold from the index farm, to determine risk factors associated with infection, and to implement control measures. A herd management plan was developed to control the outbreak and reduce risk of human exposure. Quarantine and temporary holds preventing the sale or movement of goats allowed time for trace-forward investigation, education of farmers regarding disease risk, and testing to determine the scope of the outbreak. Results—17 farms were affected; 21 human Q fever cases were identified. Bacterial shedding in feces, vaginal fluid, or milk was confirmed in 156 of 629 (25%) goats tested by PCR assay. Seroprevalence of antibodies against C burnetii in goats, determined by ELISA, was 12%. The risk for C burnetii infection in goats was highest among females, those on farms associated with human Q fever, and those on Washington farms. A protective effect was observed for goats at farms where the primary form of goat carcass disposal was burial. Conclusions and Clinical Relevance—This outbreak illustrated the importance of a joint investigation for zoonotic pathogens and the need to expand and strengthen relationships between medical, public health, and veterinary partners. Heightened awareness and enhanced veterinary diagnostic capabilities for C burnetii are needed to identify and control outbreaks expediently.

Objective: To determine the frequency and range of paraneoplastic neurologic disorders (PNDs) and neuronal antibodies in small cell lung carcinoma (SCLC). Methods: Two hundred sixty-four consecutive patients with biopsy-proven SCLC were recruited at the time of tumor diagnosis. All patients underwent full neurologic examination. Serum samples were taken prior to chemotherapy and analyzed for 15 neuronal antibodies. Thirty-eight healthy controls were analyzed in parallel. Results: PNDs were quite prevalent (n = 24, 9.4%), most frequently Lambert-Eaton myasthenic syndrome (3.8%), sensory neuronopathy (1.9%), and limbic encephalitis (1.5%). Eighty-seven percent of all patients with PNDs had antibodies to SOX2 (62.5%), HuD (41.7%), or P/Q VGCC (50%), irrespective of their syndrome. Other neuronal antibodies were found at lower frequencies (GABAb receptor [12.5%] and N-type VGCC [20.8%]) or very rarely (GAD65, amphiphysin, Ri, CRMP5, Ma2, Yo, VGKC complex, CASPR2, LGI1, and NMDA receptor [all Conclusions: The spectrum of PNDs is broader and the frequency is higher than previously appreciated, and selected antibody tests (SOX2, HuD, VGCC) can help determine the presence of an SCLC.

Toxocariasis is a preventable parasitic disease that is caused by the dog and cat roundworms Toxocara cani and T. cati, respectively. Humans become infected when they accidently ingest infectious Toxocara eggs commonly found in contaminated soil; children are most often affected. Clinical manifestations of Toxocara infection in humans include ocular toxocariasis and visceral toxocariasis. Although infection with Toxocara can cause devastating disease, the burden of toxocariasis in the United States population remains unknown. In addition, risk factors for acquiring infection need to be better defined, and research needs to be conducted to better understand the pathophysiology and clinical course of toxocariasis. Development of diagnostic tests would enable clinicians to detect active infection, and determination of optimal drug regiments would ensure patients were appropriately treated. Addressing these public health gaps is necessary to understand and address the impact of toxocariasis in the United States.

Toxocariasis is a parasitic disease caused by roundworms of cats and dogs. The disease is endemic throughout the United States and causes significant morbidity in children, including damage to the lungs, liver, or central nervous system, especially the eyes. Two well established clinical syndromes of disease include visceral and ocular toxocariasis. Symptoms of visceral toxocariasis include abdominal pain, cough, or wheezing. Vision loss or strabismus are common symptoms of ocular toxocariasis. Serologic testing for presence of Toxocara antibody is available, although a positive test result does not necessarily correlate with active clinical infection. Albendazole or mebendazole is the recommended treatment for visceral toxocariasis. Treatment options for ocular toxocariasis include corticosteroids or ophthalmic surgery; anthelminthic medications also may be used. Risk for toxocariasis can be reduced by handwashing after soil contact, routine pets deworming, discouraging geophagia, and appropriate disposal of pet feces.

IMPORTANCE: Progressive encephalomyelitis with rigidity and myoclonus is characterized by rigidity, painful muscle spasms, hyperekplexia, and brainstem signs. Recently, glycine receptor alpha 1 antibodies have been described in adult patients with progressive encephalomyelitis with rigidity and myoclonus. We describe a pediatric case. OBSERVATIONS: A 14-month-old child developed startle-induced episodes of generalized rigidity and myoclonus, axial hyperextension, and trismus, without impairment of consciousness. Episodes occurred during wakefulness and sleep, lasted seconds, and were accompanied by moaning, tachypnea, and oxygen desaturation. Imaging, cerebrospinal fluid, endocrine, metabolic, and genetic screening findings were normal or negative. She was treated with intravenous steroids and immunoglobulins with resolution of symptoms, but she relapsed weeks later. At this time, episodes were more severe. Glycine receptor alpha 1 antibodies were found in serum (titer of 1:200, later 1:320) and cerebrospinal fluid (titer of 1:2). Treatment was restarted with intravenous steroids and immunoglobulins, with major improvement, and she began treatment with oral steroids. She had 4 milder relapses, with improvement after treatment adjustments. CONCLUSIONS AND RELEVANCE: To our knowledge, this is the first pediatric case of progressive encephalomyelitis with rigidity and myoclonus associated with glycine receptor alpha 1 antibodies, a potentially severe but treatable antibody-mediated neurological disorder.

Objectives: To report an association of myelin-oligodendrocyte glycoprotein (MOG) antibodies with aquaporin-4 (AQP4) antibody–seronegative neuromyelitis optica (NMO) and neuromyelitis optica spectrum disorder (NMOSD) in adults. Methods: We describe the clinical and serologic features of 4 adult patients with an NMO/NMOSD phenotype who had antibodies to MOG. Results: Twenty-seven adult AQP4-seronegative NMO/NMOSD patients were tested for MOG antibodies. Four patients (3 male, 1 female) with severe optic neuritis and/or longitudinally extensive transverse myelitis were positive. All 4 made good recoveries with steroids or plasma exchange. Two patients experienced recurrence of symptoms when corticosteroids were withdrawn quickly but none have experienced further relapses over a mean follow-up of 12 months, although 3 patients remain on treatment. Imaging abnormalities resolved fully following clinical recovery and MOG antibody titers fell in all 4 patients. MOG antibodies were not found in 44 AQP4 antibody–positive NMO/NMOSD patients, 75 adult patients with multiple sclerosis, or 47 healthy individuals. Conclusions: MOG antibody–associated NMO/NMOSD could account for some cases thought previously to be AQP4-seronegative NMO/NMOSD. Our 4 patients appear to have more favorable clinical outcomes than those with typical AQP4 antibody–mediated disease. However, further studies of NMO/NMOSD and other demyelinating conditions are required to help clarify the diagnostic and prognostic relevance of MOG antibodies.

Purpose To assess the current burden of ocular toxocariasis (OT) and to gain knowledge regarding the diagnostic and treatment practices used in the ophthalmologic community in the United States. Design Web-based, cross-sectional survey. Participants Subspecialty ophthalmologists who are currently practicing in the United States. Methods An electronic survey was sent to 3020 ophthalmologic subspecialists belonging to the American Uveitis Society (AUS), the American Society of Retina Specialists (ASRS), or the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) to capture demographic, clinical, diagnostic, and treatment data on patients with OT seen in their practices between September 2009 and September 2010. Main Outcome Measures The demographic, epidemiologic, and clinical characteristics of each reported patient with OT. Results A total of 159 patients with OT were reported by 559 respondents (19%). The median patient age was 11.5 years (range, 1–66 years). Seventy-two patients (45%) with OT lived in the Southern region of the United States. Thirty-one (69%) of 45 patients with OT owned a dog or cat. Vision loss was reported in 46 (85%) of 54 patients with OT; 32 (71%) of 45 patients had permanent vision loss, 13 patients (29%) had temporary vision loss, and duration of vision loss was unreported for 1 patient. Of the 32 patients with OT with permanent vision loss, 30 (94%) had a subretinal granulomatous mass/scar, peripheral granuloma with traction bands, or posterior pole granuloma noted on ophthalmologic examination. Subretinal granulomatous mass/scar, vitritis, and scotoma were the most common ophthalmologic signs found on examination of patients with OT. Conclusions Ocular toxocariasis continues to occur in the United States, where it affects mainly children and causes permanent vision loss in many patients. Healthcare professionals should counsel patients and their family members about prevention strategies in an effort to decrease infection rates and morbidity due to Toxocara . Further improvement of diagnostic and treatment tools is needed to assist ophthalmologists in treating patients with OT. Financial Disclosure(s) The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Objective:To increase the detection of MuSK-Abs using a CBA and test their pathogenicity.Methods:Sera from 69 MuSK-RIA–positive patients with myasthenia gravis (MG) (Definite MuSK-MG), 169 patients negative for MuSK-RIA and AChR-RIA (seronegative MG, SNMG), 35 healthy individuals (healthy controls, HCs), and 16 NMDA receptor-Ab–positive (NMDAR-Ab) disease controls were tested for binding to MuSK on a CBA using different secondary antibodies.Results:Initially, in addition to 18% of SNMG sera, 11% of HC and 19% of NMDAR-Ab sera showed positive binding to MuSK-transfected cells; this low specificity was due to anti-IgG(H+L) detection of IgM bound nonspecifically to MuSK. Using an IgG Fc gamma-specific secondary antibody, MuSK-Abs were detected by CBA in 68/69 (99%) of Definite MuSK-MG, 0/35 HCs, 0/16 NMDAR-Ab, and 14/169 (8%) of SNMG sera, providing increased sensitivity with high specificity. The RIA-negative, CBA-positive MuSK-IgG sera, but not IgM-MuSK–binding sera, reduced agrin-induced AChR clustering in C2C12 myotubes, qualitatively similar to RIA-positive MuSK-Abs.Conclusions:An IgG-specific MuSK-CBA can reliably detect IgG MuSK-Abs and increase sensitivity. In the MuSK-CBA, IgG specificity is essential. The positive sera demonstrated pathogenic potential in the in vitro AChR-clustering assay, although less effective than Definite MuSK-MG sera, and the patients had less severe clinical disease. Use of IgG-specific secondary antibodies may improve the results of other antibody tests.Classification of evidence:This study provides Class III evidence that an IgG-specific MuSK-CBA identifies patients with MG.

We investigated whether Strongyloides infection remains endemic in rural Kentucky's Appalachian regions; 7 of 378 (1.9%) participants tested positive for Strongyloides antibodies. We identified no statistically significant association between a positive test and travel to a known endemic country (P = 0.58), indicating that transmission in rural Kentucky might be ongoing.

Currently, a 30-cluster survey to monitor drug coverage after mass drug administration for neglected tropical diseases is the most common methodology used by control programs. We investigated alternative survey methodologies that could potentially provide an estimation of drug coverage. Three alternative survey methods (market, village chief, and religious leader) were conducted and compared to the 30-cluster method in Malawi, Mali, and Uganda. In Malawi, drug coverage for the 30-cluster, market, village chief, and religious leader methods were 66.8% (95% CI 60.3–73.4), 74.3%, 76.3%, and 77.8%, respectively. In Mali, results for round 1 were 62.6% (95% CI 54.4–70.7), 56.1%, 74.8%, and 83.2%, and 57.2% (95% CI 49.0–65.4), 54.5%, 72.2%, and 73.3%, respectively, for round 2. Uganda survey results were 65.7% (59.4–72.0), 43.7%, 67.2%, and 77.6% respectively. Further research is needed to test different coverage survey methodologies to determine which survey methods are the most scientifically rigorous and resource efficient.

Sir,Acquired stuttering in previously fluent individuals may be neurogenic and is less common than developmental stuttering.[1] There have been a variety of psychotropic substances that have been a...

Objective To describe a young girl in whom stimulus sensitive spasms were a diagnostic clue to the underlying glycine receptor antibody mediated progressive encephalomyelitis with rigidity and myoclonus (PERM) which has been described mainly in adults. Methods We illustrate the clinical data from the case-notes with a video recording of stimulus-sensitive spasms. Results A previously well 15-year-old girl presented with a traumatic head injury after falling down the stairs. The noise from a doorbell had triggered a severe muscle spasm causing the fall. She sustained a complex skull fracture with coup-contrecoup brain injury. She had previously been evaluated over five months for stimulus-sensitive whole body spasms with axial hyperextension without impairment of consciousness. She also had daily stimulus-sensitive myoclonic jerks, headaches and subtle cognitive impairment over the preceding year. Whilst on the paediatric intensive care unit, she was noted to have spontaneous and stimulus-sensitive muscle spasms (EMG duration 360–680 ms with no EEG correlate). She also developed generalised tonic clonic seizures, which were treated with Levetiracetam. A diagnosis of PERM was considered and glycine receptor antibodies were found to be strongly positive in serum and CSF. VGKC-complex antibodies were also weakly positive but GAD and NMDAR antibodies were negative. Oligoclonal bands were positive in CSF but negative in serum. Paraneoplastic antibodies were negative. Brain MRI showed contusions in the right hemisphere. Body imaging did not identify any tumours. Glycine receptor gene analysis is awaited. Her spasms have improved with a residual mild startle response to touch or loud auditory stimuli. She has a residual left hemiparesis. She was not treated with immunomodulation but will be followed up, and immunotherapy considered if she does not continue to improve and antibodies persist. Conclusion Glycine receptor antibody-mediated progressive encephalomyelitis with rigidity and myoclonus can present in children as stimulus-sensitive muscle spasms.

Background In patients with glycine receptor antibodies (GlyRAb), a range of neurological syndromes that includes Stiff Person Syndrome (SPS) and its more severe variant Progressive Encephalitis with Rigidity and Myoclonus (PERM) have recently been reported in a predominantly adult cohort (Carvajal-Gonzalez et al., Brain 2014;137(Pt 8):2178–92). Objectives To report the clinical features and outcome of children with GlyR-Ab. Methods Cases were identified from samples sent to the Nuffield Department of Clinical Neurology, Oxford for a range of neuronal surface antibody testing. Results Six girls with a mean age of 8 years (median 7.5; range 1–15) were identified (2 London, 1 Oxford, and 3 Australia). The children presented with refractory focal seizures (n=2), or cognitive/behavioural changes (n=4) of whom two had tremor and gait abnormalities and one features of PERM. During the course of the illness, seizures featured in 5 patients and cognitive/behavioural changes in all. Electroencephalogram (EEG) during the illness revealed features of encephalopathy (n=3) and focal/multifocal epileptiform discharges (n=2). Two children had early imaging features of brain inflammation, and in another 2, global atrophy were identified on serial imaging despite normal acute scans. GlyR-Abs were detected in the serum (n=6) and/or CSF (n=2). Co-occurrence of low levels ( Conclusions The paediatric phenotype is predominated by female sex, seizures, and, where PERM occurs, it is associated with additional features. The clinical relevance of GlyR antibodies needs to be determined, to help guide therapies.

The economic concept ‘human capital’ refers to the fact that education and training can be regarded as a form of investment that will increase future levels of income for both individuals and society, by making people more productive, in the same way as buildings or machinery represent investment in physical capital. Economists traditionally measure the relationship between costs and benefits of investment by estimating ‘rates of return.’ This article examines the applicability of the economic concept of human capital to education, summarizes research and literature on educational aspects of human capital, discusses ways in which estimates of rates of return to education and the links between education, employment and economic growth have influenced education policy, particularly on financing of education, and examines criticisms of human capital theories, including the idea that education may represent a ‘screening device,’ rather than a genuinely productive form of investment. The article ends with a discussion of the more recently developed concept of ‘social capital,’ which challenges narrow definitions of human capital.

The figures in Table 11.1 show that all levels of education in India are profitable investments for private individuals at 8 per cent; indeed, they remain profitable even at cut-off rates as high as 10 per cent; at higher rates, a first degree at least ceases to be obviously profitable. Apart from the first general degree, however, the results are insensitive to alternative rates as high as 12 per cent. Thus, despite the fact that educated unemployment has eroded some of the financial returns of additional education, and despite the fact that there is a relatively high incidence of unemployment even for the better educated, additional education right up to the degree level still remains a profitable investment for the average Indian parent.

Background Schistosomiasis, a parasitic disease that affects over 200 million people, can lead to significant morbidity and mortality; distribution of single dose preventative chemotherapy significantly reduces disease burden. Implementation of control programs is dictated by disease prevalence rates, which are determined by costly and labor intensive screening of stool samples. Because ecological and human factors are known to contribute to the focal distribution of schistosomiasis, we sought to determine if specific environmental and geographic factors could be used to accurately predict Schistosoma mansoni prevalence in Nyanza Province, Kenya. Methodology/Principal Findings A spatial mixed model was fit to assess associations with S. mansoni prevalence in schools. Data on S. mansoni prevalence and GPS location of the school were obtained from 457 primary schools. Environmental and geographic data layers were obtained from publicly available sources. Spatial models were constructed using ArcGIS 10 and R 2.13.0. Lower S.mansoni prevalence was associated with further distance (km) to Lake Victoria, higher day land surface temperature (LST), and higher monthly rainfall totals. Altitude, night LST, human influence index, normalized difference vegetation index, soil pH, soil texture, soil bulk density, soil water capacity, population, and land use variables were not significantly associated with S. mansoni prevalence. Conclusions Our model suggests that there are specific environmental and geographic factors that influence S. mansoni prevalence rates in Nyanza Province, Kenya. Validation and use of schistosomiasis prevalence maps will allow control programs to plan and prioritize efficient control campaigns to decrease schistosomiasis burden.

Publisher Summary This chapter discusses the earnings and education. It is a well-established fact that educated workers earn higher wages or salaries than those who are illiterate or those who have completed less education, or have lower educational qualifications. The relationship between education and earnings is important on distributional grounds because the distribution of educational opportunities will have an impact on the future distribution of income, so that governments committed to long-term redistribution of income must consider the role of education. The links between education and earnings are also of crucial importance in decisions about the efficient allocation of resources. In the contribution of education to earnings, there has been a considerable improvement in the sophistication of techniques of analysis, and in the availability of data. The basic assumption of the notion that education is a form of investment in human capital is that education raises the productivity of workers and that the higher earnings of the educated reflect the value of their product.

Publisher Summary This chapter discusses the financing vocational and industrial education. Vocational and industrial education and training takes many forms. In the past, the bulk of all vocational and industrial education was provided on the job by employers for their own workers. The costs of this education and training were shared between the employers, who provided personnel, equipment, and other facilities, and the trainees, who accepted low wages during the period of training. However, as the skill requirements of the jobs became more complex, the need for more formal types of vocational education and training was widely accepted. Economists have also been much concerned with the question of whether the distinction between general and vocational education is valid. It is difficult to estimate the total costs of vocational education and industrial training, as employers do not necessarily keep accurate records of the time or expenditure devoted to on-the-job training, and it is difficult to estimate the contribution of individual trainees. Another recent development that has changed the pattern of financing vocational and industrial education in some countries is the provision of paid educational leave for employees, which means that employers continue to pay wages to employees while they receive part-time or full-time vocational or general education. In other words, paid educational leave is simply one way of distributing the costs of vocational education and training between employers, workers, and taxpayers.

Publisher Summary This chapter explains various financing methods for adult education. The term “adult education” refers to a wide range of educational activities in which adults take part and includes vocational education and training, nonvocational courses, correspondence education, and full-time and part-time courses. Because of the very wide range of educational activities included in the term “adult education” there is a wide variety of financing methods and mechanisms adopted in different countries. The Organization for Economic Co-operation and Development (OECD) carried out a series of studies on adult education that was published in 1977 and attempted to collect statistics and quantitative evidence about the magnitude and characteristics of adult education in a number of OECD member countries. In most countries finance for adult education is provided from both public and private sources. Central and local governments frequently provide funds either out of general taxation or, in a few cases, out of specific, earmarked taxes.

Publisher Summary This chapter discusses the economics of education. Contribution of education to economic growth, the profitability of investment in education, the role of educated manpower in economic development , the costs of education, the finance of education, and more recently studies of the effects of education on the distribution of income and wealth are the factors considered when economics of education is done. Economic theories of capital and investment tend to concentrate on investment in physical capital, such as buildings, factories, and machines that generate income in the form of production of goods and services. The costs of education are measured in terms of the total resources devoted to education, which economists call the opportunity cost. Cost-effectiveness analysis is used to compare the efficiency of alternative ways of achieving the same objective. Educated manpower is one of the most crucial inputs in the economy of any country. Students receive financial aid in the form of scholarships, bursaries, grants, or subsidized loans, which help to reduce the financial burden of fees or of the students' living expenses. There is a fixed and stable relationship between the level of educational qualifications of workers and the level of output of an industry or sector of the economy.

Publisher Summary This chapter highlights financing adult education for employment. Vocational and industrial education and training takes many forms. In the past, the bulk of all vocational and industrial education was provided on the job by employers for their own workers. The costs of this education and training were shared between the employers, who provided personnel, equipment, and other facilities, and the trainees, who accepted low wages during the period of training. Vocational schools were established, and new types of combined on-the-job and off-the-job training were created. It is difficult to estimate the total costs of vocational education and industrial training, because employers do not necessarily keep accurate records of the time or expenditure devoted to on-the-job training, and it is difficult to estimate the contribution of individual trainees, because this would require estimates of the value of their productive work and the distribution of their time between learning and producing. However, there are many practical and conceptual difficulties involved in estimating the total costs of vocational education and industrial training.

Publisher Summary This chapter discusses the cost effectiveness analysis in education. It is a technique for measuring the relationship between the total inputs, or costs, of a project or activity, and its outputs or objectives. Both costs and effectiveness must be quantified, but it is not necessary to measure them in monetary terms. Cost-effectiveness analysis can take two different forms. In the first case, a comparison is made between the alternative ways of achieving the same objective, to identify that with the lowest cost. The other method of using cost-effectiveness analysis is to compare two or more schools or other institutions with similar levels of cost to discover which achieves the highest level of output or results. Nevertheless, despite the difficulty of defining and measuring the output of education, it is necessary to find some way of comparing the efficiency of different institutions, of choosing between alternative methods of achieving the same or similar objectives, and of identifying the most effective ways of using educational resources.

Publisher Summary This chapter discusses cost analysis in education. The cost of education is of crucial importance to educational planners and policy makers, but there are a number of different ways of defining and measuring cost, so that it is important to distinguish between different concepts of cost before attempting to analyze the costs of education. The inputs of education can be measured in terms of money or of the real resources that are used in the educational process, namely, the time of teachers, students, and other staff and books, materials, equipment, and buildings. All these resources have alternative uses. The opportunity cost of education can be measured in terms of the cost to the individual or to society as a whole. The cost of education to individual students or their families includes expenditure on fees, books, and equipment, and also earnings forgone. Cost analysis may be concerned with the total costs of education or with unit costs, which measure the costs of educating one pupil or student. For some purposes, however, it is necessary to measure the additional costs incurred when one additional student is enrolled. The additional cost attributable to one extra student is called the marginal cost, or sometimes the incremental cost. It is measured by the increase in total costs which occurs as a result of increasing enrolment by one unit.

Publisher Summary The concept of human capital refers to the fact that human beings invest in themselves, by the means of education, training, or other activities, which raises their future income by increasing their lifetime earnings. The term investment refers to expenditure on assets that will produce income in the future and contrast investment expenditure with consumption, which produces immediate satisfaction or benefits but does not create future income. It is possible to measure the profitability of investment in human capital using the same techniques of cost benefit analysis and investment appraisal that have been traditionally applied to physical capital. The profitability, or rate of return on investment, is a measure of the expected yield of the investment, in terms of the future benefits or income stream generated by the capital compared with the cost of acquiring the capital asset. Explanations of the concept of human capital suggest that education or training raised the productivity of workers. Migration, as well as health care, can all increase earning capacity, and can therefore be regarded as investment in human capital.