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This essay addresses two controversies on the relationship between civil society and democratization in post-communist countries. It contradicts a tendency to dismiss civil society as a myth, ideology, or framing device for social movements and instead demonstrates that civil society is a real material force that has played a critical role in democratic breakthroughs in the region. It also criticizes the tendency to characterize post-communist civil society as either strong or weak in a blanket fashion. Instead, it shows that looking at differences in the strength of civil society at moments of transition is a good indicator of how durable that transition will be. This is illustrated with empirical work on both the breakthrough years of 1989-1991 and the period of the color revolutions in the 2000s. [ABSTRACT FROM AUTHOR]

The literature on civil society in postcommunist regimes highlights its weakness as compared with civil society in other democracies. In this article the authors make a general argument on how different patterns of antecedent dictatorship affect the development of civil society across a range of democracies. They examine the slow emergence of two behaviors associated with a robust civil society--participation in organizational life and in protest--and explain variation across countries as a function of regime history. They draw their individual-level data from the World Values Survey and analyze the behavior of over forty-one thousand citizens from forty-two democracies. Using methods of hierarchical linear modeling to control for both national-level and individual-level factors, the authors find that different types of dictatorship and variation in their duration produce different negative legacies for the development of civil society. [ABSTRACT FROM AUTHOR]

The maturation of emergency medicine (EM) as a specialty has coincided with dramatic increases in emergency department (ED) visit rates, both in the United States and around the world. ED crowding has become a public health problem where periodic supply and demand mismatches in ED and hospital resources cause long waiting times and delays in critical treatments. ED crowding has been associated with several negative clinical outcomes, including higher complication rates and mortality. This article describes emergency care systems and the extent of crowding across 15 countries outside of the United States: Australia, Canada, Denmark, Finland, France, Germany, Hong Kong, India, Iran, Italy, The Netherlands, Saudi Arabia, Catalonia (Spain), Sweden, and the United Kingdom. The authors are local emergency care leaders with knowledge of emergency care in their particular countries. Where available, data are provided about visit patterns in each country; however, for many of these countries, no national data are available on ED visits rates or crowding. For most of the countries included, there is both objective evidence of increases in ED visit rates and ED crowding and also subjective assessments of trends toward higher crowding in the ED. ED crowding appears to be worsening in many countries despite the presence of universal health coverage. Scandinavian countries with robust systems to manage acute care outside the ED do not report crowding is a major problem. The main cause for crowding identified by many authors is the boarding of admitted patients, similar to the United States. Many hospitals in these countries have implemented operational interventions to mitigate crowding in the ED, and some countries have imposed strict limits on ED length of stay (LOS), while others have no clear plan to mitigate crowding. An understanding of the causes and potential solutions implemented in these countries can provide a lens into how to mitigate ED crowding in the United States through health policy interventions and hospital operational changes., (© 2011 by the Society for Academic Emergency Medicine.)