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This chapter shows that individuals’ trajectories in personal networks and the labour market are closely intertwined. A person’s network facilitates access to jobs in different ways. As people create relationships and accumulate social contacts, they obtain more information about job opportunities and embark on more rewarding careers. However, personal relationships may also hamper employment prospects. If employers expect that the obligations accruing from family-care reduce productivity, the consequence will be stunted careers and lower wages, notably for mothers. Yet the extent to which social relations help or hinder work trajectories varies across Europe and crucially depends on employment and family policies. Moreover, the spill-over effects between the two life domains travel both ways as employment outcomes also affect personal relationships. A prime example is how job loss affects the stability of partnerships. While recessions reduce the divorce rate at the aggregate level, the minority of individuals who lose their jobs are more likely to see their couples break up. Our chapter discusses the theory of spill-over effects between social relations and employment and reviews cutting-edge research in economics and sociology on the topic.

Introduction COVID-19 case fatality rate in hospitalized patients varies across countries and studies. Reliable estimates, specific for age, sex, and comorbidities, are needed to monitor the epidemic, to compare the outcome in different settings, and to correctly design trials for COVID-19 interventions. The aim of this study was to provide population-based survival curves of hospitalized COVID-19 patients. Materials and methods A cohort study was conducted in three areas of Northern Italy, heavily affected by SARS-CoV-2 infection (Lombardy and Veneto Regions, and Reggio Emilia province), using a loco-regional COVID-19 surveillance system, linked to hospital discharge databases. We included all patients testing positive for SARS-CoV-2 RNA by RT-PCR on nasopharyngeal/throat swab samples who were hospitalized from 21 February to 21 April 2020. Kaplan-Meier survival estimates were calculated at 14 and 30 days for death in any setting, stratifying by age, sex, and the Charlson Index. Results Overall, 42,926 hospitalized COVID-19 patients were identified. Patients' median age was 69 years (IQR: 57-79), 62.6% were males, and 6.0% had a Charlson Index ≥3. Survival curves showed that 22.0% (95% CI 21.6-22.4) of patients died within 14 days and 27.6% (95% CI 27.2-28.1) within 30 days from hospitalization. Survival was higher in younger patients and in females. The negative impact of comorbidities on survival was more pronounced in younger age groups. Conclusion The high fatality rate observed in the study (28% at 30 days) suggests that studies should focus on death as primary endpoint during a follow-up of at least one month.

We revisit the role of labour market institutions by showing how they affect the sharing of firm-specific rents between employers and employees. We look at an Italian wage indexation mechanism (‘Scala Mobile’) that compressed the distribution of wages, imposing real wage increases at the bottom of the distribution. After developing a simplified version of a search model with intra-firm bargaining and on-the-job search, we document that skilled workers received lower wage adjustments when employed at firms with many unskilled workers and they tended to move towards more skill-intensive firms. Moreover, the system drove the least skill-intensive firms out of the market.

Entry in many occupations is regulated with the objective to screen out the least able producers and guarantee high quality of output. Unfortunately, the available empirical evidence suggests that in most cases these objectives are not achieved. In this paper we investigate entry into the legal profession in Italy and we document that such a failure is due to the combination of the incomplete anonymity of the entry exam and the intergenerational transmission of business opportunities. We use microdata covering the universe of law school graduates from 2007 to 2013 matched with their careers and earnings up to 5 years after graduation. Variation generated by the random assignment of the entry exam grading commissions allows us to identify the role of family ties in the selection process. We find that connected candidates, i.e. those with relatives already active in the profession, are more likely to pass the exam and eventually earn more, especially those who performed poorly in law school. When we simulate the process of occupational choice assuming family connections did not matter, we find that strong positive selection on ability would emerge.

BackgroundCOVID-19 case fatality rate in hospitalized patients varies across countries and studies, but reliable estimates specific for age, sex, and comorbidities are needed to design trials for COVID-19 interventions. Aim of this study is to provide population-based survival curves of hospitalized COVID-19 patients.MethodsA cohort study was conducted in Lombardy, Veneto, and Reggio Emilia using COVID-19 registries linked to hospital discharge databases containing patient clinical histories. All patients with positive SARS-CoV-2 RT-PCR test on oral/nasopharyngeal swabs hospitalized from 21st February to 21st April 2020 were identified. Kaplan Meier survival estimates were calculated at 14 and 30 days for death in any setting, stratifying by age, sex and Charlson Index.FindingsOverall, 42,926 hospitalized COVID-19 patients were identified. Patients’ median age was 69 years (IQR: 57-79), 62·6% were males, 69·4% had a Charlson Index of 0. In total, 11,205 (26·1%) patients died over a median follow-up of 24 days (IQR: 10-35). Survival curves showed that 22·0% of patients died within 14 days and 27·6% within 30 days of hospitalization. Survival was higher in younger patients and in females. Younger patients with comorbidities had a lower survival than older ones with comorbidities.InterpretationOver 27% of hospitalized COVID-19 patients died within one month in three areas of Northern Italy that were heavily affected by SARS-CoV-2 infection. Such a high fatality rate suggests that trials should focus on survival and have follow-up of at least one month.FundingThe study did not receive any external funding.Research in contextEvidence before this studyTwo recent systematic reviews with meta-analyses report case fatality rates of three to four percent in COVID-19 patients. Most studies on hospitalized cohorts report only slightly higher figures. These figures do not correspond to those derived from routinely collected clinical data in most European countries, reporting a 10% case fatality rate which has been increasing over time since the epidemic started.Robust and precise survival estimates of hospitalized COVID-19 patients which take into account prognostic factors such as age, sex and burden of comorbidities are needed to design appropriate phase II and phase III clinical studies of drugs targeting COVID-19.Added value of this studyIn this study we present the first survival estimates by age, sex and Charlson index for a large population-based cohort of Italian hospitalized COVID-19 patients.Implications of all the available evidenceOver 27% of COVID-19 patients died within one month from hospital admission. Such a high fatality rate suggests that studies should prioritize mortality as primary outcome. Furthermore, we found that the fatality rate reaches a plateau 30 days after hospitalization, suggesting that studies should have at least one month of follow up to observe deaths; shorter follow-up could lead to overestimation of treatment benefits.

In spite of a rapidly ageing population, there is a lack of population-based data on mortality among nursing home residents in Southern Europe. To assess mortality rates, their determinants, and causes of death in newly admitted nursing home residents in the Veneto region (northeastern Italy). 19,392 subjects aged ≥ 65 years admitted to regional nursing homes during 2015–2017 were recruited in a cohort mortality study based on linked health records. Risk factors for mortality were investigated by Cox regression. The distribution of causes of death was retrieved from death certificates. Mortality peaked in the first 4 months after admission; thereafter the monthly mortality rate fluctuated around 3% in males and 2% in females. Overall mortality was 23% at 6 months and 34% at 1 year. In addition to age, gender, and dependency, main risk factors for mortality were recent hospitalization (first 4 months after entry into the facility), and the burden of comorbidities (subsequent follow-up period). The most represented causes of mortality were similar in the first and in the subsequent period after admission: cardio-cerebrovascular diseases, neurodegenerative diseases, respiratory diseases, and infections. The first months after admission represent a period at high risk of mortality, especially for patients with a recent hospitalization. Causes reported in death certificates suggest mainly an acute deterioration of pre-existing chronic conditions. Health care plans should be personalized for newly admitted vulnerable patients. Palliative care needs should be recognized and addressed for high-risk non-cancer patients.

Using a randomized experiment in a public Swiss university, we study the impact of online live streaming of lectures on student achievement and attendance. We find that (i) attending lectures via live streaming lowers achievement for low-ability students and increases achievement for high-ability ones; (ii) students use the live streaming technology only occasionally, apparently when random events make attending in class too costly, and (iii) offering live streaming reduces in-class attendance only mildly. These findings have important implications for the effective design of education policies.

This paper estimates the impact of college teaching on students’ academic achievement and labor market outcomes using administrative data from Bocconi University matched with tax records. The estimation exploits the random allocation of students to teachers in a fixed sequence of compulsory courses. We find that teacher effects on students' academic and labor market outcomes are only mildly positively correlated and that the professors who are best at improving the academic achievement of their students are not always also the ones who boost their earnings the most. For the least able students, the correlation between the academic and labor market effectiveness of teachers turns out to be negative.

This retrospective observational study was based on databases of the Local Health Authority of Treviso, Italy. It evaluated the prevalence and the effectiveness of oral anticoagulation treatment (OAT) for the management of nonvalvular atrial fibrillation (NVAF) in everyday clinical practice. Out of 6,138 NVAF patients, only 3,024 received vitamin K antagonist (VKA). Potential barriers decreasing the probability of being treated with VKA were female sex, older age, antiplatelet treatment and history of bleeding. In addition, VKA-treatment was not in line with current ESC and AIAC guidelines, since the patients at high or low risk of stroke were under- or over-treated, resp. Among VKAtreated patients, 73 % of subjects were not at target with anticoagulation. OAT resulted to be effective in reducing stroke risk. However, stroke events were significantly influenced also by previous stroke or transient ischemic attack (hazard ratio, HR = 2.99, p < 0.001) and by previous bleeding events (HR = 1.60, p < 0.001).

This paper proposes a new measure of skill mismatch to be applied to the recent OECD Survey of Adult Skills (PIAAC). The measure is derived from a formal theory and combines information about skill proficiency, self-reported mismatch and skill use. The theoretical foundations underling this measure allow identifying minimum and maximum skill requirements for each occupation and to classify workers into three groups: the well-matched, the under-skilled and the over-skilled. The availability of skill use data further permits the computation of the degree of under- and over-usage of skills in the economy. The empirical analysis is carried out using the first round of the PIAAC data, allowing comparisons across skill domains, labour market statuses and countries.

Hospital admissions at the end of life (EOL) represent an established indicator of poor quality of care.To examine the impact of intensity of integrated primary and specialist home-based palliative care for chronic diseases (HPCCD) plans of care on EOL hospital access.Retrospective population-based study using linked mortality, hospitalization, and home care data. Intensity of HPCCD was measured 90-31 days before death; outcomes were hospital death and prolonged hospital stay for medical reasons in the last month of life. Outcomes were modeled through Poisson and quartile regressions. Adults aged 65-84 years with at least an ordinary hospitalization and a drug treatment in the year before death, who died from nononcological chronic diseases in the Veneto Region, January 2012-December 2013, were included.Among 2087 patients, 1016 (48.7%) did not receive any HPCCD homecare visit; 860 (41.2%), 152 (7.3%), and 59 (2.8%) had2, 2-4, and 4-7 homecare visits/week, respectively. Hospital death occurred for 1310 patients (62.8%) and the median hospital stay in the last month of life was five days (interquartile range 0-14). In multivariate analysis, a higher intensity of HPCCD was associated with lower rates of prolonged (≥14 days) EOL hospitalization and hospital death with a dose-response relationship. When no access to HPCCD was compared with 2-4 visits/week, adjusted percentage of hospital death decreased by -18.4% (95% confidence interval [CI] -5.4% to -29.7%) and the length of hospital stay decreased by 37.9% (95% CI 16.7%-56.0%).The intensity of integrated HPCCD plans of care was associated with a reduction in EOL hospital stay and in hospital death.

The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons. Multivariate analysis was conducted using a Poisson model. Among the 2211 adults who died of solid tumours and received 1+ homecare visits during the exposure period, 1077 (48.7%), 552 (25.0%) and 582 (26.3%) had 0.1–1.9, 2–3.9 and 4+ homecare visits/week, respectively. The median duration between an HPCC home visit and death was 92 days (IQR 42–257 days). Hospital death occurred in 856 (38.7%) patients, while 1087 (49.2%) and 556 (25.1%) had a hospital stay and a hospital stay ≥7 days during the exposure period, respectively. In the multivariate analysis, a greater intensity of integrated HPCC (4+ visits/week) was significantly associated with a lower risk of hospital death (relative risk [RR] = 0.67, 0.59–0.76), any hospital stay (RR = 0.69, 0.62–0.77) and hospital stay ≥7 days for medical reasons (RR = 0.59, 0.49–0.71). A late activation (≤30 days before death) of HPCC was also associated with increased both hospital stay (RR = 1.26, 0.11–1.42) and hospital stay ≥7 days (RR = 1.25, 1.01–1.54). A greater HPCC program intensity reduces the risk of hospital death and hospital stay in the end-of-life. An early activation of this program can contribute to improve these EOL outcomes.

In Italian primary care, chronic heart failure (CHF) patients are mainly managed by general practitioners (GPs). However, there are few studies analysing CHF management challenges in primary care and identifying opportunities for improvement.To describe CHF care as implemented by GPs in the Veneto Region and to identify opportunities for improvement.In 2008, using an audit process, 114 Venetian GPs analysed their electronic health records, identified CHF patients and collected clinical and care related information: prevalence, co-morbidity, caring conditions, diagnostic and therapeutic management, and hospitalization. After two training sessions, data on pharmacotherapy were analysed again in 2009.The prevalence of CHF was 1.2% (95% CI: 1.1-1.3%). Diagnostic echocardiography was used in 57% of cases. At baseline, the proportions of patients that used specific medication were: diuretics 88%; angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARB) 77%, beta-blockers 46% and anti-aldosterone agents 32%. After two training sessions, the use of ACE inhibitors/ARB and beta-blockers increased to 80% and 56%, respectively. Renal failure, chronic obstructive pulmonary disease (COPD), diabetes mellitus and dementia were the most prevalent concomitant diseases, posing specific management problems. Half of the patients were generally visited at home; they were dependent on some kind of care given.In Veneto a large number of CHF patients are mainly managed by GPs. Further improvements are necessary to meet standards of care with regard to diagnosis, medication, follow-up and home care. The care situation affected hospitalization and the quality of follow-up visits.

In this paper, we investigate differences in academic performance among students of different ages within the same cohorts using a unique database of students at Bocconi University. Our data allow to control for potential selection effects as well as for differences in cognitive ability, as measured by an attitudinal entry test. Contrary to most of the existing evidence for younger pupils, we document that at the undergraduate level, youngest students perform better compared with their oldest peers. This finding is only partly explained by differences in cognitive ability and rather seems to be associated with differences in social activities.

In this paper, we demonstrate that, in a context where peer groups do not overlap fully, it is possible to identify all the relevant parameters of the standard linear-in-means model of social interactions. We apply this novel identification structure to study peer effects in the choice of college major. Results show that one is more likely to choose a major when many of her peers make the same choice. We also show that peers can divert students from majors in which they have a relative ability advantage, with adverse consequences on academic performance, entry wages, and job satisfaction. (JEL I23, J24, J31, Z13)

We apply a novel measure of intergenerational mobility (IM) developed by Güell, Rodríguez Mora, and Telmer (2014) to a rich combination of Italian data allowing us to produce comparable measures of IM of income for 103 Italian provinces. We then exploit the large heterogeneity across Italian provinces in terms of economic and social outcomes to explore how IM correlates with a variety of outcomes. We find that (i) higher IM is positively associated with a variety of “good” economic outcomes, such as higher value added per capita, higher employment, lower unemployment, higher schooling and higher openness and (ii) that also within Italy the “the Great Gatsby Curve” exists: in provinces in which mobility is lower cross-sectional income inequality is larger. We finally explore the correlation between IM and several socio-political outcomes, such as crime and life expectancy, but we do not find any clear systematic relationship on this respect.

We apply a novel measure of intergenerational mobility (IM) developed by Guell, Rodriguez Mora, and Telmer (2014) to a rich combination of Italian data allowing us to produce comparable measures of IM of income for 103 Italian provinces. We then exploit the large heterogeneity across Italian provinces in terms of economic and social outcomes to explore how IM correlates with a variety of outcomes. We find that (i) higher IM is positively associated with a variety of "good" economic outcomes, such as higher value added per capita, higher employment, lower unemployment, higher schooling and higher openness and (ii) that also within Italy the "the Great Gatsby Curve" exists: in provinces in which mobility is lower cross-sectional income inequality is larger. We finally explore the correlation between IM and several socio-political outcomes, such as crime and life expectancy, but we do not find any clear systematic relationship on this respect.

Existing studies suggest that reforms that reduce the generosity of the unemployment benefits should lower unemployment. Despite the large number of such reforms implemented in Europe in the past decades, evidence from various data sources shows very little correlation with the evolution of unemployment. This paper suggests that the scant success of these labour market reforms can be explained by the interactions between unemployment insurance and other social assistance programmes. Evidence from the European Community Household Panel shows that recipients of unemployment insurance who are also eligible for other welfare schemes are indeed less sensitive to changes in the level and the duration of their benefits.

A high hospital utilisation at the end of life (EOL) is an indicator of suboptimal quality of health care. We evaluated the impact of the intensity of different Integrated Cancer Palliative Care (ICPC) plans on EOL acute medical hospitalisation among cancer decedents. Decedents of cancer aged 18-84 years, who were residents in two Italian regions, were investigated through integrated administrative data. Outcomes considered were prolonged hospital stay for medical reasons, 2+ hospitalisations during the last month of life and hospital death. The ICPC plans instituted 90 to 31 days before death represented the main exposure of interest. Other variables considered were gender, age class at death, marital status, recent hospitalisation and primary cancer site. Among 6,698 patients included in ICPC plans, 44.3% presented at least one critical outcome indicator; among these, 76.5% died in hospital, 60.3% had a prolonged (12+ days) medical hospitalisation, 19.1% had 2+ hospitalisations at the EOL. These outcomes showed a strong dose-response effect with the intensity of the ICPC plans, which is already evident at levels of moderate intensity. A well-ICPC approach can be very effective-beginning at low levels of intensity of care-in reducing the percentage of patients spending many days or dying in hospital.

Early implementation of home care and 30 day readmissions in65 years Veneto region patients discharged for heart failure and with disability.The effectiveness of Home care (HC) on preventing rehospitalizations in patients discharged for heart failure (HF) are uncertain.The aim of the study was to measure the impact of HC on early rehospitalizations of patients discharged for HF and with disabilities.Cohort retrospective study on65 years patients, discharged at home and with a Barthel index50. Variables considered were: previous hospitalizations for ischaemic cardiopathy ad/or chronic obstructive pulmonary disease, number of hospital admissions in the previous year, length of index hospitalization; outcomes considered were: hospital readmissions and days of hospitalizations 30 days from hospital discharge in patients with or without a home care visit within two days from hospital discharge.Of the 5.094 patients (60%85 years), 14.8% received a HC visit within 2 days from discharge (43.7% from a nurse); 18.3% of patients (933) were readmitted within one month. In multivariate analyses an HC access within 2 days did not reduce the risk for readmission (although with better results in younger males but not in older women). An early HC visit reduced the days of hospital stay in males of all ages (65-74 years IRR 0.53 CI 95% 0.37-0.75; 75-84 years IRR 0.71 CI95% 0.60-0.83; 85+ years IRR 0.79 CI 95% 0.67-0.93) while in75 years females there was a significant increase.An early HC visit (within two days from discharge) may have positive effects on males, but not in older women, possibly for the coexistence of socio-economic factors.

We use a new data set on Italy and a novel identification strategy to analyse the relationship between migrants’ employment status and the percentage of non-Italians living nearby. Our data contain information at the very local level and are representative of both legal and illegal migrants. Identification exploits the physical characteristics of local buildings as a source of exogenous variation in the incidence of migrants. We find that migrants residing in more immigrant-dense areas are less likely to be employed. This penalty is higher if the migrants leaving nearby are illegal and it is not mitigated if they are from own ethnic group or more proficient in Italian. In the 10 years predating the Great Recession Europe received twice as many immigrants (relative to the resident population) than the US and 4–5 times as many as Japan (OECD, 2009). The main motivation of these flows was finding a job. Family reunification and asylum seeking were fairly marginal. The main destination of migrants was Southern Europe, where the stock of foreign born increased by some 5 million in Spain and 3 million in Italy within a decade, doubling the migrant population in several urban areas over a few years. Most of these migrants came in illegally hoping for a subsequent regularisation and there was no major social housing programme activated in the destination countries responding to these mass migration flows, just while house prices were booming. Newcomers did not locate uniformly across the board: they often found residence where other persons of the same nationality or ethnic group were already living, increasing the residential concentration of migrants in urban areas. How did these residential location patterns affect the economic integration of migrants, notably their probability of finding a job? Is there scope for policies reducing residential concentration of migrants in specific urban areas? While in the US research related to the effects of residential concentration of migrants on their economic and social integration is long standing (Borjas, 1995; Cutler and Glaeser, 1997; Ross, 1998; Cutler et al., 1999; Card and Rothstein, 2007), in Europe, notably in Southern Europe, there is a very thin scientific literature on this issue, despite the highly controversial public debate. This paucity of studies for Europe is mainly due to a lack of detailed data on ethnic minorities and migrants, especially at the city level (Bisin et al., 2011). Moreover data collection is particularly problematic

This paper estimates the impact of university teachers on their students’ academic achievement and labor market outcomes using administrative data from Bocconi University matched with Italian tax records. The estimation exploits the random allocation of students to teachers in a fixed sequence of compulsory courses. We find that the academic and labor market returns of teachers are only mildly positively correlated and that the professors who are best at improving the academic achievement of their best students are not always also the ones who boost their students’ earnings the most, especially for the least able students.

This paper proposes a new measure of skills mismatch that combines information about skill proficiency, self-reported mismatch and skill use. The theoretical foundations underling this measure allow identifying minimum and maximum skill requirements for each occupation and to classify workers into three groups, the well-matched, the under-skilled and the over-skilled. The availability of skill use data further permit the computation of the degree of under and overusage of skills in the economy. The empirical analysis is carried out using the first wave of the OECD Survey of Adult Skills (PIAAC) and the findings are compared across skill domains, labour market status and countries.

In this paper we estimate the short-run elasticity of substitution between male and female workers, using data on employment and wages from Italian provinces from 1993-2006. We adopt a production function approach similar to that of Card and Lemieux (2001a) and Acemoglu, Autor and Lyle (2004). Our identification strategy relies on a natural experiment. In 2000 the Italian parliament passed a law to abolish compulsory military service; the reform was implemented through a gradual reduction in the number of draftees, and compulsory drafting was definitively terminated in 2004. We use data on the (planned) maximum number of draftees at the national level (as stated in the annual budgetary law), interacted with sex-ratios at birth at the provincial level, as instruments for (relative) female labor supply. Our results suggest that young males and females are imperfect substitutes, with an elasticity of substitution ranging between 1.1 and 1.6. Our results have implications for the evaluation of policies aimed at increasing female labor market participation, suggesting that they do not necessarily displace male employment.

We present new comparable data on the incidence of performance pay schemes in Europe and the USA. We find that the percentage of employees exposed to incentive pay schemes ranges from around 10-15 percent in some European countries to over 40 percent in Scandinavian countries and the US. Individual pay and profit/gain sharing schemes are widely diffused, whereas share ownership schemes are much less common, particularly in Europe. We document a number of empirical regularities. Incentive pay is less common in countries with a higher share of small firms. Higher product and labour market regulation are associated with lower use of incentive pay. Capital market development is a necessary requirement for a wider diffusion of incentive pay, particularly sharing and ownership schemes. When we control for a large set of individual characteristics and company attributes, we find that the probability that a worker is covered by an incentive scheme is higher in large firms and in high-skilled occupations, while it is much lower for females.

This paper contrasts measures of teacher effectiveness with the students' evaluations for the same teachers using administrative data from Bocconi University (Italy). The effectiveness measures are estimated by comparing the subsequent performance in follow-on coursework of students who are randomly assigned to teachers in each of their compulsory courses. We find that, even in a setting where the syllabuses are fixed and all teachers in the same course present exactly the same material, teachers still matter substantially. The average difference in subsequent performance between students who were assigned to the best and worst teacher (on the effectiveness scale) is approximately 43% of a standard deviation in the distribution of exam grades, corresponding to about 5.6% of the average grade. Additionally, we find that our measure of teacher effectiveness is negatively correlated with the students' evaluations: in other words, teachers who are associated with better subsequent performance receive worst evaluations from their students. We rationalize these results with a simple model where teachers can either engage in real teaching or in teaching-to-the-test, the former requiring higher students’ effort than the latter. Teaching-to-the-test guarantees high grades in the current course but does not improve future outcomes. Hence, if students are myopic and evaluate better teachers from which they derive higher utility in a static framework, the model is capable of predicting our empirical finding that good teachers receive bad evaluations, especially when teaching-to-the-test is very effective (for example, with multiple choice tests). Consistently with the predictions of the model, we also find that classes in which high skill students are over-represented produce evaluations that are less at odds with estimated teacher effectiveness.

This paper contrasts measures of teacher effectiveness with the students' evaluations for the same teachers using administrative data from Bocconi University (Italy). The effectiveness measures are estimated by comparing the subsequent performance in follow-on coursework of students who are randomly assigned to teachers in each of their compulsory courses. We find that, even in a setting where the syllabuses are fixed and all teachers in the same course present exactly the same material, teachers still matter substantially. The average difference in subsequent performance between students who were assigned to the best and worst teacher (on the effectiveness scale) is approximately 43% of a standard deviation in the distribution of exam grades, corresponding to about 5.6% of the average grade. Additionally, we find that our measure of teacher effectiveness is negatively correlated with the students' evaluations: in other words, teachers who are associated with better subsequent performance receive worst evaluations from their students. We rationalize these results with a simple model where teachers can either engage in real teaching or in teaching-to-the-test, the former requiring higher studentsﾒ effort than the latter. Teaching-to-the-test guarantees high grades in the current course but does not improve future outcomes. Hence, if students are myopic and evaluate better teachers from which they derive higher utility in a static framework, the model is capable of predicting our empirical finding that good teachers receive bad evaluations, especially when teaching-to-the-test is very effective (for example, with multiple choice tests). Consistently with the predictions of the model, we also find that classes in which high skill students are over-represented produce evaluations that are less at odds with estimated teacher effectiveness.

There is a large literature on social interactions and still little is known about the economic mechanisms leading to the high level of clustering in behavior that is so commonly observed in the data. In this paper we present a model in which agents are allowed to interact according to three distinct mechanisms, and we derive testable implications on the mean and the variance of the outcomes within and across groups. The empirical tests allow us to distinguish which mechanism(s) generates the observed patterns in the data. In our application we study the performance of undergraduate students and we find that social interactions take the form of mutual insurance. Such a result bears crucial policy implications for all those situations in which social interactions are important, from teamwork to class formation in education and co-authorship in academic research.

The frequency and risk factors for intracerebral haemorrhage (ICH) after ischemic stroke are well-known. ICH frequency is increased by the use of antithrombotic or thrombolytic drugs. Several experimental studies have demonstrated a relationship between ICH and hypertension after fibrinolysis, but the optimal blood pressure levels in patients treated with recombinant tissue plasminogen activator (rTPA) are as yet unknown. We evaluated the role of blood pressure in patients with ischemic stroke treated with rTPA within 3h of symptom onset. We treated 86 consecutive patients admitted to our stroke unit between 2002 and 2008 and prospectively recorded the clinical and instrumental data in our stroke registry. We evaluated haemorrhagic complications by reviewing imaging findings. Blood pressure was recorded before rTPA and at 6, 12, 18, and 32h. Total cerebral haemorrhage occurred in eleven (12.7%) patients, and symptomatic intracerebral haemorrhage occurred in seven (8.1%). We failed to find a correlation between blood pressure levels and stroke severity at admission. High blood pressure levels correlated with a worse outcome. Systolic blood pressure was significantly higher in ICH patients relative to rTPA-treated patients without haemorrhagic complications (p0.03). This study indicates that rTPA-induced haemorrhage is influenced by systolic blood pressure. More aggressive pharmacological reduction of hypertension during fibrinolysis and the subsequent 32h may reduce this complication.

In this paper we investigate whether peers' behavior influences the choice of college major, thus contributing to the mismatch of skills in the labor market. Using a newly constructed dataset, we are able to identify the endogenous effect of peers on such decisions through a novel identification strategy that solves the common econometric problems of studies of social interactions. Results show that, indeed, one is more likely to choose a major when many of her peers make the same choice. We also provide evidence on skills mismatch in terms of entry wages and occupation. We find that peers can divert students from majors in which they have a relative ability advantage, with adverse consequences on academic performance, entry wages and job satisfaction.

We study how class size and composition affect the academic and labor market performances of college students, two crucial policy questions given the secular increase in college enrollment. We rely on the random assignment of students to teaching classes. Our results suggest that a one standard deviation increase in the class-size would result in a 0.1 standard deviation deterioration of the average grade. Further, the effect is heterogenous as female and higher income students seem almost immune to the size of the class. Also, the effects on performance of class composition in terms of gender and ability appears to be inverse U-shaped. Finally, a reduction of 20 students (one standard deviation) in one's class size has a positive effect on monthly wages of about 80 Euros (115 USD) or 6% over the average.

The enlargement of the European Union has increased concerns about the role of generous welfare transfers in attracting migrants. This paper explores the issue of welfare migration across the countries of the pre-enlargement European Union and finds a significant but small effect of the generosity of welfare on migration decisions. This effect, however, is still large enough to distort the distribution of migration flows and, possibly, offset the potential benefits of migration as an inflow of mobile labour into countries with traditionally immobile native workers.