Offers of assistance in politician–constituent interaction

This paper was accepted in the journal Discourse Studies [© Sage] and the definitive version is available at http:dx.doi.org/10.1177/1461445615602376How do politicians engage with and offer to assist their constituents; the people who vote them into power? We address the question by analyzing a corpus of 80 interactions recorded at the office of a Member of Parliament (MP) in the United Kingdom, and comprising telephone calls between constituents and the MP’s clerical ‘caseworkers’ as well as face to face encounters with MPs in their fortnightly ‘surgeries’. The data were transcribed, then analysed using conversation analysis, focusing on the design and placement of offers of assistance. We identified three types of offers within a longer ‘offering’ sequence: 1) ‘proposal offers’, which typically appear first in any offering sequence, in which politicians and caseworkers make proposals to help their constituents using formats that request permission to do so, or check that the constituent does indeed want help (e.g., “do you want me to”; “we could…”); 2) ‘announcement offers’, which appear second, and indicate that something has been decided and confirm the intention to act (e.g., “I will do X”), and 3) ‘request offers’, which appear third, and take for form “let me do X”. Request offers indicate that the offer is available but cannot be completed until the current conversation is closed; they also appear in environments in which the constituent reissues their problems and appears dissatisfied with the offers so far. The paper contributes to what we know about making offers in institutional settings, as well as shedding the first empirical light on the workings of the constituency office: the site of engagement between everyday members of the public and their elected representatives

Pneumocystis pneumonia after lung transplantation: A retrospective multicenter study

International audienceBackground: Lung transplantation (LT) is an identified risk factor for Pneumocystis pneumonia (PCP). However, PCP management and outcomes remain poorly described in LT recipients and PCP incidence is rarely documented in this population.Methods: PCP episodes that occurred in 9 French LT centers between January 2010 and October 2017 were included in this analysis. PCP was defined as compatible clinical and radiologic findings associated with fungal identification.Results: Forty-seven PCP were included. The annual incidence rate of PCP was 2.7/1000 patients/year. Patients had a mean age of 53 +/- 14 years. Median time from LT was 2.4 +/- 3.0 years. Sixty-five percent of patients were not on prophylaxis at the time of PCP while all patients were receiving steroids at the time of PCP. Diagnosis was obtained by bronchoalveolar lavage in 91% (direct examination: 47%, PCR: 62%). The majority of patients were treated with trimethoprim-sulfamethoxazole (78%). Fifty-five percent of patients were hospitalized in ICU for organ failure (for which non-invasive ventilation was used for 21% and mechanical ventilation for 23%). Mortality rate was 15% at day 28 and reached 23% at day 90. Mortality was associated with decreased FEV1, everolimus treatment, Pseudomonas aeruginosa coinfection, fungal coinfection (especially Aspergillus sp.), mechanical ventilation and vasopressors. PCP primary prophylaxis, steroid modification during PCP and the number of immunosuppressive molecules were not associated with mortality.Conclusion: PCP is associated with a high mortality in LT. Our data suggest the need for a lifetime PCP prophylaxis in LT recipients. The benefit of adjuvant steroids remains unclear