The Effects of Social Security on the Distribution of Wealth in Italy

The degree of substitutability between social security wealth and private wealth is a much-debated topic; however, less time and energy has been devoted to the study of the distributive properties of a measure of wealth summing future pension benefits net of contributions to the other traditional components of households’ net worth (financial and real activities, net of liabilities). The present paper has two essential aims: by using six cross-sections of the Bank of Italy’s Survey of Income and Wealth (1991, 1993, 1995, 1998, 2000 and 2002), it firstly aims to estimate an “augmented” measure of net worth incorporating social security wealth, and secondly it examines the composition and distribution of such augmented wealth among Italian households during the period 1991-2002. The result is that augmented wealth is found to have remained constant in real term over the last decade due to two opposing forces, namely an increase in net worth and a parallel, stronger decline in social security wealth, resulting from the two main pension reforms implemented in 1992 and 1995. Wealth inequality, after rising steeply at the beginning of the 1990s, levelled off during the second part of the period in question. The major contribution towards this upwards movement came from social security wealth, the distribution of which, although less unequal than that of real wealth and financial wealth, widened at a much faster pace at the beginning of the decade.

The effects of social security on the distribution of wealth in Italy

The degree of substitutability between social security wealth and private wealth is a widely discussed topic. Much less effort is devoted to study the distributive properties of a measure of wealth which sums the future streams of pension benefits net of the contributions to the other traditional components of households net worth (financial and real activities, net of liabilities). This paper has two aims. By using the last six crosssections of the Bank of Italy Survey of Income and Wealth, firstly it estimates an “augmented” measure of net worth which incorporates social security wealth, and secondly it examines the composition and the distribution of such augmented wealth among Italian households in the period 1991-2002. Augmented wealth is found to have fallen in the last decade as a product of two opposite forces, an increase in net worth and a parallel stronger decline in social security wealth, due to the two main pension reforms in 1992 and 1995. Wealth inequality, after rising steeply at the beginning of the 1990s, levelled off in the second part of the period. The major contribution to the upwards movement mainly came from social security wealth, whose distribution, although less unequal than the real and financial one, widened in the first part of the decade at a much faster pace.Social security wealth; Wealth distrubution; Wealth inequality; Italy

Eine retrospektive Langzeitstudie

Facial deformities as a result of inborn or acquired facial defects often lead to functional impairment and psychological strain. Especially orbital defects rank among the most emotionally distressing deformations. Affected patients can be rehabilitated by covering the defects with crainofacial prostheses. The development of osseointegrated implants for bone anchorage offers a reliable fixation technique of the prostheses and is applied for many years. But only a little number of studies exists investigating long-term success rates of extraoral implants. This study focused on implants installed for retention of orbital prostheses. The aim was to evaluate long-term survival rates and possible influence factors of implants in the orbital region. Retrospectively, a patient population with a large number of orbital implants was involved in the present study during a reasonable time period (1991 – 2014). The implant survival as well as influence of gender, age, nicotine use, side, irradiation status, location of implant placement, implant system, length and retention type on success rates were investigated. Therefore, patient data were collected by examination of patients and checking patient files. The collected data were transferred into a SPSS-table for calculating Kaplan-Meier curves and performing log-rank test. In total, 282 orbital implants in 78 patients with mean follow-up of 94.97 months (2 to 268 months) were assessed. These implants showed survival rates of 91.3% after 2 years, 80.5% after 5 years, 68.7% after 10 years and 62.2% after 15 years. The results showed that implants in females were more successful than in males (75.3% vs. 47.3%). Furthermore a significant higher survival rate for supraorbital (67.4%) than for infraorbital implants (51.5%) was indicated. The results also revealed that implants with machined surface were more successful than implants with rough surface (70.2% vs. 54.5%). Length and magnetic fixation seemed to have a positive influence on implant survival. However, no significant relationship was found between age, nicotine abuse, side, irradiation status and implant survival. In conclusion, implants in the orbit seem to have a good to passable prognosis over a long period. The study implicates that female gender, localization in the supraorbital rim, machined surface of the implant system, length and magnetic fixation have a positive effect on the survival of orbital implants, while irradiation status, age, nicotine abuse and location side don’t seem to have any impact. Prospective patient treatment should take these aspects into account.Entstellungen des Gesichts aufgrund angeborener oder erworbener Defekte führen bei betroffenen Patienten neben der funktionellen Beeinträchtigung auch zu psychologischer Belastung. Vor allem im Orbitabereich zählen diese zu den emotional äußerst stigmatisierenden Deformierungen. Mit Epithesen, welche diese Defekte abdecken, können betroffene Patienten behandelt werden. Durch die Entwicklung enossaler Titanimplantate wird eine zuverlässige, seit vielen Jahren angewandte Verankerung der Epithesen ermöglicht. Allerdings gibt es nur wenige Studien, welche sich mit Langzeitüberlebensraten extraoraler Implantate befassen. Die vorliegende Studie untersuchte extraorale Implantate im Bereich der Orbita und hatte zum Ziel, Langzeitüberlebensraten und mögliche Einflussfaktoren der Implantate zu analysieren. In dieser retrospektiven Untersuchung wurden Patientendaten ausgewertet, bei denen im Zeitraum von 1991 bis 2014 enossale Implantate zur Fixierung von Orbitaepithesen inseriert wurden. Verschiedene Parameter, wie die Überlebensrate der Implantate als auch das Geschlecht, Alter, Nikotineinfluss, Patientenseite, Bestrahlungsstatus, Implantatlokalisation, Implantatsystem, Implantatlänge und der prothetische Retentionstyp wurden ausgewertet. Mit den Daten, welche durch Patientenuntersuchung und Aktenauswertung erhoben wurden, wurde eine SPSS- Tabelle erstellt. Etwaige Zusammenhänge der Überlebenskurven anhand der Kaplan-Meier Methode mit verschiedenen Parametern wurden mittels des Log-Rank Tests geprüft. Insgesamt wurden 78 Patienten mit 282 Orbitaimplantaten über einen Beobachtungszeitraum von 2 bis 268 Monaten (Mittelwert 94.97 Monate) untersucht. Die kumulative Implantatüberlebensrate lag nach 2 Jahren bei 91.3%, nach 5 Jahren bei 80.5%, nach 10 Jahren bei 68.7% und nach 15 Jahren bei 62.2%. Die Überlebensrate war bei Frauen mit 75.3% signifikant höher als bei Männern mit 47.3%. Bei den supraorbital inserierten Implantaten lag sie höher als bei infraorbitalen Implantaten (67.4% vs. 51.5%) und Implantate mit maschinierter Oberfläche (70.2%) zeigten höhere Überlebensraten gegenüber Implantaten mit rauen Oberflächen (54.5%). Die Implantatlänge und Magnetverankerung schienen einen positiven Einfluss auf das Implantatüberleben zu haben. Kein signifikanter Zusammenhang wurde zwischen Alter, Nikotineinfluss, Patientenseite, Bestrahlungsstatus und Implantatüberleben gefunden. Schlussfolgernd deuten die Ergebnisse der vorliegenden Studie auf gute bis akzeptable Ergebnisse bezüglich der Langzeit-Vorhersagbarkeit von Orbitaimplantaten hin. Faktoren wie das weibliche Geschlecht, die Lokalisation am Supraorbitalrand, die maschinierte Oberfläche des Implantatsystems, die Implantatlänge und Magnetfixierung der Epithese scheinen die Implantatüberlebensrate positiv zu beeinflussen, wohingegen der Bestrahlungsstatus, Alter, Nikotineinfluss und Patientenseite keine Relevanz zeigen. Diese Faktoren sollten bei der zukünftigen Patientenversorgung berücksichtigt werden