RELIABILITY OF STATED PREFERENCE METHODS

Many times governments and policy makers have to choose among different projects or policies to implement. In principle, the best choice is the one which maximizes the social welfare that, in turn, depends on individual preferences. But very often preferences are unknown and even not observable. In practice, a common procedure is to directly ask a sample of individuals about their preferences, which are therefore stated by agents rather than revealed by their behaviour. Methods for preference revelation can be classified into two broad families. The first one involves the case in which respondents are asked to simulate their market behaviour in a fictitious context designed by the researcher. The final goal of these studies is the estimation of willingness to pay (WTP), or willingness to accept (WTA), for changes in provision of non-market goods. A large literature investigates both theoretical issues connected with these procedures (Bates, 1988) and empirical results from country experiences (Mackie at al., 2003). The second family of surveys are commonly employed in public opinion analysis. In this case respondents are asked to reveal their current attitudes, whilst in some circumstances they are required to state their satisfaction with a certain policy or service. In the last decades the interest towards such analysis largely increased and a broad amount of surveys have been systematically collected (Rabin, 2002). Whatever the kind of analysis, when individuals correctly report the behaviour they would keep in a real context, or honestly admit their attitudes and perceptions, the target of the policy maker is reached. Hence, the issue of reliability of stated preferences becomes crucial in order to understand what we can learn from surveys and how SP analysis can be exploited by policy makers. Our research question is simply the following one: can we trust in SP methods? In order to answer this question the work is organised in three sections. The first one is devoted to the definition of the concept of \u201creliability\u201d. In the first place, the latter depends on the family of SP methods we are dealing with. When individuals are required to replicate their market behaviour in a fictitious scenario, two perspectives can be applied: the first one based on mainstream economic theory (Hicks and Allen, 1934) and the other one in accordance to the so called behavioural programme (Sunstein and Thaler, 2008). Both approaches are discussed, pointing out the problematic issues which characterise each methodology and trying to propose a definition for the concept of reliability. The second family of surveys can be classified into two sub-groups, based on the object of the analysis. The first group includes all situations where agents are required to reveal their actual behaviour (Bertrand and Mullainathan, 2001) while the second one is composed by those studies in which agents are asked to express their feelings or perceptions about a certain aspect of their life (McFadden et al. 2005). Again, the concept of reliability has been investigated for each group of surveys. The second and the third sections are devoted to empirical works which try, recalling the definition of reliability suggested in the first chapter, to apply this concept to empirical studies

Citizens' perception of the Cohesion Policy and support for the European Union

Using a novel database, this study assesses the impact of the perception of the personal benefits of the EU Cohesion Policy on support for the European project. The results show that the gap in support between people who claim to have benefited from the Cohesion Policy and those who feel they have not vanished once differences in individual traits and reverse causality are taken into account. This means that, despite the significant positive effect that the intensity of the Cohesion Policy in the region exerts on the perception of the policy, it does not stimulate support for the EU

Consumers’ satisfaction and regulation of local public transport: evidence from European cities

In recent decades, market-opening policies in local public transport (LPT) have impacted most European countries. However, we can observe a high degree of variability in possible LPT arrangements, from public monopolies to open markets. This work addresses the following research question: How does user satisfaction correlate to alternative organisational models of LPT service provision? We use the results of a large survey conducted in 2009 in 33 European cities to analyse the likelihood of satisfaction with standard probit models. Results show that the highest levels of satisfaction correlate with the presence of a single LPT provider, as opposed to an industry structure in which multiple providers operate in the same market area

High Levels of Circulating Type II Collagen Degradation Marker (CTx-II) Are Associated with Specific VDR Polymorphisms in Patients with Adult Vertebral Osteochondrosis

Both vitamin D and collagen have roles in osteocartilaginous homeostasis. We evaluated the association between the circulating 25-hydroxyvitamin D (25(OH)D) type I and II collagen degradation products (CTx-I, and CTx-II), and four vitamin D receptor gene (VDR) polymorphisms, in Italian males affected by low back pain (LBP) due to herniation/discopathy and/or vertebral osteochondrosis. FokI, BsmI, ApaI, and TaqI VDR-polymorphisms were detected through PCR-restriction fragment length polymorphism (RFLP), and circulating 25(OH)D, CTx-I and CTx-II were measured by immunoassays in 79 patients (of which 26 had osteochondrosis) and 79 age-, sex- and body mass index (BMI)-matched healthy controls. Among all 158 subjects, carriers of FF and Ff genotypes showed lower 25(OH)D than ff, which suggested a higher depletion of vitamin D in F allele carriers. Higher CTx-I concentrations were observed in TT versus Tt among controls, and Tt versus tt among LBP cases, which suggested a higher bone-cartilaginous catabolism in subjects bearing the T allele. Higher CTx-II concentrations were observed in patients with osteochondrosis bearing FF, bb, TT, or Aa genotypes in comparison with hernia/discopathy patients and healthy controls. Vertebral osteochondrosis shows peculiar genotypic and biochemical features related to vitamin D and the osteocartilaginous metabolism. Vitamin D has roles in the pathophysiology of osteochondrosis

Autologous Microfragmented Adipose Tissue Reduces the Catabolic and Fibrosis Response in an in Vitro Model of Tendon Cell Inflammation

Background. Mesenchymal stem cells (MSCs) emerged as a promising therapy for tendon pathologies. Microfragmented adipose tissue (\u3bcFAT) represents a convenient autologous product for the application of MSC-based therapies in the clinical setting. In the present study, the ability of \u3bcFAT to counteract inflammatory processes induced by IL-1\u3b2 on human tendon cells (TCs) was evaluated. Methods. Cell viability and proliferation were evaluated after 48 hours of transwell coculture of TCs and autologous \u3bcFAT in the presence or absence of IL-1\u3b2. Gene expression of scleraxis, collagen type I and type III, metalloproteinases-1 and -3, and cyclooxygenase-2 was evaluated by real-time RT-PCR. The content of VEGF, IL-1Ra, TNF\u3b1, and IL-6 was evaluated by ELISA. Results. IL-1\u3b2-treated TCs showed augmented collagen type III, metalloproteases, and cyclooxygenase-2 expression. \u3bcFAT was able to reduce the expression of collagen type III and metalloproteases-1 in a significant manner, and at the same time, it enhanced the production of VEGF, IL-1Ra, and IL-6. Conclusions. In this in vitro model of tendon cell inflammation, the paracrine action of \u3bcFAT, exerted by anti-inflammatory molecules and growth factors, was able to inhibit the expression of fibrosis and catabolic markers. Then, these results suggest that the application of \u3bcFAT may represent an effective conservative or adjuvant therapy for the treatment of tendon disorders

Do neurologists agree in diagnosing drug resistance in adults with focal epilepsy?

OBJECTIVE: To evaluate interrater agreement in categorizing treatment outcomes and drug responsiveness status according to the International League Against Epilepsy (ILAE) definition of drug-resistant epilepsy. METHODS: A total of 1053 adults with focal epilepsy considered by the investigators to meet ILAE criteria for drug resistance were enrolled consecutively at 43 centers and followed up prospectively for 18-34 months. Treatment outcomes for all antiepileptic drugs (AEDs) used up to enrollment (retrospective assessment), and on an AED newly introduced at enrollment, were categorized by individual investigators and by 2 rotating members of a 16-member expert panel (EP) that reviewed the patient records independently. Interrater agreement was tested by Cohen's kappa (k) statistics and rated according to Landis and Koch's criteria. RESULTS: Agreement between EP members in categorizing outcomes on the newly introduced AED was almost perfect (90.1%, k = 0.84, 95% confidence interval [CI] 0.80-0.87), whereas agreement between the EP and individual investigators was moderate (70.4%, k = 0.57, 95% CI 0.53-0.61). Similarly, categorization of outcomes on previously used AEDs was almost perfect between EP members (91.7%, k = 0.83, 95% CI 0.81-0.84) and moderate between the EP and investigators (68.2%, k = 0.50, 95% CI 0.48-0.52). Disagreement was related predominantly to outcomes considered to be treatment failures by the investigators but categorized as undetermined by the EP. Overall, 19% of patients classified as having drug-resistant epilepsy by the investigators were considered by the EP to have "undefined responsiveness." SIGNIFICANCE: Interrater agreement in categorizing treatment outcomes according to ILAE criteria ranges from moderate to almost perfect. Nearly 1 in 5 patients considered by enrolling neurologists to be "drug-resistant" were classified by the EP as having "undefined responsiveness.

Measuring mobility in people with lower limb amputation: Rasch analysis of the mobility section of the prosthesis evaluation questionnaire

Objective: To assess the psychometric properties of the Mobility Section of the Prosthesis Evaluation Questionnaire (PEQ-MS). Design: A postal survey, including self-report assessment of prosthetic capability and performance with the PEQ-MS and the Locomotor Capabilities Index, and of other variables associated with prosthetic wear and use. The PEQ-MS data underwent Rasch analysis for rating scale diagnostics and a reliability and validity study. Patients: A total of 123 subjects (mean age 54 years) who had undergone lower limb amputation in the previous 5 years and who had completed rehabilitation and a prosthetic training programme. Results: According to Rasch analysis and expert review, some response categories of the PEQ-MS (13 items, 11-level numeric rating scale) were collapsed and one item was deleted. The remaining 12 items fitted to the Rasch model and created a revised scale with a 5-level response format, the PEQ-MS12/5. The PEQ-MS12/5 demonstrated good reliability (person-separation reliability = 0.95, item-separation reliability = 0.98) and internal construct validity. Moreover, the correlation with the Locomotor Capabilities Index (r(s) = 0.78) and with prosthetic wear and use (r(s) range 0.41-0.59) supported the convergent validity of the PEQ-MS 12/5. Conclusion: The new PEQ-MS12/5 presents good psychometric characteristics for measuring mobility in people with lower limb amputations. These preliminary results provide an already applicable instrument and a solid basis for further validation studies

ILAE Genetic Literacy Series: Postmorterm Genetic Testing in Sudden Unexpected Death in Epilepsy

A 24-year-old man with non-lesional bitemporal lobe epilepsy since age 16 years was found dead in bed around midday. He was last seen the previous night when he was witnessed to have a tonic–clonic seizure. Before his death, he was experiencing weekly focal impaired awareness seizures and up to two focal-to-bilateral tonic–clonic seizures each year. He had trialed several antiseizure medications and was on levetiracetam 1500 mg/day, lamotrigine 400 mg/day, and clobazam 10 mg/day at the time of death. Other than epilepsy, his medical history was unremarkable. Of note, he had an older brother with a history of febrile seizures and a paternal first cousin with epilepsy. No cause of death was identified following a comprehensive postmortem investigation. The coroner classified the death as “sudden unexpected death in epilepsy” (SUDEP), and it would qualify as “definite SUDEP” using the current definitions.1 This left the family with many questions unanswered; in particular, they wish to know what caused the death and whether it could happen to other family members. Could postmortem genetic testing identify a cause of death, provide closure to the family, and facilitate cascade genetic testing of first-degree family members who may be at risk of sudden death? While grieving family members struggle with uncertainty about the cause of death, we as clinicians also face similar uncertainties about genetic contributions to SUDEP, especially when the literature is sparse, and the utility of genetic testing is still being worked out. We aim to shed some light on this topic, highlighting areas where data is emerging but also areas where uncertainty remains, keeping our case in mind as we examine this clinically important area