Parents' and staff's perceptions of parental needs during a child's admission to hospital: an English perspective

The aim of this research was to compare perceptions of parental needs held by parents of hospitalized children and the staff caring for them, so that potential communication breakdown could be avoided. A well-trialled tool was used with a convenience sample in paediatric facilities in a National Health Service trust in north-east England. Some differences were found between parents and staff for scores for perceived importance of the 51 needs that were included in the questionnaire, and whether or not they were being satisfactorily met during the child’s hospital admission, but there were no consistent patterns, so it is difficult to draw conclusions. Parents declared themselves more independent than the staff perceived them to be. Such findings facilitate improvements in communication between parents and staff and can be included in education programmes for both.

Hospital care of children in four countries

Background. While perceptions of parents and staff about care of hospitalized children have been explored in developed countries, little research has examined these in developing countries. Assumptions about family-centred care are often based on Western values, with little evidence of how cultural constructs affect care delivery in developing nations. Aim. This paper reports a study to provide evidence from which culturally-appropriate hospital care for children can be delivered. Methods. Using a rigorously devised and trialed questionnaire, attitudes of staff and parents about the way children are cared for in children's hospitals in four countries were examined and subjected to a four way analysis: parents and staff within and between developed and developing countries. Results. There were no questions where all parents and staff in both developed and developing country groups were in complete agreement. However, there was some indication that, while culture plays a major role in paediatric care delivery, basic concepts of family-centred care are similar. Conclusions. The findings are limited by the sampling strategy. Nevertheless, while differences were found between parents' and staff's expectations of the delivery of care to children in hospitals, similarities existed and the influence of culture cannot be ignored. Education programmes for staff and parents should reflect these influences to ensure the optimum delivery of family-centred care, regardless of where the hospital is situated.

Breastfeeding and obesity at 14 years: A cohort study

Aim: To determine the influence of breastfeeding on overweight and obesity in early adolescence. Methods: Data about breastfeeding duration, BMI of children at 14 years, and confounding variables, were collected from an ongoing longitudinal study of a birth cohort of 7776 children in Brisbane. Prevalence of overweight and obesity at 14 years was assessed according to duration of breastfeeding, with logistic regression being used to adjust for the influence of confounders. Results: Data were available for 3698 children, and those not included were significantly different in age, educational level, income, race, birthweight, and small-for-gestational-age status. Breastfeeding for longer than six months was protective of obesity (OR 0.6, 95% CI 0.4, 0.96) though not of overweight. When confounding variables were considered the effect size diminished and lost statistical significance OR 0.8 (95% CI 0.5, 1.3). Breastfeeding for less than 6 months had no effect on either obesity or overweight though a trend was found for increased prevalence of overweight at 14 years with shorter periods of breastfeeding. Conclusion: This investigation contributes to the gathering body of evidence that breastfeeding for longer than 6 months has a modest protective effect against obesity in adolescence.

Family centred care: a review of qualitative studies

Aim. To review systematically qualitative studies, which were found during a literature search for a Cochrane systematic review of the use of family centred care in children's hospitals. Background. Family centred care has become a cornerstone of paediatric practice, however, its effectiveness is not known. No single definition exists, rather a list of elements that constitute family centred care. However, it is recognized to involve the parents in care planning for a child in health services. A new definition is presented here. Methods. The papers were found in wide range of databases, by hand searching and by contacting the authors where necessary, using terms given in detail in the protocol in the Cochrane Library, in 2004. Qualitative studies could not be used for statistical analysis, but are still important to the review and so are described separately in this paper. Results. Negotiation between staff and families, perceptions held by both parents and staff roles influenced the delivery of family centred care. A sub-theme of cost of family centred care to families and staffs was discovered and this included both financial and emotional costs. Conclusion. Further research is needed to generate evidence about family centred care in situations arising from modern models of care in which family centred care is thought to be an inherent part, but which leave families with the care of sick children with little or no support. Relevance to clinical practice. Family centred care is said to be used widely in practice. More research is needed to ensure that is it being implemented correctly.

Transcriptome analysis of Neotyphodium and Epichloë grass endophytes

Large-scale gene discovery has been performed for the grass fungal endophytes Neotyphodium coenophialum, Neotyphodium lolii, and Epichloe festucae. The resulting sequences have been annotated by comparison with public DNA and protein sequence databases and using intermediate gene ontology annotation tools. Endophyte sequences have also been analysed for the presence of simple sequence repeat and single nucleotide polymorphism molecular genetic markers. Sequences and annotation are maintained within a MySQL database that may be queried using a custom web interface. Two cDNA-based microarrays have been generated from this genome resource, They permit the interrogation of 3806 Neotyphodium genes (Nchip (TM) rnicroarray), and 4195 Neotyphodium and 920 Epichloe genes (EndoChip (TM) microarray), respectively. These microarrays provide tools for high-throughput transcriptome analysis, including genome-specific gene expression studies, profiling of novel endophyte genes, and investigation of the host grass-symbiont interaction. Comparative transcriptome analysis in Neotyphodium and Epichloe was performed. (c) 2006 Elsevier

The Sarkozy effect: France’s new presidential dynamic

The election on 6 May 2007 of Nicolas Sarkozy as President of the Republic ushered in the promise of a new era in France. Sarkozy’s presidency follows those of the Socialist François Mitterrand (1981-95) and the neo-Gaullist Jacques Chirac (1995-2007), who together occupied France’s highest political office for more than a quarter-century. From the outset, Sarkozy’s presidential campaign was predicated on the need for change in France, for a “rupture” with the past; and his emphatic victory against the Socialist Ségolène Royal gave him a mandate to effect this. The legislative elections of June 2007, by assuring a strong majority in the National Assembly for Sarkozy’s centre-right Union pour un Mouvement Populaire (UMP), left the way clear for implementing the new President’s reform agenda over the next five years. This article examines the political context within which Sarkozy was elected to power, the main proposals of his presidential program, the challenges he faces, and his prospects for bringing real change to France.

Politics, ethics, and the search for a just international order:symposium in honour of Stanley Hoffmann

Published symposium with Stanley Hoffmann (Harvard), Suzanne Berger (MIT), Michael Doyle (Columbia), Peter Gourevitch (California San Diego), Robert Keohane (Princeton), Andrew Moravcsik (Princeton). Ed. James Shields, French Politics, 7 (3/4) 2009, 359-436. ISSN 1476-3419 (print) 1476-3427 (online)

The extreme right in France:from Pétain to Le Pen

The Front National has for some years been France's third political party and the most notable far-right force in Europe; its leader, Jean-Marie Le Pen, contested the 2002 presidential election run-off with 5.5 million votes. What do Le Pen and the FN represent? What are their historical roots, their values and their policies? Who votes for them and why? And what has been their impact on the political agenda in France? Adopting an essentially chronological approach, the book traces the political lineage of Le Pen and the FN through key figures, movements and events on the French extreme right from the Vichy regime to the present, providing a detailed historical perspective for understanding the FN today. Part I provides a historical study of the extreme right in France since 1940, examining • the Vichy regime, collaboration and ‘collaborationism’, • the aftermath of Liberation and the post-war extreme right, • the Poujadist movement and the politics of populism, • the Algerian War as a catalyst for change, • the ‘Nouvelle Droite’ and the search for doctrinal renewal, • old and new forms of extreme-right ideology and activism. Part II undertakes a comprehensive study of the FN, analysing • the party’s early development and electoral rise, • its evolving programme and strategy, • the factors underlying its popular appeal, • the geography and composition of its electorate, • its exercise of local power and regional influence, • and its defining impact on the national political agenda. The FN, it is argued, represents both the latest manifestation of a long tradition of authoritarian nationalism and a complex new phenomenon within the changing social and political dynamics of contemporary France.

Charlemagne’s crusaders: French collaboration in arms, 1941–1945

Military collaboration is one of the least acknowledged aspects of France under the Occupation. Yet from summer 1941 France raised a number of fighting units for Hitler’s armies, each with its distinctive mission and each drawing the Vichy regime deeper into collaboration with Nazi Germany. This article discusses that process and its diverse implications. It shows how the Paris collaborationists used military engagement to pressure the Vichy government into more activist collaboration and explores the divergent perspectives in which this was viewed from Berlin, Paris and Vichy; it considers the mobilising myths, motivations and misapprehensions behind military collaboration; and it identifies some of the anomalies of that collaboration, with its reconceptualising of France and Other, friend and foe, belonging and alienation. Those French ‘patriots’ who fought in German uniform would become effective exiles from a homeland they departed to ‘defend’ only to see it ‘liberated’ by their ‘enemies’. Exposing the divisions and the delusions underlying military collaboration, the article sheds light on conflicting political calculations and shifting allegiances in occupied France.

Political representation in France: a crisis of democracy?

The past two decades have witnessed growing political disaffection and a widening mass/elite disjuncture in France, reflected in opinion polls, rising abstentionism, electoral volatility and fragmentation, with sustained voting against incumbent governments. Though the electoral system has preserved the duopoly of the mainstream coalitions, they have suffered loss of public confidence and swings in electoral support. Stable parliamentary majorities conceal a political landscape of assorted anti-system parties and growing support for far right and far left. The picture is paradoxical: the French express alienation from political parties yet relate positively to their political institutions; they berate national politicians but retain strong bonds with those elected locally; they appear increasingly disengaged from politics yet forms of ‘direct democracy’ are finding new vigour. While the electoral, attitudinal and systemic factors reviewed here may not signal a crisis of democracy, they point to serious problems of political representation in contemporary France.

An enigma still: Poujadism fifty years on

Few names resonate more loudly from the French Fourth Republic than that of Pierre Poujade, and few terms exude such a sulfurous odour as le poujadisme. Between 1953 and 1958, the Poujadists secured their place in modern French history, winning 52 seats in the National Assembly and inscribing a lasting entry in the lexicon of political protest. Taking as its starting point the fiftieth anniversary of Poujade’s movement held in its birthplace of Saint-Céré in July 2003, this article reassesses Poujadism fifty years on from its heyday. It considers Poujadism as the first important anti-globalisation movement in post-war France, a locus for the conflict between ‘stalemate’ traditionalism and socio-economic modernisation. It examines the trajectory of the Poujadists from anti-tax movement to political party, arguing the difficulty of defining Poujadism in classic political terms. In particular, the article takes issue with the perception of Poujadism as an extreme-right ideology and interprets it instead as a form of populist protest lacking a solid doctrinal core and opportunistic in its exploitation of political issues and allies. As such, it is argued, Poujadism represents a complex synthesis of both right-wing and left-wing values and discourses, as impervious to definition today as it was fifty years ago. The article considers the brief alliance of convenience between Poujade and Le Pen, and locates in Le Pen’s early Poujadist experience some of the methods and even some of the arguments used by the FN today. It concludes by discussing Poujade’s political activities after 1958, tracing his long-term conversion from violent opposition to the State under the Fourth Republic to co-operation under the Fifth. The author draws here on correspondence with Pierre Poujade up until his death in August 2003.

Political radicalism in France:perspectives on a protean concept

This introductory article reflects on the new momentum that political radicalism has taken on in France. The ebb and flow of radical aspiration featured regularly in French politics under the Fourth and early Fifth Republics, before the failure of the "Socialist experiment" in the early 1980s brought about a paradigm shift. In the wake of this failure and with the "end of ideology" supposedly in sight, political leaders and parties tempered their appeals to radical solutions and conspired, not least through recurrent power-sharing, to vacate mainstream political discourse of much of its former radicalism. Since the presidential election of 2007, however, there has been a marked return to promises of radical change as the common currency of political discourse across the full left-right spectrum in France. This article introduces a special issue of French Politics, Culture & Society that brings together scholars from France, Britain, and Canada to discuss some of the meanings, expressions, and prospects of political radicalism in France today.