Different Caregiver, Different Collaboration

The quality of the collaboration between health professionals and caregivers is of great significance to outcome and recovery. Severe brain injuries after a stroke can leave patients unable to communicate their needs and wishes with health professionals, in which case the role of the caregiver(s) becomes even more important. This position is highly differentiated, and there are substantial variations in how caregivers participate in the collaboration. Using the Bourdieusian concept of cultural health capital, we aimed to develop a broader understanding of the role played by the patient’s caregiver and how inequality is produced in the encounter with professionals. This qualitative study was conducted from 2014 to 2018. We observed the meetings and interactions between caregivers and health professionals during patients’ neurorehabilitation after a stroke, and we interviewed caregivers and health professionals on their experiences during this period. Constructing three different caregiver types—the proactive, the persistent, and the deferential—we discovered different ways of interacting and different attitudes related to cultural health capital, which provided the caregiver with more or fewer opportunities to participate in a dialogue and negotiation on behalf of the patient

A Two-Step Theory and Test of Democratic Waves *

Abstract Scholars, observing clustering in transitions to democracy, argue that democratization diffuses across borders as citizens in autocracies demand the same reforms they witness in neighboring states. We disagree. The present paper asserts that the diffusion of democracy literature rests on weak theoretical foundations and does not properly test for diffusion. We advance an alternative two-step argument to explain clustering of democratization: (1) economic shocks, which are clustered spatially and temporally, induce the breakdown of authoritarian regimes; then (2) democratic diffusion, in turn, influences whether a fallen dictatorship will be replaced by a democracy or a new autocracy. Diffusion, despite playing an important role, is insufficient to explain the clustering of transitions, notably because it cannot account for the timing of the waves. Using data on 125 autocracies from 1875 to 2004, we show that economic crises trigger authoritarian breakdowns, while diffusion determines whether the new regime is democratic or authoritarian. * Thanks t