The marginal propensity to spend on adult children

We examine how much of an extra dollar of parental lifetime resources willultimately be passed on to adult children in the form of inter vivostransfers and bequests. We infer bequests from the stock of wealth late inlife. We use mortality rates and age specific estimates of the response oftransfers and wealth to permanent income to compute the expected presentdiscounted values of these responses to permanent income. Our estimatesimply parents pass on between 2 and 3 cents out of an extra dollar ofexpected lifetime resources in bequests and about 2 cents in transfers.The estimates increase with parental income and are smaller for nonwhites.They imply that about 15 percent of the effect of parental income onlifetime resources of adult children is through transfers and bequestsand about 85 percent is through the intergenerational correlation inearnings, although these estimates are sensitive to assumptions about theintergenerational earnings correlation, taxes, and the number of children.We compare our estimates to the implications of alternative computablebenchmark models of savings behavior in order to assess the likelyimportance of intended bequests for the wealth/income relationship.

Social security in theory and practice (I): Facts and political theories

166 countries have some kind of public old age pension. What economic forcescreate and sustain old age Social Security as a public program? We document some of the internationally and historically common features of Social Security programs including explicit and implicit taxes on labor supply, pay-as-you-go features, intergenerational redistribution, benefits which areincreasing functions of lifetime earnings and not means-tested. We partition theories of Social Security into three groups: "political", "efficiency" and "narrative" theories. We explore three political theories in this paper: the majority rational voting model (with its two versions: "the elderly as the leaders of a winning coalition with the poor" and the "once and for all election" model), the "time-intensive model of political competition" and the "taxpayer protection model". Each of the explanations is compared with the international and historical facts. A companion paper explores the "efficiency" and "narrative" theories, and derives implicationsof all the theories for replacing the typical pay-as-you-go system with a forced savings plan.

Gerontocracy, retirement, and social security

Why are the old politically successful? We build a simple interest group model in which political pressure is time-intensive, showing that in the political competitive equilibrium each group lobbies for government policies that lower their own value of time but the old do so to a greater extent and as a result are net gainers from the political process. What distinguishes the elderly from other political groups (and what makes them more succesful) is that they have lower labor productivity and/or that we are all likely to become elderly at some point, while we are relatively unlikely to change gender, race, sexual orientation, or even ocupation, The model has a variety of implications for the design of social security programs, which we test using data from the Social Security Administration. For example, the model predicts that social security programs with retirement incentives are larger and that the old are more "single-minded" in their politics, implications which we verify using cross-country government finance data and cross-country political participation surveys. Finally, we show that the forced savings programs intended to "reform" the social security system may increase the amount of intergenerational redistribution. As a model for evaluating policy reforms, ours has the attractive feature that reforms must be time time consistent from a political point of view rather than a public interest point of view.

Proyecto de ejecución para las obras de concesión de dominio público para la reforma y adecuación de la central térmica y de la red de saneamiento en un hospital de 350 camas

El Hospital Punta de Europa en Algeciras (Cádiz), centro sanitario del Servicio Andaluz de Salud, desea optimizar la gestión de sus instalaciones de generación de energía térmica (vapor, agua caliente sanitaria y agua caliente de calefacción) y adecuarlas a la normativa vigente así como la sustitución de bajantes del edificio, para lo cual sacará a concurso público la licitación para la concesión de dominio público de dichas instalaciones. Para definir el alcance y condiciones de la citada concesión, el Hospital Punta de Europa (Algeciras) del Servicio Andaluz de Salud ha solicitado a Pedro Alonso Martín el estudio para la reforma y adecuación de las instalaciones productoras de energía térmica del citado Hospital. El objetivo principal de este trabajo es hacer un estudio, propuesta y valoración de las actuaciones necesarias para la reforma y mejora de la explotación de las instalaciones generadoras de energía térmica y de la red saneamiento interior del Hospital Punta de Europa de Algeciras (Cádiz). Las actuales instalaciones de generación térmica consumidoras de energía del hospital dentro del alcance de este Proyecto son: Generación de vapor (lavandería y esterilización). Producción de agua caliente sanitaria (ACS). Producción de agua caliente de calefacción. La mayoría de los equipos productores de energía datan del año 1975, por lo que en la mayoría de los casos se ha cumplido su plazo de amortización y periodo de vida útil. Se hace necesaria la instalación de gas natural, debido a que se tendrá que abastecer a todas las calderas de la central térmica. El diseño del sistema de producción de agua caliente sanitaria garantiza el máximo confort y economía del usuario, compatible con el máximo ahorro energético y la protección del medio ambiente, cubriendo las necesidades de agua caliente sanitaria mediante la combinación de un sistema de calderas a gas con los colectores solares.

Control d'il·luminació i ventilació d'un pàrquing

El treball presentat ve motivat per la necessitat d’instal•lació d’un pàrquing públic i privat de nova construcció a nivell d’il•luminació i ventilació. Per poder satisfer les necessitats del nostre client d’estalvi energètic i confort en l’edifici es decideix d’implementar una instal•lació immòtica que és l’aplicació de tècniques de gestió i control automatitzat a un edifici terciari amb bus de comunicació KNX/EIB. Per a la il•luminació s’han utilitzat fluorescents amb balasts DALI, que permeten la seva regulació i control, per així poder adequar en tot moment l’encesa i intensitat de llum d’aquests. En quant a la ventilació s’han utilitzat variadors de freqüència per també poder optimitzar el funcionament dels ventiladors podent posar-los en marxa quan realment sigui necessari i a la potència que calgui. Per enllaçar tots els elements de la instal•lació, detectors i actuadors, sorgeig la necessitat d’implementar xarxes de comunicació com el KNX/EIB, DALI, Modbus i Ethernet. Per gestionar variables, comunicacions i controlar elements, s´hi han implementen dos autòmats programables a més d’un PC integrat per la visualització i el control del pàrquing. S’ha aconseguit de realitzar un pàrquing totalment automàtic on no és necessaria l’actuació dels operaris i amb les principals càrregues elèctriques totalment regulables en potència. S’ha comprovat que la instal•lació funciona per sota de la potència nominal de les càrregues amb l’estalvi energètic que això suposa.

An approach to costs and energy consumption in private urban Spanish Mediterranean landscapes from a simplified model in sprinkle irrigation

The number of private gardens has increased in recent years, creating a more pleasant urban model, but not without having an environmental impact, including increased energy consumption, which is the focus of this study. The estimation of costs and energy consumption for the generic typology of private urban gardens is based on two simplifying assumptions: square geometry with surface areas from 25 to 500 m2 and hydraulic design with a single pipe. In total, eight sprinkler models have been considered, along with their possible working pressures, and 31 pumping units grouped into 5 series that adequately cover the range of required flow rates and pressures, resultin in 495 hydraulic designs repeated for two climatically different locations in the Spanish Mediterranean area (Girona and Elche). Mean total irrigation costs for the locality with lower water needs (Girona) and greater needs (Elche) were € 2,974 ha-¹ yr-¹ and € 3,383 ha-¹ yr-¹, respectively. Energy costs accounted for 11.4% of the total cost for the first location, and 23.0% for the second. While a suitable choice of the hydraulic elements of the setup is essential, as it may provide average energy savings of 77%, due to the low energy cost in relation to the cost of installation, the potential energy savings do not constitute a significant incentive for the irrigation system design. The low efficiency of the pumping units used in this type of garden is the biggest obstacle and constraint to achieving a high quality energy solution

Transitional effects of a pension system change in Spain

This paper studies the output effects, transition costs and the change in pension benefits derived from the substitution of the current unfunded pension system by a fully funded pension system financed through mandatory savings.These effects are estimated by using reduced versions of the neoclassical and endogenous growth frameworks. Because of the greater capital accumulation during the transition phase, final output increases by 23,6% (neoclassicalframework); and a 24,5-31,5% (endogenous growth framework). The initial revenue loss for the government would represent a 4,8% of the GDP, raising very slowly during the transition period. Given the new growth rates, rates of return ofphysical capital, and financial intermediation costs, we have that the capitalization pension benefits obtained by all 30-contribution-year worker would be more than twice than those that guarantee the financial sustainability of thepublic pension system

Transitional effects of a pension system change in Spain

This paper studies the output effects, transition costs and the change in pension benefits derived from the substitution of the current unfunded pension system by a fully funded pension system financed through mandatory savings.These effects are estimated by using reduced versions of the neoclassical and endogenous growth frameworks. Because of the greater capital accumulation during the transition phase, final output increases by 23,6% (neoclassicalframework); and a 24,5-31,5% (endogenous growth framework). The initial revenue loss for the government would represent a 4,8% of the GDP, raising very slowly during the transition period. Given the new growth rates, rates of return ofphysical capital, and financial intermediation costs, we have that the capitalization pension benefits obtained by all 30-contribution-year worker would be more than twice than those that guarantee the financial sustainability of thepublic pension system

The Effect of a Physical Activity Program on the Total Number of Primary Care Visits in Inactive Patients: A 15-Month Randomized Controlled Trial

Abstract Background: Effective promotion of exercise could result in substantial savings in healthcare cost expenses in terms of direct medical costs, such as the number of medical appointments. However, this is hampered by our limited knowledge of how to achieve sustained increases in physical activity. Objectives: To assess the effectiveness of a Primary Health Care (PHC) based physical activity program in reducing the total number of visits to the healthcare center among inactive patients, over a 15-month period. Research Design: Randomized controlled trial. Subjects: Three hundred and sixty-two (n = 362) inactive patients suffering from at least one chronic condition were included. One hundred and eighty-three patients (n = 183; mean (SD); 68.3 (8.8) years; 118 women) were randomly allocated to the physical activity program (IG). One hundred and seventy-nine patients (n = 179; 67.2 (9.1) years; 106 women) were allocated to the control group (CG). The IG went through a three-month standardized physical activity program led by physical activity specialists and linked to community resources. Measures: The total number of medical appointments to the PHC, during twelve months before and after the program, was registered. Self-reported health status (SF-12 version 2) was assessed at baseline (month 0), at the end of the intervention (month 3), and at 12 months follow-up after the end of the intervention (month 15). Results: The IG had a significantly reduced number of visits during the 12 months after the intervention: 14.8 (8.5). The CG remained about the same: 18.2 (11.1) (P = .002). Conclusions: Our findings indicate that a 3-month physical activity program linked to community resources is a shortduration, effective and sustainable intervention in inactive patients to decrease rates of PHC visits. Trial Registration: ClinicalTrials.gov NCT00714831

White under Black. Works from the Imperceptible / 2. Mar Arza: Readings and Consumption...

In the works of Mar Arza we perceive a sustained concern with lines of writing on surfaces. Earlyon, she altered the pages and letters of old books. More recently she has intervened in the lettersand the blank spaces on all kinds of printed paper — savings books, electricity bills, medical referrals, calendar pages, lottery tickets...

Economic evaluation of the levonorgestrel-releasing intrauterine system for the treatment of dysfunctional uterine bleeding in Spain

To compare the cost and effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus combined oral contraception (COC) and progestogens (PROG) in first-line treatment of dysfunctional uterine bleeding (DUB) in Spain. STUDY DESIGN: A cost-effectiveness and cost-utility analysis of LNG-IUS, COC and PROG was carried out using a Markov model based on clinical data from the literature and expert opinion. The population studied were women with a previous diagnosis of idiopathic heavy menstrual bleeding. The analysis was performed from the National Health System perspective, discounting both costs and future effects at 3%. In addition, a sensitivity analysis (univariate and probabilistic) was conducted. RESULTS: The results show that the greater efficacy of LNG-IUS translates into a gain of 1.92 and 3.89 symptom-free months (SFM) after six months of treatment versus COC and PROG, respectively (which represents an increase of 33% and 60% of symptom-free time). Regarding costs, LNG-IUS produces savings of 174.2-309.95 and 230.54-577.61 versus COC and PROG, respectively, after 6 months-5 years. Apart from cost savings and gains in SFM, quality-adjusted life months (QALM) are also favourable to LNG-IUS in all scenarios, with a range of gains between 1 and 2 QALM compared to COC and PROG. CONCLUSIONS: The results indicate that first-line use of the LNG-IUS is the dominant therapeutic option (less costly and more effective) in comparison with first-line use of COC or PROG for the treatment of DUB in Spain. LNG-IUS as first line is also the option that provides greatest health-related quality of life to patients.

Nitrogen replacement value of alfalfa to corn and wheat under irrigated Mediterranean conditions

In crop rotations that include alfalfa (Medicago sativa L.), agronomic and environmental concerns mean that it is important to determine the N fertilizer contribution of this legume for subsequent crops in order to help to increase the sustainability of cropping systems. To determine the N fertilizer replacement value (FRV) of a 2-yr alfalfa crop on subsequent crops of corn (Zea mays L.) followed by wheat (Triticum aestivum L.) under irrigated Mediterranean conditions, two 4-yr rotations (alfalfa-corn-wheat and corn-corn-corn-wheat) were conducted from 2001 to 2004 in a Typic Xerofluvent soil. Corn yields were compared after two years of alfalfa and a third year of corn under monoculture and wheat yields were also compared after both rotations. Corn production after alfalfa outyielded monoculture corn at all four rates of N fertilizer application analyzed (0, 100, 200 and 300 kg N/ha). The FRV of 2-yr alfalfa for corn was about 160 kg N/ha. Wheat grown after the alfalfa-corn rotation outyielded that grown after corn under monoculture at both the rates of N studied (0 and 100 kg N/ha). The FRV of alfalfa for wheat following alfalfa-corn was about 76 kg N/ha. Soil NO3 -N content after alfalfa was greater than with the corn monoculture at all rates of N fertilizer application and this higher value persisted during the second crop after alfalfa. This was probably one of the reasons for the better yields associated with the alfalfa rotation. These results make a valuable contribution to irrigated agriculture under mediterranean conditions, show reasons for interest in rotating alfalfa with corn, and explain how it is possible to make savings when applying N fertilizer.

¿Turnos o demanda? En el proyecto de redes de distribución de riego a presión

Actualmente vuelve a ser viable la organización mediante turnos de redes de distribución de riego a presión gracias al desarrollo de sistemas de automáticos de telegestión. La organización por turnos supone una disminución de los caudales en la red y el consiguiente ahorro económico. En la comunicación se presentan diversas expresiones sencillas para calcular la disminución relativa de caudales conseguida mediante la organización por turnos respecto a la demanda. Dicha disminución depende del número de hidrantes abastecidos por un tramo y de la probabilidad de que los hidrantes estén abiertos. Se ha contrastado los resultados de las expresiones propuestas con datos de proyecto y se consiguen buenos ajustes. El ahorro económico obtenido con la organización por turnos respecto a la demanda se puede estimar entre un 26 y un 49 % el ahorro medio de caudales.

Economic evaluation of the levonorgestrel-releasing intrauterine system for the treatment of dysfunctional uterine bleeding in Spain

To compare the cost and effectiveness of the levonorgestrel-releasing intrauterine system (LNG-IUS) versus combined oral contraception (COC) and progestogens (PROG) in first-line treatment of dysfunctional uterine bleeding (DUB) in Spain. STUDY DESIGN: A cost-effectiveness and cost-utility analysis of LNG-IUS, COC and PROG was carried out using a Markov model based on clinical data from the literature and expert opinion. The population studied were women with a previous diagnosis of idiopathic heavy menstrual bleeding. The analysis was performed from the National Health System perspective, discounting both costs and future effects at 3%. In addition, a sensitivity analysis (univariate and probabilistic) was conducted. RESULTS: The results show that the greater efficacy of LNG-IUS translates into a gain of 1.92 and 3.89 symptom-free months (SFM) after six months of treatment versus COC and PROG, respectively (which represents an increase of 33% and 60% of symptom-free time). Regarding costs, LNG-IUS produces savings of 174.2-309.95 and 230.54-577.61 versus COC and PROG, respectively, after 6 months-5 years. Apart from cost savings and gains in SFM, quality-adjusted life months (QALM) are also favourable to LNG-IUS in all scenarios, with a range of gains between 1 and 2 QALM compared to COC and PROG. CONCLUSIONS: The results indicate that first-line use of the LNG-IUS is the dominant therapeutic option (less costly and more effective) in comparison with first-line use of COC or PROG for the treatment of DUB in Spain. LNG-IUS as first line is also the option that provides greatest health-related quality of life to patients.

Pharmacoeconomics of Cyclamen europaeum in the management of Acute Rhinosinusitis

Objective. To carry out a pharmacoeconomic analysis of Cyclamen europaeum (CE) in the management of acute rhinosinusitis (ARS) in Spain using data from the PROSINUS study. Study Design. This was a prospective observational study to compare the effectiveness and cost-effectiveness between therapies including CE vs. other therapies in the management of ARS. Methods. The study was carried out as a secondary analysis of the PROSINUS, combining healthcare resource use, productivity loses, and health outcomes from the observational study with costs representative of the Spanish Health System. Results. CE given as monotherapy appears to be more effective (cure rate) than other monotherapies (15.3% higher, p<0.05) and combination (10.3% higher, p<0.05) therapies. The addition of CE to other single-drug or combination therapies showed a statistically significant improvement in terms of cure rates when adding CE to 2-drug combinations (93.9% vs. 76.5%; p<0.05), and no significant effect when added to combinations of three or more drugs (81.1% vs. 79.8; NS). CE based therapies generally showed lower indirect costs, although only the comparison of CE alone vs. other monotherapies, with a net cost savings of 101 per patient, reached statistical significance (331 vs. 432 , p<0.05). In addition, CE-based therapies show lower cost per cured patient in all comparisons except when CE was used in combination with three or more other drugs. Conclusions. The use of Cyclamen europaeum may be associated to better clinical outcomes at no additional cost for the healthcare system, respect to treatments commonly used for ARS in clinical practice.