Luigi Ventura

Long-Term Outcome after Multimodality Treatment for Stage III Thymic Tumors

BACKGROUND Surgery remains the cornerstone of therapy for thymic tumors, but the optimal treatment for advanced, infiltrative lesions is still controversial. The introduction of multimodality protocols has substantially modified survival and recurrence rate. We reviewed our 13-year prospective experience with multimodality treatment of stage III thymoma and thymic carcinoma. METHODS Since 1989 we have prospectively used a multimodality approach in 45 stage III thymic tumors. Sixteen patients (35%) had myasthenia gravis. Twenty-three patients (51%) had pure or predominantly cortical thymoma (group 1), 11 (24.5%) had well-differentiated thymic carcinoma (group 2), and 11 (24.5%) had thymic carcinoma (group 3). Tumors that were not considered radically resectable at preoperative workup underwent biopsy and induction chemotherapy (15 patients, 33%) followed by surgical resection; all patients were referred for adjuvant chemoradiotherapy. RESULTS No operative mortality was recorded; 1 treatment-related death during adjuvant chemotherapy was observed in group 1. Complete resection was feasible in 91% of patients in groups 1 and 2 and 82% in group 3. The overall 10-year survival was 78%. Ten-year survival for groups 1 and 2 was 90% and 85%, respectively; 8-year survival for group 3 was 56%. During follow-up, tumor recurrence was noted in 3 patients (13%) from group 1, 3 (27%) from group 2, and 3 (27%) from group 3. CONCLUSIONS Multimodality treatment with induction chemotherapy (when required) and adjuvant chemoradiotherapy offers encouraging results for stage III thymic tumors; the outcome is more favorable for cortical thymoma and well-differentiated thymic carcinoma.

Survey measures of risk aversion and prudence

This paper utilizes a thought experiment conducted by the Bank of Italy to estimate absolute and relative risk aversion along with absolute and relative prudence for a broad cross-section of Italian households. Upper and lower bounds are calculated for each parameter, and comparisons are made across socio-demographic groups. Evidence is found of decreasing absolute risk aversion, decreasing absolute prudence, increasing relative risk aversion, and increasing relative prudence.

The prevalence of hyperbolic discounting: some European evidence

Experimental matching data are used from the 2000 Bank of Italy Survey of Household Income and Wealth (SHIW) and the 2000 wave of the Center for Economic Research (CentER) Savings Survey at Tilburg University to compare the relative frequencies of hyperbolic and exponential discounters. Among 3200 Italian respondents and 1400 Dutch respondents, less than a quarter exhibited hyperbolic discounting. This finding is both statistically significant and robust with respect to various assumptions regarding utility; moreover, it holds across a wide variety of economic, social and demographic characteristics. The youngest, poorest, most urban and least educated individuals are the most likely to be hyperbolic discounters. In addition, it is found that hyperbolic discounters accumulate less wealth and are somewhat less likely than exponential discounters to utilize commitment devices to constrain their future choices.

Labor Income and Risky Assets under Market Incompleteness: Evidence from Italian Data

Theory suggests that uninsurable income risk induces individuals to accumulate assets as a precautionary reserve of value. Most assets, however, bear rate of return risk, that can be diversified only if every asset is traded by a large number of individuals and arbitrage is frictionless. Using Italian micro-data, we find evidence of income and asset risks that affect consumption. Italian households are particularly well insured against illness but not against job losses. Moreover, we detect a positive, yet weak, effect of asset holding on the variability of consumption streams across households.

Prudence and precautionary saving

Households save income for various reasons, including the need to plan for the future, the intention to leave a bequest, and the desire to guard against unforeseen expenditures and income fluctuations. Although it is widely believed that prudent individuals engage in precautionary saving, the extent of such saving is not well understood. This paper develops a model of saving with an explicit role for the Leland-Kimball measure of prudence. Estimation of the model using household-level data from Italy suggests an average value of relative prudence near 4 or 5, with approximately 15 to 36 percent of total saving being precautionary.

The Relevance of Precautionary Saving

Abstract This paper develops a model of personal saving that includes, unlike previous models appearing in the literature, an explicit role for the Leland-Kimball measure of prudence. Estimation of the model using Bank of Italy survey data suggests that about 20 per cent of total saving is driven by precautionary reasons.

Fundamentals, Beliefs, and the Origin of Money: A Search Theoretic Perspective

This survey aims at introducing readers to the main features of search theoretic, monetary paradigms, as anticipated in earlier contributions by Jones, Oh, and Iwai, thoroughly formulated in the seminal papers by Kiyotaki and Wright, and subsequently developed in several directions by the same and other authors. The perspective of our analysis will be critical and analytic, and will mainly focus on the delicate trade-off between fundamentals and beliefs which, in our view, underlies the most intriguing results presented in this branch of the literature.

International risk sharing and globalization

The main research question of this empirical work is whether or not globalization, in its various forms, has had an impact upon international risk sharing. The empirical literature so far has only investigated on one aspect of globalization: economic and financial integration. By decomposing globalization in its economic, political and social aspects, and using a standard framework of consumption insurance tests to gauge the extent of risk sharing among countries, we obtain some interesting results. One of the main findings is that economic and social integration help better cope with idiosyncratic risk, but also that without political integration this might result in an increasing exposure to systemic (uninsurable) risk.

Interval risk aversion

The conventional measures of absolute and relative risk aversion are appropriate for measuring preferences locally, but because they rely on differential calculus, they cannot accurately capture attitudes towards high-stakes risks involving potentially large changes in wealth. Eisenhauer (2006) has recently proposed an alternative approach which avoids the use of calculus. The present article extends that work in two ways. First, the Pratt–Arrow coefficient of absolute risk aversion is generalized into a measure of interval risk aversion, suitable for analysing preferences over risks of any magnitude, and a corresponding interval measure of relative risk aversion is constructed from preference and risk parameters, without explicit reference to initial wealth or income. Second, the new measures are applied to survey data from the Bank of Italy, to illustrate their empirical applicability to large-scale risk.

The Italian Insurance Sector between Macro and Micro Facts: Salient Features, Recent Trends, and an Econometric Analysis

The Italian insurance market has undergone a series of profound modifications over the last decade. This is immediately apparent by looking at the performance of the market in terms of premiums collected, volume of investments, and profits earned, and also by looking at the number and variety of insurance instruments that have been launched on the market and at the distribution of such instruments among households. Moreover, transformation is even more evident if we compare the statistics of the Italian market with those of the markets of other European countries that possess a similar structure.