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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]

Abstract: This paper explores the idea of the ‘fourth age’ as a form of social imaginary. During the latter half of the twentieth century and beyond, the cultural framing of old age and its modern institutionalisation within society began to lose some of its former chronological coherence. The ‘pre-modern’ distinction made between the status of ‘the elder’ and the state of ‘senility’ has re-emerged in the ‘late modern’ distinction between the ‘third’ and the ‘fourth’ age. The centuries-old distaste for and fear of old age as ‘senility’ has been compounded by the growing medicalization of later life, the emergence and expansion of competing narratives associated with the third age, and the progressive ‘densification’ of the disabilities within the older institutionalised population. The result can be seen as the emergence of a ‘late modern’ social imaginary deemed as the fourth age. This paper outlines the theoretical evolution of the concept of a social imaginary and demonstrates its relevance to aging studies and its applicability to the fourth age. [Copyright &y& Elsevier]

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 discusses the gendered nature of reproductive citizenship in contemporary Turkey through reading the abortion chronicles and exposes the utilization of women's bodies and subjection of women to demographic state policies. To this end, we focus on recent abortion debates originating from Prime Minister Erdoğan's statement on May 25, 2012 that suggested that "every abortion is a murder". Our paper is a qualitative analysis of the arguments of the members of the parliament following PM's statement on abortion. We documented and contextualized the recurrent themes; (1) abortion as a rhetorical tool, (2) trivialization of abortion, (3) medicalization of abortion, (4) abortion in the cases of rape, (5) abortion as an economic imperative. As a result, we unravel the gendered discursive limits of "pro-abortion" arguments in Turkey and reveal the frameworks within which the political debates are shaped when women's bodies, sexualities and reproductive capacities are at stake. [ABSTRACT FROM AUTHOR]

Abstract: The increased medicalization of different life stages, including menopause, is a subject studied mostly in the Western context. Examining medicalization in the non-Western world advances discussions of body, identity and health. In this paper, I analyze the discourses around postmenopausal osteoporosis in Turkey, focusing on the different constructions of risk in the medical and popular literature. The empirical basis of the paper draws on ethnographic research done in Istanbul, Turkey between June 2006 and March 2007. The research includes participant observation in gynecology clinics, interviews with clinicians and menopausal women and archival research on the representations of menopause in the Turkish media between 1999 and 2006. Referred to as kemik erimesi (melting of the bones) in colloquial Turkish, osteoporosis has been an essential component in the medicalization of menopause in Turkey. I argue that postmenopausal osteoporosis is defined as a combination of embodied risk, which is related to the definition of menopause as a risky period, and lifestyle risk, demonstrated in discussions around “traditional” vs. “modern” clothing and healthcare habits. The Turkish example emphasizes the importance of local conditions in defining medical risk and complicates the embodied vs. lifestyle risk categories. [Copyright &y& Elsevier]

Abstract: One way of reducing maternal mortality in developing countries is to ensure that women have a referral system at the local level that includes access to emergency obstetric care. Using a 13-month ethnographic study from 2003 to 2005 of women’s social positions and maternal health in a semi-urban community of Hindu-caste women in the Kathmandu Valley, this paper identifies impediments to receiving obstetric care in a context where the infrastructure and services are in place. As birth in Nepal predominantly takes place at home, this paper identifies the following areas for potential improvement in order to avoid the loss of women’s lives during childbirth: the frequency of giving birth unaided, minimal planning for birth or obstetric complications, and delayed responses at the household level to obstetric emergencies. Focusing particularly on the last item, this study concludes that women do not have the power to demand biomedical services or emergency care, and men still viewed birth as the domain of women and remained mostly uninvolved in the process. As the cultural construction of birth shifts from a “natural” phenomenon that did not require human regulation toward one that is located within the domain of biomedical expertise and control, local acceptance of a biomedical model does not necessarily lead to the utilization of services if neither women nor men are in a culturally-defined position to act. [Copyright &y& Elsevier]

Abstract: This paper revisits the concept of medicalisation and considers its value as a framework for understanding the ongoing development of new reproductive technologies, and their impact on women’s reproductive decision-making. This evaluation is drawn from a qualitative discourse analysis of the public debate about the first extended cycle oral contraception (ECOC) to suppress menstruation in the United States of America in 2003/2004, and subsequent interviews with women living in Australia who had already extended their cycles without it being medically approved for widespread practice. Firstly, the debates about menstrual suppression are couched within a discussion of the ongoing usefulness of medicalisation as an analytical tool. It is posited that medicalisation occurs in a particular social and cultural moment, and is a dynamic process where dominant social relations can be both reproduced and challenged. Secondly, qualitative interviews with women about practices of menstrual suppression are used to explore the productive nature of agency in this particular medicalisation contest. Specifically, the ways in which these women engage with the discourses of ‘risk’, ‘choice’ and ‘nature’, as canvassed by menstrual suppression advocates, reveal accommodation and modification as much as resistance and contradiction. This paper suggests that if the concept of medicalisation is to have ongoing traction as a frame of analysis, such a critique must incorporate a generative discussion of agency. [Copyright &y& Elsevier]

Some researchers in the field of ageing claim that significant extension of the human lifespan will be possible in the near future. While many of these researchers have assumed that the community will welcome this technology, there has been very little research on community attitudes to life extension. This paper presents the results of an in-depth qualitative study of community attitudes to life extension across age groups and religious boundaries. There were 57 individual interviews, and 8 focus groups (totalling 72 focus group participants) conducted with community members in Brisbane, Australia. Community attitudes to life extension were more varied and complex than have been assumed by some biogerontologists and bioethicists. While some participants would welcome the opportunity to extend their lives others would not even entertain the possibility. This paper details these differences of opinion and reveals contrasting positions that reflect individualism or social concern among community members. The findings also highlight the relationship between Christianity, in particular belief in an afterlife, and attitudes to life extension technology. Overall, the study raises questions about the relationship between interest in life extension, the medicalisation of ageing and the increasing acceptability of enhancement technologies that need to be addressed in more representative samples of the community. [Copyright &y& Elsevier]

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]

In debates over diagnoses of Attention Deficit/Hyperactivity Disorder (ADHD) and use of the drug Ritalin among the American school age population, discussion often centers around who is to blame for rising diagnoses and increasing use of Ritalin. Parents have come under particular scrutiny by critics who associate ADHD behaviors in children with poor parenting and view Ritalin as a “quick-fix” for socially situated problems. Biologically oriented researchers of ADHD, on the other hand have posited organically based dysfunction as the cause of ADHD behaviors. This paper explores the problem of blame in relation to ADHD diagnoses and Ritalin use from the perspective of mothers of boys with ADHD. Qualitative interviews with mothers suggest that medicalization of problematic behaviors in young boys includes an inherent narrative of blame transformation; this transformation can be expressed as a binarism: mother-blame–brain-blame. The first two sections of the paper document mothers’ experiences of blame for their sons’ symptomatic behaviors against the background of a cultural mothering ideology. The third section considers the promise of absolution from mother-blame inherent in the transformative binary structure. I argue that medicalization of boys’ problem behaviors supports and reconstitutes the potential for mother-blame and does little to pierce oppressive cultural mothering ideals. [Copyright &y& Elsevier]

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]

Abstract: This paper examines mindfulness as a popular and paradigmatic alternative healing practice within the context of contemporary medicalization trends. In recognition of the increasingly influential role popular media play in shaping ideas about illness and healing, what follows is a discursive analysis of bestselling mindfulness meditation self-help books and audio recordings by Jon Kabat-Zinn. The central and contradictory elements of this do-it-yourself healing practice as presented in these materials are best understood as aligned with medicalization trends for three principal reasons. First, mindfulness represents a significant expansion in the definition of disease beyond that advanced by mainstream medicine. Second, its etiological model intensifies the need for therapeutic surveillance and intervention. Third, by defining healing as a never-ending process, it permanently locates individuals within a disease–therapy cycle. In sum, the definition, cause, and treatment of disease as articulated by popular mindfulness resources expands the terrain of experiences and problems that are mediated by medical concepts. The case of mindfulness is a potent illustration of the changing character of medicalization itself. [Copyright &y& Elsevier]

This paper uses the domain of breastfeeding in the U.S. and the work of International Board Certified Lactation Consultants to refine the concept of medicalization-demedicalization. Given lactation consultants' origins and current role in maternity care, they provide a unique lens on these processes because they are positioned at the crossroads of medicalization and demedicalization. Using 150 h of ethnographic observation and 39 interviews conducted between 2008 and 2012, I identify aspects of medicalizationedemedicalization in the work of lactation consultants according to four dimensions: medical definition, medical control, pathology, and medical technology. Lactation consultants work to demedicalize breastfeeding by challenging the construction of breastfeeding pathology and limiting intervention. At the same time, they hold a position of medical control and medicalize breastfeeding by reinforcing a medical definition and using medical technology to treat breastfeeding problems. However, lactation consultants are not only working toward demedicalization and medicalization simultaneously, but are also medicalizing to demedicalize. Their position of medical control over breastfeeding provides them with a certain measure of authority that they can use in their efforts to depathologize breastfeeding and limit medical intervention. These findings build upon previous research that has identified cases of medicalization and demedicalization occurring simultaneously and draw attention to the need for an understanding of medicalizationedemedicalization as a continuous process. Furthermore, the concept of "medicalizing to demedicalize" provides a novel contribution to the literature. [ABSTRACT FROM AUTHOR]

Abstract: In this paper we seek to understand the influence of gender on the different approaches to managing poor sleep by older men and women through the conceptual framework of existing theoretical debates on medicalization, healthicization and ‘personalization’. In-depth interviews undertaken between January and July 2008 with 62 people aged 65–95 who were experiencing poor sleep, revealed that the majority of older men and women resisted the medicalization of poor sleep, as they perceived sleep problems in later life were an inevitable consequence of ageing. However, older men and women engaged differently with the healthicization of poor sleep, with women far more likely than men to explore a range of alternative sleep remedies, such as herbal supplements, and were also much more likely than men to engage in behavioural practices to promote good sleep, and to avoid practices which prevented sleep. Women situated ‘sleep’ alongside more abstract discussions of ‘diet’ and health behaviours and drew on the discourses of the media, friends, family and their own experiences to create ‘personalized’ strategies, drawn from a paradigm of healthicization. Men, however, solely relied on the ‘body’ to indicate when sleep was needed and gauged their sleep needs largely by how they felt, and were able to function the following day. [Copyright &y& Elsevier]

Abstract: Medicalization studies have changed dramatically in the past decade in part due to the increased attention to the role of pharmaceuticals and the pharmaceutical industry in modern life. This review paper explores the relationship between the concepts of medicalization and the newly developed terms of pharmaceuticalization and the pharmaceuticalization of public health. We show how and why modernist thinking limits the terms'' utility to explain a world in which both modern and postmodern objects and people interact with each other. We provide a framework for reconceptualizing and empirically studying these key processes of the 21st century. [Copyright &y& Elsevier]

Abstract: This paper builds on our prior work concerning the emergence of Alzheimer’s disease (AD) as a major social and health concern. Our study was conducted in two phases (1985–1987 and 2009–2011). We examined the historical evolution of the concept of AD and the emergence of the AD social movement in the U. S. Sources include interviews with movement leaders and scientists, historical documents of the Alzheimer’s Association, Congressional records, and published literature. We identified recurrent themes and salient issues motivating those in the movement, its barriers and facilitators, and the roles of government and NGOs in the creation of an organizational structure to maintain it. The characterization of AD as a leading cause of death among the elderly was crucial to sustaining the movement, but also operated as a “double edged sword”. By construing “senility” as a treatable, even curable biomedical entity, the movement substantively contributed to the notion of an impending “crisis” of the aging population to be avoided at all costs, compounding the effect of conservative federal policies that emphasized the treatment or cure of AD, and less so the long-term care service needs of sufferers and caregivers that had given rise to the movement. We also discuss how the continuing hegemony of the medical model establishes a race against the demographic clock, pitting advances in biomedical research against the needs of an aging population. We propose that alternative framings and sources of legitimization are critical to address the needs and preserve the humanity of people living with AD and their caregivers. [Copyright &y& Elsevier]

Abstract: Fibromyalgia syndrome is a debilitating pain disorder of unknown origins and a paradigmatic contested illness. As with other contested illnesses, the reality of fibromyalgia is disputed by many physicians. Thus, millions of individuals who are diagnosed with fibromyalgia must cope with chronic symptoms as well as medical and public skepticism. In this context, the U.S. Federal Drug Administration’s approval of Lyrica, the first prescription medication specifically for the management of fibromyalgia, is of considerable interest. In this paper I examine the cultural logic whereby the existence (and marketing) of an officially approved prescription medication for a condition lends support to the biomedical existence of the condition itself. I label this logic pharmaceutical determinism and argue that it represents an important new phase in the proliferation of contested illness diagnoses. Using the case of Lyrica, I describe the role that pharmaceutical companies and pharmaceuticals themselves play in promoting and legitimating contested diagnoses and validating those who are so diagnosed. Through a narrative analysis of the Lyrica direct-to-consumer advertising campaign and the responses of fibromyalgia sufferers to the introduction and marketing of Lyrica, I demonstrate the symbiotic relationship between the interests of the pharmaceutical industry, contested illness legitimization, and medicalization. I also provide a gender analysis of this relationship, foregrounding how contested illnesses continue to be shaped by their feminization in a cultural context that equates women with irrationality. Finally, I address the consequences and limitations of relying on the pharmaceutical industry for illness validation. [Copyright &y& Elsevier]

Abstract: This paper deals with the question of child abuse in xixth century, as it is practically and theoretically considered by forensic medicine and psychiatry. Two exemplary cases are first evoked, as related by par François Leuret (1836) and Adolphe Toulmouche (1838). Then is examined in details the founding text by Ambroise Tardieu (1860), devoted to child abuse and mistreatment. Is recalled the development of the abused child theme in the second half of xixth century, and the building of a child protection system, leading to the 1898 french law. It is shown how the anthropological psychiatric theories (Lombroso, Dupré) fail to explain the child abuse phenomenon. On the other hand, the works of Richard von Krafft-Ebing are fruitful, although they lead to sexualise the problem. Is briefly evoked the new configuration of the problem in xxth century, with “child abuse and neglect” (CAN). Is finally sketched an assessment of xixth century: success of practical forensic medicalization of child abuse, but failure on the side of psychiatric theories concerning the psychopathology of mistreaters. [Copyright &y& Elsevier]

Abstract: Classic studies of medicalisation point to the ‘rise of the experts’ as disempowering patients and refusing to acknowledge their expertise in their own lives. More recently, medicalisation scholarship has taken a different turn, arguing that patient choice is both a responsibility imposed on patients, and a driver of medicalisation. To what extent does autism, a childhood developmental disorder in which parents are invited to take a close role, instantiate these different manifestations of medicalisation? This paper reports on a qualitative study of parents’ experience of diagnosis and treatment, conducted in four states in Australia in 2008–2009. It draws on 49 interviews with parents of young children with autism, and with early intervention service providers and clinicians. Our study shows that the importance of choice in decisions around treatment cannot be subsumed under the single category of disenfranchisement or engagement. The diverse responses of parents to the diffuse, complex field of autism treatment illustrate an admixture of consumption, advocacy and education driving contemporary medicalisation. [Copyright &y& Elsevier]

Abstract: Since the 1970s, governments in many high-income countries have implemented a series of reforms in their health care systems to improve efficiency and effectiveness. Many of these reforms have been of a market-oriented character, involving the deregulation of key services, the creation of competitive markets, and the privatization of health and social care. Some scholars have argued that these “neoliberal” reforms have unseated the historical structural embeddedness of medicine, and in some cases even resulted in the proletarianisation of physicians. Other scholars have challenged this view, maintaining that medical hegemony continues to shape health care provision in most high-income countries. In this paper we examine how policy reforms may have altered medical dominance over maternity care in two comparatively similar countries – Canada and Australia. Our findings indicate that neoliberal reforms in these two countries have not substantially changed the historically hegemonic role medicine has played in maternity care provision. We discuss the implications of this outcome for the increased medicalisation of human reproduction. [Copyright &y& Elsevier]

Abstract: Medicalization is the process by which non-medical problems become defined and treated as medical problems, usually as illnesses or disorders. There has been growing concern with the possibility that medicalization is driving increased health care costs. In this paper we estimate the medical spending in the U.S. of identified medicalized conditions at approximately $77 billion in 2005, 3.9% of total domestic expenditures on health care. This estimate is based on the direct costs associated with twelve medicalized conditions. Although due to data limitations this estimate does not include all medicalized conditions, it can inform future debates about health care spending and medicalization. [Copyright &y& Elsevier]

Abstract: This paper explores the major factors underpinning the expansion in medicine use over recent decades, using England as an example. It begins by constructing a ‘progressive’ model of the expansion and considers its limitations; it then uses a framework of countervailing powers to examine the contribution of key actors in the field. It examines the commercial orientation of the pharmaceutical industry and the strategies companies deploy to generate demand for their products. It explores the part played by doctors as researchers and gatekeepers to medicines, considering how features of medical knowledge and practice contribute to, rather than curtail, the expansion. It considers the role of the public as consumers of medicines, and the role of governments and insurance companies in both facilitating and controlling medicine use. [Copyright &y& Elsevier]

Abstract: Premenstrual syndrome (PMS) and its derivative Premenstrual Dysphoric Disorder (PMDD) are controversial medical diagnoses. On one hand they are ubiquitous in English-language cultures; on the other they are for many emblematic of unnecessary medicalization of natural physiological processes. In this paper, we use data produced by IMS, a health care information and research firm, to analyze office-based medical practice related to PMS/PMDD in five countries. We come to several conclusions: 1. Relatively few doctors in any country diagnose women as suffering from PMS/PMDD, despite significant national variations in frequency of diagnosis; 2. Women diagnosed with this condition are usually prescribed a medication no matter what kind of specialist they see; and 3. In North America and the UK, practitioners generally follow USA practice guidelines which favour use of anti-depressive drugs like SSRIs but this is not the case in France and Germany which exhibit unique prescription patterns. In France hormonal treatment and analgesics dominate; in Germany the plant extract Vitex agnus-castus, considered an alternative therapy in much of the English-speaking world, is most common. We go on to discuss the relevance of these conclusions to discussions of variations in medical practices, to the existing PMS literature that claims high rates of prevalence for this condition, and to recent studies of “demedicalization” in certain domains. [Copyright &y& Elsevier]

This paper uses UK media coverage of the sleep drug modafinil to investigate the medicalisation of sleep at a conceptual level. Using metaphorical frame analysis we investigate the conceptual links created in media discourse between sleep and health, and the body and technology in the UK. Using this novel analytical tool we explore under what circumstances modafinil is constructed as a necessary medical treatment or a (il)legitimate performance enhancement and, how in this process, various images of the body are constructed. We found that media discourse on modafinil was structured through four types of sleep discourse: patient, sports, recreational, and occupational. Each discourse was built up around the specific deployment of three central metaphorical frames ‘war’, ‘commodity’ and ‘competition’ that acted to construct the biological body in a particular way. How the body was framed in each discourse impacted upon how modafinil use was portrayed in terms of therapy or enhancement and the level of engagement with a medical rhetoric. This had distinct normative implications strongly influencing the legitimacy afforded to modafinil use in each domain. We argue that medical authority acts to legitimise modafinil use for repair, restoration and relief of suffering, whilst being deployed to pass judgment on its use in bodies already perceived as functioning normally. This leads us to conclude that conceptually, the acceptability of ‘enhancement’ is strongly tied to context of use and intricately related to medical social control. [Copyright &y& Elsevier]

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]

Abstract: A number of studies have found an association between what people see, hear and read in the mass media and their corresponding actions and beliefs. This link has been demonstrated both at the micro and at the macro levels of analysis. However, when people are asked directly about the impact of mass media they tend to deny that they are personally affected. In fact, they tend to describe themselves as critical and skeptical media consumers. The purpose of this paper is to explore this contradiction through 12 in-depth focus group discussions undertaken in Ontario, Canada in 2004. Findings from the focus group interviews confirm earlier research in that people claimed that they were not susceptible to media influence. At the same time as they said that they took information from the mass media “with a grain of salt”, they articulated sophisticated and nuanced accounts of how and why they evaluated some information as good and some as bad. In general they evaluated media stories on the basis of the values of allopathic medicine and positivistic science. Moreover, in the context of the focus groups and their explicit comments on their skepticism, they discussed health information from the magazine articles that they were given to read (on either HIV/AIDS, Alzheimer''s disease, or a heart disease). Possible explanations for these paradoxical findings are discussed. [Copyright &y& Elsevier]

Medical approaches to sexual difficulties prioritise the physical aspects of sexuality over other aspects, locating ‘disorders’ primarily in the anatomy, chemistry or physiology of the body. In accordance with this perspective on sexual matters, physicians look to physical interventions (for example, hormones, drugs, and surgery) to treat any ‘abnormalities’. Following the discovery of popular—and profitable—sexuopharmaceuticals such as sildenafil citrate (Viagra™) for the treatment of erectile difficulties affecting men, the medical model has gained increasing influence in the domain of sexual health and well-being. However, while medical definitions of—and interventions related to—sexual difficulties are underpinned by an understanding of a ‘universal’ body (that is, an essential biological body that transcends culture and history), and by the categorisation of the normal and the pathological, the accounts of users of Viagra, and their sexual partners, do not necessarily support such understandings. In some cases, the experiences and perspectives of those affected by erectile difficulties directly challenge the reductionist model of sexuality and sexual experience espoused by medicine. In this paper, we report on a New Zealand study investigating the socio-cultural implications of Viagra, involving 33 men and 27 women discussing the impact of erectile difficulties and Viagra use within relationships. The diverse experiences of participants are discussed in relation to two key issues: the notion of ‘sexual dysfunction’ itself; and the idea of drugs such as Viagra acting as a ‘quick fix’ for sexual difficulties affecting men. We argue that the existence of a range of Viagra ‘stories’ disrupts a simplistic mechanistic portrayal of the male body, male sexuality and ‘erectile disorder’. [Copyright &y& Elsevier]

In the past several decades there has been an explosion in our understanding of genetics. The new genetics is an integral part of contemporary biomedicine and promises great advances in alleviating disease, prolonging human life and leading us unto the medicine of the future. The aim of this paper is to explore the ways in which people make sense of the uncertainties that are associated with the new genetics, which by definition involve family and kinship relations. We explore the degree to which medical genetics places the patient in a double bind between the qualitative certainty and quantitative uncertainty of genetic inheritance that reinforce notions both of fear, and control of a person''s future health. Second, we propose that the new genetics has medicalized family and kinship creating profound ethical and practical dilemmas for both the individual and for medicine as a whole. [Copyright &y& Elsevier]

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]

Abstract: Pulse wave velocity (PWV) is widely used for estimating the stiffness of an artery. PWV is an average measurement of artery stiffness between two measuring sites. From measured PWV, the diameter and thickness are needed to calculate the elastic modulus of the artery. In this paper a new method of using ring resonant mode for estimation of arterial elastic modulus is proposed. To generate the ring resonance, a localized radiation force of ultrasound is remotely and non-invasively applied at the artery. The vibration response of the artery is measured by optical techniques. Three ring resonant modes are identified for estimation of the elastic modulus. The viscoelasticity and the complex modulus of the artery can be obtained. Experiments were carried out on a porcine artery embedded in gelatin. The estimation only requires the diameter of the artery, but does not need the thickness of the artery which is difficult to measure with accuracy and precision. [Copyright &y& Elsevier]