Can post-Corona fiscal discipline be sustained? The case of Norway proves top civil servants can make it happen

COVID-19 has caused extremally high levels of budgetary deficits and government borrowing, which in the future will require more stringent fiscal policies write Benny Geys and Rune J. Sørensen (BI Norwegian Business School). How can post-Corona fiscal discipline be sustained? Budget preparation by top civil servants can allow for better balancing of the books, they claim

Political (Over)Representation of Public Sector Employees and the Double-Motive Hypothesis: Evidence from Norwegian Register Data (2007-2019)

Postponed access: the file will be available after 2023-09-02Countries have widely diverging regulations regarding the eligibility of public sector employees for political office, and the stringency of such regulations remains fiercely debated. Building on a demand and supply model of political selection, this article contributes to such debates by studying whether and how the incentives of public employees as both consumers and producers of public services (their ‘double motive’) affects their descriptive political representation. Our analysis employs population-wide individual-level register data covering four Norwegian local elections between 2007 and 2019 (N>13 million observations). Using predominantly individual-level panel regression models, we find that public employees are strongly overrepresented on election lists and have a higher probability of election (conditional on running). Looking at underlying mechanisms, we provide evidence consistent with the ‘double motive’ of public employees inducing their self-selection into standing for elected office (at higher-ranked ballot positions). Demand-side effects deriving from party and voter selection receive more limited empirical support. We discuss ensuing concerns about the potential substantive representation of policy self-interests by elected public employees.acceptedVersio

Clinical effectiveness of fresh frozen plasma compared with fibrinogen concentrate: a systematic review

ABSTRACT: INTRODUCTION: Haemostatic therapy in surgical and/or massive trauma patients typically involves transfusion of fresh frozen plasma (FFP). Purified human fibrinogen concentrate may offer an alternative to FFP in some instances. In this systematic review, we investigated the current evidence for the use of FFP and fibrinogen concentrate in the perioperative or massive trauma setting. METHODS: Studies reporting the outcome (blood loss, transfusion requirement, length of stay, survival and plasma fibrinogen level) of FFP or fibrinogen concentrate administration to patients in a perioperative or massive trauma setting were identified in electronic databases (1995 to 2010). Studies were included regardless of type, patient age, sample size or duration of patient follow-up. Studies of patients with congenital clotting factor deficiencies or other haematological disorders were excluded. Studies were assessed for eligibility, and data were extracted and tabulated. RESULTS: Ninety-one eligible studies (70 FFP and 21 fibrinogen concentrate) reported outcomes of interest. Few were high-quality prospective studies. Evidence for the efficacy of FFP was inconsistent across all assessed outcomes. Overall, FFP showed a positive effect for 28% of outcomes and a negative effect for 22% of outcomes. There was limited evidence that FFP reduced mortality: 50% of outcomes associated FFP with reduced mortality (typically trauma and/or massive bleeding), and 20% were associated with increased mortality (typically surgical and/or nonmassive bleeding). Five studies reported the outcome of fibrinogen concentrate versus a comparator. The evidence was consistently positive (70% of all outcomes), with no negative effects reported (0% of all outcomes). Fibrinogen concentrate was compared directly with FFP in three high-quality studies and was found to be superior for > 50% of outcomes in terms of reducing blood loss, allogeneic transfusion requirements, length of intensive care unit and hospital stay and increasing plasma fibrinogen levels. We found no fibrinogen concentrate comparator studies in patients with haemorrhage due to massive trauma, although efficacy across all assessed outcomes was reported in a number of noncomparator trauma studies. CONCLUSIONS: The weight of evidence does not appear to support the clinical effectiveness of FFP for surgical and/or massive trauma patients and suggests it can be detrimental. Perioperatively, fibrinogen concentrate was generally associated with improved outcome measures, although more high-quality, prospective studies are required before any definitive conclusions can be drawn