Prudent Budget Planning and Budgetary Process Effectiveness: The Canadian Federal Government’s Experience (Working Paper 47)

In 1994, the Liberal government introduced a structured approach to prudent budgeting to provide the fiscal discipline needed to meet its debt reduction targets in which explicit prudence factors were introduced into the fiscal framework to reduce the amount of fiscal flexibility available for allocation in each annual budget. Although that framework was successful in contributing to the elimination of persistent budgetary deficits, this paper advances three linked arguments: • that additional but undisclosed prudence factors were also introduced into the fiscal framework to attenuate the political risk of missing budget targets; • that these undisclosed prudence factors are one cause of a number of unintended budgetary outcomes that put the effectiveness of the budgetary process at risk; and • that there is nothing inherently politically partisan about the Liberal’s approach to prudent budget planning and, changes to terminology and display notwithstanding, the present Conservative government has continued to apply most elements of that framework in its budgets. Moving from a single-year budget target to one that is expressed as a cumulative total over the election cycle is discussed as one option that would help preserve the merits of prudent budgeting.

The Canadian Federal Government’s Experience with Prudent Budget Planning (Working Paper 42)

The Liberal government made three significant changes to the budget process during the twelve years that it held office (from 1993 to the election call in the winter of 2005). The first of these changes was the formal introduction of prudent budget planning. The second was a focus on reallocation, beginning with its 1994 Program Review initiative, followed by a series of other measures. The third was the introduction for fiscal 2003-04 of a full accrual basis for the budget (though not, it should be noted, full accrual budgeting) and for the Public Accounts. This paper focuses predominantly on the first of these changes and examines its impact on the government’s budget and expenditure management decision-making processes.

MARKERS OF CARDIOVASCULAR DYSFUNCTION AFTER PREGNANCIES COMPLICATED BY PRE-ECLAMPSIA

Pre-eclampsia (PE) is a hypertensive disorder of pregnancy characterized by maternal systemic endothelial dysfunction. While the clinical manifestations resolve soon after delivery, a large body of epidemiological evidence indicates significant long-term maternal risk for cardiovascular disease (CVD) after PE. The mechanisms by which PE and future CVD are associated are unclear, although shared constitutional risk factors likely contribute to the features of endothelial dysfunction characteristic to both. We postulate that PE offers a window of opportunity for the identification of unique markers of dysfunction in the earliest stages of disease that may be used to validate cardiovascular risk screening in the early postpartum period. The studies presented in this thesis provide evidence of changes in circulating factors in women with a recent history of PE. Using blood samples collected within the first year of pregnancy, unique patterns of microRNA expression, enrichment of coagulation system proteins and endothelial progenitor cell dysfunction were described. Many of the described changes appear to be independent of cardiovascular risk. In addition to alterations in circulating factors however, longitudinal postpartum assessments demonstrated that microvascular and cardiac abnormalities were evident in the early periods postpartum after a pre-eclamptic pregnancy. Collectively, the data presented in this thesis reveal that physiological alterations in women with a recent history of PE are not necessarily dependent on clinical parameters of cardiovascular risk, and that resulting dysfunction may be demonstrated within the first year postpartum. Importantly, the biomarkers presented herein are all demonstrated elsewhere in the literature to benefit from lifestyle modification and risk reduction. In closing, the findings of this thesis support a need for cardiovascular risk screening based on obstetrical history, namely after pregnancies complicated by PE.