On the preconditions for large-scale collective action.

The phenomenon of collective action and the origin of collective action problems have been extensively and systematically studied in the social sciences. Yet, while we have substantial knowledge about the factors promoting collective action at the local level, we know far less about how these insights travel to large-scale collective action problems. Such problems, however, are at the heart of humanity's most pressing challenges, including climate change, large-scale natural resource depletion, biodiversity loss, nuclear proliferation, antibiotic resistance due to overconsumption of antibiotics, and pollution. In this paper, we suggest an analytical framework that captures the theoretical understanding of preconditions for large-scale collective action. This analytical framework aims at supporting future empirical analyses of how to cope with and overcome larger-scale collective action problems. More specifically, we (i) define and describe the main characteristics of a large-scale collective action problem and (ii) explain why voluntary and, in particular, spontaneous large-scale collective action among individual actors becomes more improbable as the collective action problem becomes larger, thus demanding interventions by an external authority (a third party) for such action to be generated. Based on this, we (iii) outline an analytical framework that illustrates the connection between third-party interventions and large-scale collective action. We conclude by suggesting avenues for future research.

On defining "mental disorder": purposes and conditions of adequacy.

All definitions of mental disorder are backed up by arguments that rely on general criteria (e.g., that a definition should be consistent with ordinary language). These desiderata are rarely explicitly stated, and there has been no systematic discussion of how different definitions should be assessed. To arrive at a well-founded list of desiderata, we need to know the purpose of a definition. I argue that this purpose must be practical; it should, for example, help us determine who is entitled to publicly funded health care. I then propose eight conditions of adequacy that can be used to assess competing definitions (e.g., the ordinary language condition, the coherence condition, and the condition of normative adequacy). These conditions pull in different directions, however, and we must decide which are most important. I also suggest that there is no single definition that can help us deal with all the relevant practical issues.

Patients' understanding of the concepts of health and quality of life.

OBJECTIVE: The aim of this study was to identify how persons' with rheumatoid arthritis (RA) understand the concepts of health and quality of life (QoL). METHODS: A phenomenograpic approach was used to gauge variations in understanding of health and QoL. Semistructured interviews were conducted with 22 persons having RA. The interviews were audiotaped, transcribed verbatim, and analyzed, resulting in a descriptive system consisting of categories and subcategories. RESULTS: Health was primarily associated with being healthy/being free from disease, being able to function normally, experiencing well-being, and having a healthy lifestyle. Two above-mentioned domains, "being healthy" and "being able to function normally" overlapped with respondents' understanding of QoL. Additional perceived domains included attitudes towards life and, social and physical environments. CONCLUSION: The results show that patients' understanding of the two concepts of health and QoL partially overlap and partially differ. PRACTICE IMPLICATIONS: Patients' understanding of the concepts is individual and diverse, which needs to be taken into account in patient-physician consultations to ensure good communication. Furthermore, the interpretation of results based on patient-reported outcomes instruments measuring health status and/or QoL needs to be further studied over time to identify possible changes in these conceptions.