A Second Republic for Italy?

Radical change in the representative dimension of Italy's political system was expected to bring a transition to a 'Second Republic' in Italy. That has not happened. Nevertheless, after three consultations using the new parliamentary electoral system, studies focusing on the 'input' side of Italian politics are beginning to agree that substantial change has occurred. It is, however, too early to identify the extent of change in public administration and centre–local government relations, whilst even in parliament it is argued that consensual decision-making continued at least into the late 1990s. The impact of party system change on policy-making has thus been shown to be less direct than many expected, providing rich material for research into the relationship between institutional and policy change. Nevertheless, institutional change continues, particularly with regard to the decentralisation of government, and some studies suggest that this is the key to Italy's political transformation, rather than electoral reform or even change in the form of government. Still, the election of Italy's first right-wing majority government in 2001 may yet bring change in parliamentary practice and policy-making more generally.     

Ethical issues in pro‐social advertising: the Australian 2006 White Ribbon Day campaign

• The Australian White Ribbon Day 2006 campaign was severely criticized by mental health professionals and those working in the family and domestic violence sector because of depictions of suicide and self‐harm in the television advertisement and accompanying promotional materials. The White Ribbon Day (WRD) National Leadership Group (NLG) rejected all requests by concerned groups to not use these campaign materials. They and their apologists claimed that such violent imagery was necessary to attract men's attention and was being misinterpreted as depicting suicide attempts.
• With preliminary ethics approval we set out to assess reactions to the television advertisement. After 24 interviews, the testing was terminated by the university research ethics officer after two male respondents demonstrated significant distress after viewing the ad. Furthermore, the results by that stage showed that there were perceived messages of suicide in the ad. These results were sent to the WRD NLG with a request to reconsider proceeding with the television advertisement and associated materials. Mental health and domestic violence organizations lodged similar requests. All requests were rejected. The case raises a number of ethical issues for pro‐social organizations when dealing with sensitive issues and using execution techniques that may impact negatively on vulnerable audiences.

Copyright © 2009 John Wiley & Sons, Ltd.     

Internships and the State Government Human Resources Crisis

State governments face massive retirements over the next few years. Since internships have been a significant source of bright new blood, we examine what all fifty states are doing with internships. Some exemplary programs were found, but the typical state intern program serves only a few unpaid students, supervisors receive no special training, and no tracking is done to see whether interns stay in state service or what their contributions are. While many states blame stringencies, the budgets involved are comparatively modest and potential benefits significant. We propose an action agenda for state governments and the public administration community.     

Proportional representation and attitudes about politics: results from New Zealand

PR systems often are credited with producing more equitable outcomes between political parties and encouraging wider social group representation than majoritarian systems. Theory suggests that this should instill greater trust, efficacy, and faith in the political system. We assume that citizens disadvantaged by majoritarian rules (political minorities) will have a relatively greater shift toward positive attitudes about democracy following a transition from a majoritarian system to proportional representation. We employ panel data from the 1993–1996 New Zealand Election Study (NZES) to test hypotheses about the effects of electoral system change on attitudes about governmental responsiveness, trust in government, and political efficacy. We find that there is a general shift in mass opinion toward more positive attitudes on some measures of efficacy and responsiveness. Political minorities display a greater shift toward feelings of efficacy than other voters.     

Fatal Fentanyl Patch Misuse in a Hospitalized Patient with a Postmortem Increase in Fentanyl Blood Concentration

Opioid‐related mortality happens, even in healthcare settings. We describe serial postmortem fentanyl blood concentrations in a hospital inpatient who fatally abused transdermal fentanyl. This is a single‐patient case report. A 42‐year‐old man with lymphoma was started on transdermal fentanyl therapy while hospitalized for chronic abdominal pain. The patient was last seen awake 1.3 h prior to being found apneic and cyanotic. During the resuscitation attempt, a small square‐shaped film was removed from the patient's oropharynx. Femoral blood was collected 0.5 and 2 h postmortem, and the measured fentanyl concentration increased from 1.6 to 14 ng/mL. Study limitations include potential laboratory or collection errors and missing data. (i) Providers must be vigilant for signs of fentanyl patch abuse. (ii) Postmortem blood concentrations are not static postmortem, likely secondary to decreasing pH, increased aqueous solubility, and tissue redistribution, and are therefore unlikely to accurately represent antemortem blood concentrations.     

Unity of effort requires unity of object: why industry should not be involved in formulating public health policy

This paper provides a framework for examining the general issue of public health authorities' collaboration with industry. The framework distinguishes between industry involvement in the development of public health policy and the implementation of policy‐driven interventions. A distinction is also made between industries marketing products conducive to good health versus products that impact negatively on public health (e.g. alcohol and energy‐dense, nutrition‐poor food and beverage industries). Drawing on concepts with respect to the effectiveness of military coalitions, it is argued that a common goal (i.e. ‘unity of object’) is a prerequisite for optimal co‐operation (i.e. ‘unity of effort’) between collaborators in any sphere of activity. However, this vital precondition does not exist in the public health arena because the end goals of industry and those of public health are fundamentally different, if not opposed (i.e. profits to owners/shareholders versus the social good). It is argued that because of this fundamental disjunct between industry profit goals and the public good, unity of effort will always be compromised in any form of collaboration with industry, and particularly where public health policies and interventions are designed to negatively impact on product consumption. Hence, while industry can be asked to co‐operate in implementing public health policy initiatives, industry should never be involved in developing policy initiatives. Copyright © 2014 John Wiley & Sons, Ltd.