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"Excited Delirium Syndrome" (ExDS) is a controversial diagnosis. The supposed syndrome is sometimes considered to be a potential cause of death. However, it has been argued that its sole purpose is to cover up excessive police violence because it is mainly used to explain deaths of individuals in custody. In this paper, we examine the epistemic conditions giving rise to the controversial diagnosis by discussing the relation between causal hypotheses, evidence, and data in forensic medicine. We argue that the practitioners' social context affects causal inquiry through background assumptions that enter inquiry at multiple stages. This analysis serves to better understand the wide usage of the controversial diagnosis of ExDS. [ABSTRACT FROM AUTHOR]

This paper provides new perspectives on the scholarship on medicalization and demedicalization, building on an ethnography of hymenoplasty consultations in the Netherlands. By examining how doctors can play an active role in demedicalization, this paper presents novel insights into Dutch physicians' attempt to demedicalize the “broken” hymen. In their consultations, Dutch doctors persuade hymenoplasty patients to abandon the assumed medical definition of the “broken” hymen and offer nonmedical solutions to patients' problems. Drawing from unique ethnographical access from 2012 to 2015 to 70 hymenoplasty consultations in the Netherlands, this paper's original contribution comes from closely examining how demedicalization can be achieved through the process of medicalization. It investigates how Dutch physicians go even further in their efforts to demedicalize by medicalizing “cultural” solutions as an alternative course of action to surgery. [ABSTRACT FROM AUTHOR]

The concept of geneticization belongs to a style of thinking within the social sciences that refers to wide-ranging processes and consequences of genetic knowledge. Lippman’s original use of the term was political, anticipating the onerous consequences of genetic reductionism and determinism, while more recent engagements emphasise the productivity and heterogeneity of genetic concepts, practices and technologies. This paper reconstructs the geneticization concept, tracing it back to early political critiques of medicine. The argument is made that geneticization belongs to a style of constructionist thinking that obscures and exaggerates the essentializing effects of genetic knowledge. Following Hacking’s advice, we need a more literal sense of construction in terms of ‘assembly’ to give a clearer account of the relationship between processes and products. Using the ‘assemblage’ concept to explore the social ontology of genetics, the paper reviews three areas of the empirical literature on geneticization – disease classification, clinical practice and biosociality – to show that a new style of thinking has appeared within the social sciences. In the final assessment, the conditions that gave rise to geneticization are now obsolete. While it may serve as a useful ritual of debate, conceptually geneticization offers a limited account of the heterogeneity of socio-technical change. [ABSTRACT FROM AUTHOR]

Medicalization is increasingly recognized as a bidirectional process, with patients and their families as agents. The paper considers the specific case of the medicalization of autism in Italy, from the point of view of parents of autistic people with different levels of support needs. Through reporting and comparing results of two independently conducted qualitative studies, this paper aims to analyze how parents embrace and resist the medicalization of autism in their everyday lives and in healthcare contexts. Both studies involved participant-observation with services that targeted autistic people and interviews with parents, professionals, and autistic people. Results show that parents of autistic people both embrace and resist medicalization. While parents (sometimes ambivalently) accept the responsibilization inherent in their engagement with interventions (a sort of "therapeutization" of life) and reject lay expertise by deferring to experts' knowledge, they also resist the application of medical labels, language and practices in various ways in their everyday lives. Both embracing and resisting medicalization can be useful for achieving overarching social goals of being a good parent, helping their children, and pursuing respect and social harmony. Medicalization derives not only from the cultural dominance of medical discourses, which seems to incorporate resistance to medicalization stances, but also from the absence of continuity and coordination of services, particularly in the Italian context of public (but increasingly privatizing) health and welfare services. • Parents accept the responsibilization inherent in medicalization and resist it. • Both embracing and resisting medicalization is useful for achieving social goals. • Medicalization is due to the cultural dominance of medicine. • Medicalization also derives from the absence of continuity of services. • Cultural and biopolitical context impact on how people engage with medicalization. [ABSTRACT FROM AUTHOR]

This paper examines how parents of children diagnosed with autism resist the medicalization of their children's behavior. Drawing on video and ethnographic data collected over four years of fieldwork at a clinic for developmental disorders, the paper distinguishes two orders of practice – that of the clinic and that of the family – and argues that behavior which is interpreted as disordered in the clinic may be seen as ordinary in the home. These different interpretations reflect and renew distinct orders of sensemaking in the clinic and home, and parents may mobilize familial knowledge of the child to counter the medicalization of specific behavior patterns, even where they otherwise accept an autism diagnosis. In showing how medicalization and labelling are achieved and resisted in the mundane details of social interaction, the paper contributes to studies of diagnosis, disability, and deviance. Further, the myriad ways parents and clinicians contest which regions of a child's behavior get medicalized – i.e. which behavioral patterns are labeled disordered – present a challenge to binary conceptions of medicalization, recommending instead a more nuanced model of medicalization as a multi-dimensional continuum: more or less, rather than either-or. • The interaction order of the clinic medicalizes behavior that may be seen as benign in other settings. • Parents resist medicalization of children's behavior by drawing on personal knowledge of the child. • Medicalization is not all or nothing, but is negotiated at the level of individual behavior. • Even where a diagnosis is accepted, parents may reject the medicalization of specific behaviors. • Parents can reveal the sensibility of children's behavior in which clinicians see only deficits. [ABSTRACT FROM AUTHOR]

This paper provides an examination of the process used by ordinary courts in Chile when making legal capacity determinations. It provides an up-to-date account of various aspects of law and procedure related to legal capacity in this jurisdiction. Also, by drawing on semi-structured interviews with judges, this paper examines judicial understandings of legal capacity decision-making focusing on problems related to the medicalisation of mental disability and the participation of persons with disabilities in legal capacity procedures. [ABSTRACT FROM AUTHOR]

There is ongoing disagreement about the moral implications of developing and/or using neurotechnologies that would affect romantic love and relationships. In this paper, we argue that scientists should actively pursue a research program into such technology. Our call for research is based in part on the fact that a number of pharmaceuticals already in use are very likely to have ramifications for our relationships (romantic and otherwise), and we suggest that we should attempt to understand the effects of these drugs on our interpersonal commitments. In a similar vein, we argue for a shift in scientific research norms, according to which the study of relationships and other social factors would be given higher priority than they currently are given. Finally, in an Appendix, we discuss our use of the term “love drug,” and consider whether it is appropriate in light of debates about neuroreductionism. [ABSTRACT FROM AUTHOR]

Older adults consume the most prescription medication in the U.S. For those who develop Alzheimer's disease, risk of medication misuse increases with the progression of the disease. Family members commonly intervene to lessen risks by taking over the management and administering of a medication regimen. Despite the potential for grave harm around the misuse of powerful drugs, few studies provide insight into the household social context of medication use for this disease. Drawing on 60 in-depth interviews conducted in four waves over 2.5 years, this study investigates how family members administered prescription and over-the-counter medications to elders with Alzheimer's. The findings detail how family members initially created and enacted the role of proxy-administrator to avoid self-administration errors and then expanded the role to manage disruptive behaviors. During this process, family members perceived themselves as working in partnership with doctors, especially in the effort to craft a regimen that controlled the affected individual's mood and sleep/wake cycle. The paper concludes by discussing the implications that family members used medications to improve conformity to a preferred household social order. The study offers conceptual advances in understanding 1) the process of proxy-administration in Alzheimer's care and 2) the role of proxy-administrators in the medicalization of deviant behavior. [ABSTRACT FROM AUTHOR]

This research focusses on low mood as a generic category in everyday social interactions, outside the clinical realm and among non-patients. We examine if and how a clinical depression label and treatment are employed when low mood occurs in everyday life, which enables us to analyze the extent and content of medicalization and brings to the fore the interactional mechanisms and cultural concerns that potentially drive medicalization. The analysis is based on 316 observations of everyday life in the Netherlands. We observed and recorded interactions in which low mood was spontaneously expressed. Our paper shows that the clinical depression label resonates widely even if low mood is not fully medicalized. People de-medicalize low mood, and low mood can be un-medicalized. Our analysis thus suggests that dominance is not achieved, which nuances Horwitz and Wakefield's claim that the clinical category of depression has come to encompass all forms of low mood. Moreover, uncertainties about the meaning of low mood and about the depression label remain pragmatic concerns of everyday life. The cultural norm of happiness and active citizenship are very prominent in everyday life across medicalized and un-medicalized interactions. These norms thus seem to be a necessary but insufficient condition for medicalization. While pragmatic concerns do not seem to trigger medicalization either, one specific type of concern is consistently related to medicalization: relational conflicts. In sum, the cultural construction of low mood is not dominated by a single medical approach; however, it mirrors the diversity and uncertainties within and around the medical field. [ABSTRACT FROM AUTHOR]

This paper examines infant feeding in relation to three core concerns: its medicalization, normalization by technologies of the state, and its expression through techniques of the body. This three-tiered focus allows for a respective focus on how medicine exercises authority over spheres of life not previously considered medical; the internalisation of the state's disciplinary regimes and their perpetuation through the use of normalising judgement in practice; and the minute practices of everyday infant nurture, and what these say about the development of specific types of people. In so doing, we build on a stream of feminist scholarship on infant feeding since the 1980s, but we also diverge, in that our focus is not only breastfeeding but more broadly the nourishment of infants — be this from the mother's breasts, or through lactational surrogacy, including wet-nursing and milk sharing as well as infant milks derived from other sources, animal or vegetable. To this, we expand our view beyond milks to include the feeding of other foodstuffs and the absorption of nourishment through other-than-oral nourishing practices. In so doing, we highlight the epistemologies that underscore these practices, and problematize the ontological premises of the concept of nurture. [ABSTRACT FROM AUTHOR]

With an increase in the survival rate and shift in the age composition of women, menopause is emerging as one of the major health issues in the sociology of health. Thanks to demographic transition, a sizeable number of women will now spend onethird to half of their life as post-menopausal. The present paper focuses upon the prevailing discourses on women's menopausal health in the Indian setting. It suggests that though women's health beliefs, behaviour and coping patterns in the Indian context differ from their Western counterparts, huge similarities are found in sociocultural and medical discourses on menopause. In most of these discourses women are marginalised and seen as inferior to men. However, the epidemiological studies on women's menopausal health in India suggest that menopause is a normal life event where menstruation ceases; it is not associated with the bio-psycho-social morbidity paradigm as prevalent in the West. [ABSTRACT FROM AUTHOR]

Background and objectives Computer aided analysis of mammograms has been employed by radiologists as a vital tool to increase the precision in the diagnosis of breast cancer. The efficiency of such an analysis is dependent on the employed mammogram enhancement approach; as its major role is to yield a visually improved image for radiologists. Methods Non-linear Polynomial Filtering (NPF) framework has been explored previously as a robust approach for contrast improvement of mammographic images. This paper presents the extension of NPF framework for sharpening and edge enhancement of mammogram lesions. Proposed NPF serves to provide enhancement of edges and sharpness of the lesion region (region-of-interest) in mammograms, in a manner to minimize the dependencies on pre-selected thresholds. In the present work, Logarithmic Image Processing (LIP) model has been employed for the purpose of improvement in visualization of mammograms based on Human Visual System (HVS) characteristics. Results The proposed NPF filtering framework yields mammograms with significant improvement in contrast, edges as well as sharpness of the lesion region. The performance of the proposed approach has been validated using state-of-art objective evaluation measures (of mammogram enhancement) like Contrast Improvement Index (CII), Peak Signal-to-Noise Ratio (PSNR), Average Signal-to-Noise Ratio (ASNR) and Combined Enhancement Measure (CEM); as well as subjective evaluation by radiologists’ opinions. Conclusions The proposed NPF provides a robust solution to perform noise controlled contrast as well as edge enhancement using a single filtering model. This leads to a better visualization of the fine lesion details predictive of their severity. The applicability of single filtering methodology for carrying out denoising, contrast and edge enhancement improves the worth of the overall framework. [ABSTRACT FROM AUTHOR]

Nowadays, in the era of common computerization, transmission and reflection methods are intensively developed in addition to improving classical ultrasound methods (US) for imaging of tissue structure, in particular ultrasound transmission tomography UTT (analogous to computed tomography CT which uses X-rays) and reflection tomography URT (based on the synthetic aperture method used in radar imaging techniques). This paper presents and analyses the results of ultrasound transmission tomography imaging of the internal structure of the female breast biopsy phantom CIRS Model 052A and the results of the ultrasound reflection tomography imaging of a wire sample. Imaging was performed using a multi-modal ultrasound computerized tomography system developed with the participation of a private investor. The results were compared with the results of imaging obtained using dual energy CT, MR mammography and conventional US method. The obtained results indicate that the developed UTT and URT methods, after the acceleration of the scanning process, thus enabling in vivo examination, may be successfully used for detection and detailed characterization of breast lesions in women. [ABSTRACT FROM AUTHOR]

In the late 1990s researchers in Pelotas Southern Brazil began documenting what they considered to be unacceptably high rates of licensed psychotropic use among individuals of all ages, including youth. This came as a surprise, since the vast majority of psychiatrists in Pelotas draw on psychoanalytic theory and approach pharmaceutical use, especially for children and adolescents, in a consciously tempered way. Drawing from a longitudinal ethnographic sub-study, part of a larger 1982 birth cohort study, this paper follows the circuitous trajectories of emergent pharma-patterns among “shantytown” youth over a ten-year period, exploring the thickly layered and often moralized contingencies in which psychodynamic psychiatrists' intention to resist excessive pharmaceuticalization both succeed and crumble. I juxtapose these trajectories with the growing salience of an “anti-biologizing” explanatory framework that psychiatrists and researchers are using to pre-empt the kind of diagnostics-driven “biopsychiatrization” so prevalent in North America. My analysis suggests that psychiatrists' use of this framework ironically contributes to their failed attempts to “resist” pharmaceuticalization. [ABSTRACT FROM AUTHOR]

Medicalization is a central topic of concern in the sociology of disability and of health and illness. In this paper, I examine how medicalization is inequitably applied and circulates in the context of schools, specifically in serving students with educational disabilities. My aim is to advance understandings of medicalization through this case. Using a mixed-methods design, I first show, descriptively, how race and gender intersectionally predict educational disability status in a dataset of all Wisconsin public school students. Next, I examine how racial and gender disparities in disability status are produced at the micro level, using interviews with 27 Wisconsin teachers, including in-depth discussions of 73 individual students that were struggling academically or behaviorally. My quantitative findings show variation by race, gender, and disability category: White children have higher probability of special education receipt than comparable children of color for academic difficulties, but lower probability for behavioral difficulties, and girls have lower probability than comparable boys overall. My interview data suggest that these disparate outcomes reflect stratified medicalization processes, in which institutional constraints, status beliefs, and cultural discourses of race and gender shape both stratified noticing of schooling difficulties and stratified interpretation of those difficulties as medicalized conditions. • White children and boys are more likely than comparable peers to receive special education for higher-status disabilities. • Children of color and boys are more likely than comparable peers to receive special education for lower-status disabilities. • These inequalities are explained by stratified definitional processes of medicalization by teachers. • Institutional constraints and cultural discourses of race and gender shape stratified medicalization processes. • These processes include stratified noticing and stratified interpretation of students' difficulties. [ABSTRACT FROM AUTHOR]

Attention Deficit Hyperactivity Disorder (ADHD) has been medicalized in the United States since the 1960s. Primarily used in North America until the 1990s, ADHD diagnosis and treatment have increasingly been applied internationally. After documenting the expansion of ADHD in a global context, this paper presents five brief international examples examining ADHD usage and expansion: the United Kingdom, Germany, France, Italy and Brazil. We then identify and describe several vehicles that facilitate the migration of the ADHD diagnosis: the transnational pharmaceutical industry; the influence of western psychiatry; moving from ICD to DSM diagnostic criteria; the role of the Internet including the related advent of easily accessible online screening checklists; and advocacy groups. Finally, we discuss what this globalization of a diagnosis reflects about the potential global medicalization of other conditions. [ABSTRACT FROM AUTHOR]

The way newspapers frame infectious disease outbreaks and their connection to the environmental determinants of disease transmission matter because they shape how we understand and respond to these major events. In 2017, following an unexpected climatic event named "El Niño Costero," a dengue epidemic in Peru affected over seventy-five thousand people. This paper examines how the Peruvian news media presented dengue, a climate-sensitive disease, as a public health problem by analyzing a sample of 265 news stories on dengue from two major newspapers published between January 1st and December 31st of 2017. In analyzing the construction of responsibility for the epidemic, I find frames that blamed El Niño Costero's flooding and Peru's poorly prepared cities and public health infrastructure as the causes of the dengue outbreak. However, when analyzing frames that offer solutions to the epidemic, I find that news articles call for government-led, short-term interventions (e.g., fogging) that fail to address the decaying public health infrastructure and lack of climate-resilient health systems. Overall, news media tended to over-emphasize dengue as requiring technical solutions that ignore the root causes of health inequality and environmental injustice that allow dengue to spread in the first place. This case speaks to the medicalization of public health and to a long history of disease-control programs in the Global South that prioritized top-down technical approaches, turning attention away from the social and environmental determinants of health, which are particularly important in an era of climate change. • Analyzes 265 articles on Peru's 2017 dengue outbreak following El Niño Costero. • Finds that individualizing narratives are not as prevalent as seen in past studies. • However, calls for government action still emphasize short-term technical solutions. • In particular, eco-social approaches to prevent transmission were overlooked. • Concludes that this narrow view on public health still reflects medicalization. [ABSTRACT FROM AUTHOR]

Female Genital Cutting (FGC) is increasingly being performed by trained health professionals. International, national, and local institutions strongly oppose this medicalization trend, arguing that the involvement of health-care providers in the performance of FGC will counteract efforts to eliminate the practice. However, no empirical research to date has confirmed or refuted this claim. Therefore, it remains unclear how the medicalization of FGC relates to changes in the prevalence of the practice. In the current paper, we aim to fill this gap in the literature by examining the association between this medicalization trend and the risk of FGC. We focus on Egypt because of its high medicalization and prevalence rates and its unique history of FGC legislation. We performed a discrete-time event-history regression analysis combined with governorate fixed effects using the Egyptian Demographic Health Surveys from 2005, 2008, and 2014 (N = 49,273 daughters clustered within 29,810 mothers). Our results show that increasing medicalization rates coexist with decreasing prevalence rates. This effect is particularly pronounced in a context where a substantial number of cuts were medicalized (estimated at 40% and above). This effect is significantly more pronounced in higher educated mothers. Our study thus shows that the medicalization of FGC can coincide with decreasing prevalence rates of FGC. Medicalization of FGC may take place in a context where an awareness of the health hazards related to FGC is more pronounced, thereby also discouraging the practice as a whole. In addition, the medicalization of FGC may make the practice more individualized and therefore reduce the incentives for FGC. • The FGC medicalization trend coincides with decreases in FGC prevalence in Egypt. • A sharp decline in FGC prevalence is established in the youngest age groups. • Increases in the medicalization of FGC reduce the risk of FGC even further. [ABSTRACT FROM AUTHOR]

Orthorexia nervosa was first proposed as a diagnosis in 1997, referring to a pathological obsession with healthy food. While not formally accepted by the medical establishment, since its inception, it drew the attention of news outlets around the world. This paper examines almost two decades of news coverage about orthorexia to understand how writers have made sense of the proposed diagnosis. Based on an inductive thematic analysis of 492 articles, I find news stories have overwhelmingly framed orthorexia as a medical problem but relied on narratives that mix moral and medical beliefs to explain what is problematic about it, depicting it as absurd, obnoxious, paradoxical, and dangerous. I also examine how shifting explanations of orthorexia's causes differentially allocate responsibility, presenting it as a matter of personal choice when associating it with diets, while presenting orthorexics as victims in technology-focused explanations. I compare orthorexia coverage with discourses about obesity and eating disorders to show how the label simultaneously draws from and contests preceding health discourse. While narratives about orthorexia demonstrate the pervasiveness of medicalization, I suggest they can also be read as a backlash against healthism, relying on metaphors of mental health, illness, and risk to speak to healthism in its own language. • News stories overwhelmingly framed orthorexia as a medical problem. • Primary narratives depicted orthorexia as absurd, obnoxious, paradoxical, and dangerous. • Shifting explanations of orthorexia's causes differentially allocated blame. • Narratives about orthorexia can be read as a backlash against healthism. [ABSTRACT FROM AUTHOR]

This paper explores the role of medicine in the regulation of legal gender recognition for trans and gender diverse people in France and Italy. I focus on the processes that led the two countries to establish for the first time a procedure for legal gender change in the 1980s/1990s. Despite the differences, both in France and in Italy medical knowledge and technologies were embedded in the procedures for legal gender change and health professionals took a role as gatekeepers to gender recognition. The medicalization of legal gender recognition, I argue, was part of the deploying of a bio-political apparatus that aimed at regulating and controlling "gender transitions" through regulation and normalization rather then through repression. • In France and Italy medicine was embedded in the regulation of legal gender recognition. • The medicalization of legal gender recognition was driven by different social actors. • The medicalization of legal gender recognition aimed at governing "gender transitions" through normalization. [ABSTRACT FROM AUTHOR]