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In the context of constraining services and support within public home care, this contribution analyses how older adults and home care workers experience and navigate administrative burdens. Relying on focus groups, interviews, and a survey conducted in the province of Québec (Canada), we demonstrate that older adults face an increasing number of administrative burdens designed to alter, delay, and restrict access to public services while homecare workers experience a loss of discretion in their practice due to the introduction of administrative requirements with dubious purposes. As such, administrative burdens play a vital role in the hidden politics of the welfare state and contribute to foster cynicism and a loss of faith in essential public services. [ABSTRACT FROM AUTHOR]

Medical sociologists have much to gain by bringing in global health. In this article, I make the case for expanding our field by furthering sociological perspectives on global health. I reflect on my career, the influence of scholar-activist mentors, and my contributions to the development of scholarship about medicalization, narrative, and global health in medical sociology. First, I focus on medicalization, its relationship to biomedicalization and pharmaceuticalization, and critiques of the medicalization of global health. Second, I analyze the narrative turn in studies of illness experiences and the inclusion of visual materials as an integral part of narrative studies of illness. Third, I explore global health and show examples of bodies of knowledge that medical sociologists are building. Although I present each as a distinct area, my discussion illustrates how the three areas are intertwined and how my contributions to each traverse and build connections among them. [ABSTRACT FROM AUTHOR]

A brief autoethnographic commentary that describes the harms of a pervasive emphasis on medications and medication adherence in the treatment of schizophrenia, including within "best practice" early psychosis programs. The narrative emphasizes the extent to which, in spite of endless rhetoric of person-centered, recovery-oriented care, the reality remains that medication-centric treatment tends to dominate clinical services and programs, fueling the objectification and alienation of service users, and ultimately, in all too many cases, disengagement. The author's personal experiences are provided as an illustration of the potentially devastating impacts that a narrow and rigid focus on medications (and medicalized clinical relationships) can have. Impact and Implications: Direct personal accounts of the symbolic and structural harms of medication-centered psychosis treatment are largely absent from the academic literature. This autoethnographic commentary illustrates concrete and specific ways in which medication-centrism can damage the agency autonomy and selfhood of service users, and harm the vital process of integrating experiences of psychosis with valued social identities and roles. [ABSTRACT FROM AUTHOR]

Various trends have driven the digital transformation of health: Developments in digital technologies, pressures for cause reduction in healthcare and increasing demand and expenditures from aging populations. In parallel, Turkey is actively engaged in a great transformative journey with its Health Transformation Program (HTP) since 2003, embracing the age of digitalization in healthcare. This study explores the interplay among historical discourse, political influences, technological advancements which shaped the centralization of Turkey's health system. Specifically, it delves into how Turkey's healthcare system has undergone centralization under the aegis of digital transformation. Amidst this transition, a compelling question arises: How has the positive perception of digital health innovations by both the public and authoritative health institutions converged with the challenges posed by low health and digital literacy levels? This article uses the concept of biomedicalization to encompass the multisited and multidirectional health transformation processes in Turkey. By cultivating a technology-friendly environment, the nation is nurturing (bio)digital citizens through the process of biomedicalization. Drawing on a historical narrative of Turkey's digital health transformation, the article posits that the phenomenon of biomedicalization in the country, molded by intricate multidimensional factors at both micro and macro levels, compels policymakers, privacy advocates, and lawmakers to devise effective and sustainable regulations concerning data utilization, protection, and privacy. By investigating these dynamics, the research provides insights into how a country like Turkey navigates the multifaceted aspects of digital health implementation, shedding light on the potential strategies and mechanisms that enable the successful adoption of digital technologies in healthcare despite existing limitations. This contribution to the broader discourse on digital transformation enriches our understanding of the intricacies involved in leveraging technology to enhance healthcare systems, especially in contexts where there are literacy levels might pose

Recent scientific and policy initiatives frame clinical settings as sites for intervening upon inequality. Electronic health records and data analytic technologies offer opportunity to record standard data on education, employment, social support, and race-ethnicity, and numerous audiences expect biomedicine to redress social determinants based on newly available data. However, little is known on how health practitioners and institutional actors view data standardization in relation to inequity. This article examines a public safety-net health system's expansion of race, ethnicity, and language data collection, drawing on 10 months of ethnographic fieldwork and 32 qualitative interviews with providers, clinic staff, data scientists, and administrators. Findings suggest that electronic data capture institutes a decontextualized racialization within biomedicine as health practitioners and data workers rely on biological, cultural, and social justifications for collecting racial data. This demonstrates a critical paradox of stratified biomedicalization: The same data-centered interventions expected to redress injustice may ultimately reinscribe it. [ABSTRACT FROM AUTHOR]

This study explores how Swedish women narrate experiences of hormonal contraceptives through utilizing the frameworks of biomedicalization and reproductive justice, adding a social justice perspective previously lacking. Ten in-depth interviews were conducted with women who had experience of using hormonal contraception. Political narrative analysis illuminated how these women moved narratively both chronologically, from the teenage years to adulthood, and through social positioning, in their contraceptive stories. Two different, often conflicting, discourses of hormonal contraceptives emerged, which the women constantly negotiated. These can be described as (1) a biomedical interpretative prerogative, promoting hormonal methods as an easy fit for everyone, and negating the diverse lived experiences of women, and (2) a simplified critical media and online discourse, painting hormonal methods as an enemy to female health. From a reproductive justice standpoint, these stories illuminate that age is a relevant intersectional location, and even privileged women in a country known for its 'gender equality agenda' can experience subtle yet very real, reproductive coercion, when agency becomes constrained to choosing hormonal contraceptives within a dominant biomedical script. Even though critique of the mechanistic prescription of hormonal contraception is rather ubiquitous, the opposition in these narratives does not take the form of rejection of biomedical knowledge, rather the biomedical paradigm is internalized and incorporated into the embodied knowledge. This study shows that upstream factors such as gendered social injustices, reproductive norms, and a biomedical expansion are intricately interwoven with embodied experience of hormonal contraceptive use. It is important to acknowledge that distinct lived experiences of mood or personality change in women using hormonal contraceptives are contextual and dependent on intersectional location. I propose no simple panacea, but when a state-sanctioned biomedical prerogative puts all emphasis on individual reproductive planning behaviour, it obscures structural inequalities and narrows imaginable life trajectories. [ABSTRACT FROM AUTHOR]

The article discusses the interface between gender, social classes, and (bio)technologies to improve body aesthetics. Dialoguing with gender studies, it investigates how these (bio)technologies act in the production of contemporary bodies and femininities in different social groups based on ethnographic research performed in circuits where these interventions occur. We analyze the uses, meanings, and moralities attributed to them, showing how they fabricate conventions simultaneously aesthetic, moral, and bodily of femininity in a process also traversed by distinctions and class belonging. [ABSTRACT FROM AUTHOR]

Various trends have driven the digital transformation of health: Developments in digital technologies, pressures for cause reduction in healthcare and increasing demand and expenditures from aging populations. In parallel, Turkey is actively engaged in a great transformative journey with its Health Transformation Program (HTP) since 2003, embracing the age of digitalization in healthcare. This study explores the interplay among historical discourse, political influences, technological advancements which shaped the centralization of Turkey's health system. Specifically, it delves into how Turkey's healthcare system has undergone centralization under the aegis of digital transformation. Amidst this transition, a compelling question arises: How has the positive perception of digital health innovations by both the public and authoritative health institutions converged with the challenges posed by low health and digital literacy levels? This article uses the concept of biomedicalization to encompass the multisited and multidirectional health transformation processes in Turkey. By cultivating a technology-friendly environment, the nation is nurturing (bio)digital citizens through the process of biomedicalization. Drawing on a historical narrative of Turkey's digital health transformation, the article posits that the phenomenon of biomedicalization in the country, molded by intricate multidimensional factors at both micro and macro levels, compels policymakers, privacy advocates, and lawmakers to devise effective and sustainable regulations concerning data utilization, protection, and privacy. By investigating these dynamics, the research provides insights into how a country like Turkey navigates the multifaceted aspects of digital health implementation, shedding light on the potential strategies and mechanisms that enable the successful adoption of digital technologies in healthcare despite existing limitations. This contribution to the broader discourse on digital transformation enriches our understanding of the intricacies involved in leveraging technology to enhance healthcare systems, especially in contexts where there are literacy levels might pose. [ABSTRACT FROM AUTHOR]

Global HIV/AIDS responses have been increasingly biomedically dominated over the past years. In line with this shifting paradigm, China has prioritized mass HIV testing as a practical approach to controlling its HIV/AIDS epidemics among at-risk populations, especially gay men and other men who have sex with men (MSM). This study analyzed why China's mass HIV testing mainly targeted gay men by understanding the perspectives of public health professionals, community-based organization (CBO) workers, and gay men. In addition, this study revealed the tensions and unintended consequences of HIV/AIDS prevention and the representation of gay men in China. The study involved fieldwork conducted in a major city in Eastern China from 2015 to 2019. Semi-structured interviews were held with participants from the three abovementioned groups (N = 25). The study identified four processes concerning why gay men are mainly targeted for HIV testing. Some public health professionals believe that being a gay man is equivalent to having HIV/AIDS risks. In addition, this study particularly noted tensions between public health professionals and gay men, including gay men-identified CBO workers, over whether mass HIV testing should target gay men or anyone who engaged in sexual risk behaviors. This study argued that a particular focus on gay men due to pursuing biomedical advances in HIV/AIDS prevention seems to have unintendedly stereotyped gay men based on the presumptions that they are at risk of developing HIV/AIDS. In addition, this study corresponded to the broader social scientific discussion concerning whether HIV/AIDS intervention should target specific sexual risk practices or sexual identity/population. [ABSTRACT FROM AUTHOR]

This article uses ethnography and coproduced ethnography to investigate mental health labels amongst university students in the UK. We find that although labels can still be a source of stigma, they are also both necessary and useful. Students use labels as 'campus technologies' to achieve various ends. This includes interaction with academics and administrators, but labels can do more than make student distress bureaucratically legible. Mental health labels extend across the whole student social world, as a pliable means of negotiating social interaction, as a tool of self-discovery, and through the 'soft-boy' online archetype, they can be a means of promoting sexual capital and of finessing romantic encounters. Labels emerge as flexible, fluid and contextual. We thus follow Eli Clare in attending to the varying degrees of sincerity, authenticity and pragmatism in dealing with labels. Our findings give pause to two sets of enquiry that are sometimes seen as opposed. Quantitative mental health research relies on what appear to be questionable assumptions about labels embedded in questionnaires. But concerns about the dialogical power of labels to medicalise students also appears undermined. [ABSTRACT FROM AUTHOR]

In this introduction to the thematic issue Critical Psychedelic Studies we argue that many and diverse critical analyses of psychedelic cultures and practices are needed to counter the current hype around the biomedicalization of psychedelic substances. The social sciences and humanities offer insights and methods to resist appropriation and to establish community based ethical practices. The assembled articles and book reviews indicate an urgency and vitality of research aimed at growing psychedelic cultures outside the medico-pharmaceutical complex, offering inter- and transdisciplinary perspectives. Critical psychedelic studies challenge hegemonial or colonizing knowledge practices in historical and contemporary psychedelic discourse. Bringing together insights from the different original contributions we reflect on power relations in the psychedelic revival. In this article we argue against field definitions and in favour of diverse and agile formations of consciousness and praxis. We provide critical ideas for deconstructing both the patriarchal colonial legacies and the contemporary power dynamics focussed on wealth creation that characterize today's psychedelic revival. [ABSTRACT FROM AUTHOR]

In this study I explore discourses of contraception and reproduction, which are drawn upon and reproduced in Swedish official online sources on contraceptive advice, through the theoretical frameworks of biomedicalization and reproductive justice. The analysis yielded three interwoven themes: 1) women in need of contraceptives have to balance discourses of exogenous hormones as both an "unnatural" threat to their bodies and as desirable, effective regulators of the same "naturally unruly" body; 2) in search of a "perfect contraceptive fit", it is the woman who needs to accommodate to available methods, rather than the other way around; 3) women are made discursively invisible, while simultaneously being constructed as individually responsible for reproduction. Underpinning all these themes is the discourse of rational, responsible choices, of exerting agency by choosing the right contraceptive. In the era of biomedicalization, finding a "contraceptive fit" becomes a moral and gendered health practice demanding thorough self-surveillance. The rational woman, exercising control over her reproduction and body, by planning her pregnancy with safe contraceptives, emerges as the only possible position. Recognizing that women's and fertile person's reproductive choices are made amid a societal context, with differing personal resources and experiences, would bring us even closer to reproductive justice. [ABSTRACT FROM AUTHOR]

Background: This research was conducted in response to concerns reported by social work practitioners to a Canadian College of Social Work which indicated that their practice was constrained by ideological and system limitations in publicly funded mental health and addiction systems. Method: The dislocation theory of addiction which posits globalization and neoliberalism is linked to addiction rates worldwide, serves as an analytical frame to examine findings from fifty interviews, three focus groups and an online survey with one hundred and fifteen respondents. Results: Themes specific to social work practice in addiction services referred to neoliberalism, stigma, biomedicalization, trauma and addiction, elimination of women services, shrinking services and privatization. Conclusion: Social workers expressed a dissonance between their training rooted in relational approaches and biopsychosocial models of practice and system expectations. Our findings indicate concern about the erosion of core social work values within addiction services, the reduction of state funded programming and need for further research. [ABSTRACT FROM AUTHOR]

Expanding the concept of “precision” or “personalized” medicine, personalized health and precision public health designate the use of various kinds of data—genomic, other omics, clinical, or those produced by individuals themselves through self-tracking—to optimize health interventions benefiting the whole population. This paper draws on an ethnography of the implementation of a population-based environmental health cohort to shed light on the reconfigurations brought about by the “personalization” of public health in Switzerland. Combining human biomonitoring and molecular epidemiology, this cohort aims to advance the science of the exposome, a notion referring to the totality of exposures to which individuals are subjected over their lifecourse. Addressing the tension between holism and reductionism, this paper points to the important gap between the promissory horizon of the exposome and the realities of practices. Situations of reductionism are defined as moments of friction and negotiation between different rationales and values, exposing what makes the science of the exposome, including its material, economic, institutional, and methodological constraints, as well as its imaginaries and values. Rather than opposing holism and reductionism, I emphasize that they constitute two sides of the same coin, as they both pragmatically enable action and produce situated versions of the social. This empirical case shows how reductionism operates at the chemical, biological, and populational levels to produce public health scientific and social values. It thus contributes to contextualizing the pragmatic and strategic choices made by scientists, as well as the values they favor, in a research environment marked by the predominance of biomedicine over public health. It shows how the reductionism of the “social environment” was made for a better social integration of the cohort into the Swiss political and scientific landscape of public health. Bringing together actors involved in public health and questions of environmental exposures, this cohort can be interpreted as a biomedicalization of public health research, as well as an attempt to socialize it through the broad category of the exposome.

Medical and pharmaceutical uses of animal life have gone through vast changes in the past centuries. Although the commodification of animals and animal parts is by no means an invention of modernity, its procedures and practices have evolved in multiple ways across time. Most notably, the exploitation of non-human animal life has been increasingly segmented, industrialized, and globalized. The collateral expansion of scientific and market institutions has led to specific modes of rationalization of animal breeding, culture, and trade for pharmaceutical purposes. However, this rationalization process has never been immune to its own matter—and the materiality of non-human commodification processes irrigates seemingly ordered and layered practices. Based upon a study on the international trade of donkey hide, this paper offers a characterization of the current pharmaceutical uses of animal life through a series of epistemic and environmental tensions expressing frictions between the market's absorptive logic and non-human modes of existence. We describe this set of tensions as 'feral pharmaceuticalization' and contend that they offer new perspectives on the analysis of the contemporary pharmaceuticalization process. In addition, such tensions showcase the importance of investigating the expansion of technological markets not only as simultaneous knowledge and milieux (or bodies) making, or as simple science and market hegemonic processes, but also as the construction of new stages of conflict. [ABSTRACT FROM AUTHOR]

Copyright of Salud Uninorte is the property of Fundacion Universidad del Norte and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The United States is experiencing a demographic transition toward older motherhood. Biomedicine classifies pregnancies among all women of advanced maternal age (AMA) as high-risk; paradoxically, women having first births at AMA are typically economically and racially privileged, which can reduce the risk of risks. This article examines the implications of the biomedicalization of AMA for first-time mothers, age 35 and older, using qualitative interviews. We find participants had substantial cultural health capital, which informed their critiques of AMA and the medical model of birth. When they found themselves subjected to biomedical protocols and concerned about reproductive risk as their pregnancies progressed, their subsequent biomedical subjectification compelled most to accept biomedical interventions. Consequently, some participants had traumatic birth experiences. Our findings illustrate that while first-time mothers of AMA anticipated that they would have more control over the birth process because of their advantages, ultimately, most did not. [ABSTRACT FROM AUTHOR]

Abstract Background Sweden has provided around 300 youth clinics (YCs) to address the health needs of young people since the 1970s. During the last few years, and as part of an effort to strengthen mental healthcare for young people, YCs’ role in the provision of mental healthcare has been widely debated. With such debates as background, the aim of this study is to analyse Swedish YCs’ responses to the mental (ill) healthcare needs of young people, from the perspective of national level stakeholders. Methods We used thematic analysis of interviews with eight national level stakeholders in the field of youth mental health in Sweden. Building upon the concept of biomedicalization we examined the discourses on mental (ill) health, healthcare and youth that such responses reproduce. Results YCs engage in the three simultaneous, but at times contradictory, responses of protecting, managing and bending boundaries. Remaining true to their mission as a health-promotion service compels them to protect their boundaries and limit the type of mental health issues they address. However, the perceived malfunctioning of specialized services has led them to bend these boundaries to allow in more young people with severe mental health problems. Caught between protecting and bending boundaries, the response of managing boundaries to decide who should be allowed in and who should be sent elsewhere has emerged as a middle-way response. However, it is not free from conflicts. Conclusion Building upon the concept of biomedicalization, this study poses two questions. The first relates to whether it is possible to support young people and their health without reinforcing discourses that represent young people as collectively at risk, and if so how this can be done. The second relates to the provision of mental healthcare for young people, and the need to identify conditions for integrating diagnosis and treatment within YCs, without hindering their holistic and youth-centred approach.

The article has analyzed the meanings of the use of PrEP among gay man, trans women, and travestis in Rio de Janeiro, based on research on the biomedicalization of the response to AIDS. The analysis and interpretation of the field diary entries and interviews allowed us to describe how the use of this HIV prevention technology occurs simultaneously with other biomedical resources, aesthetics, dietary interventions, and physical exercises. We argue that such self-care is shaped according to the expectations of gender and class and the health ideals of their users. The results of the study allow us to discuss the boundaries between health, lifestyle, and enhancement. It is concluded that PrEP seems to produce a singularization in the forms of self-production, via biomedical and aesthetic-cosmetic enhancement, in a synergistic encounter between different technologies; perceived both in the routine use of the drug and in the management of its effects. For most of the people interviewed, PrEP is coupled with a previous self-care, which indicates the social location of its users in terms of class and gender and the reflexive way from which they describe their health and themselves. [ABSTRACT FROM AUTHOR]

Copyright of Er(r)go: Teoria, Literatura, Kultura is the property of Wydawnictwo Uniwersytetu Slaskiego and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract After decades of criminalization, psychedelic substances such as psilocybin and LSD are experiencing their comeback in science and Western culture more broadly. While psychedelic plants and fungi have a long history of use in Indigenous cultures, the Western prohibitionist reality instantiated around 1970 has stigmatized psychedelics as medically useless and a threat to society. Yet studies are increasingly demonstrating their potential to treat widespread mental health conditions such as PTSD, depression, or anxiety in combination with psychotherapy. Most of this research is currently taking place in the US, where additionally decriminalization and legalization efforts and religious exemptions have paved the way to make psychedelics legally accessible. Based on 3 years of ethnographic research in the US (both in-person and virtual), this article explores contemporary US-American socio-psychedelic imaginaries, i.e., collective visions articulated and enacted to reintegrate psychedelics legally and responsibly into society. Four socio-psychedelic imaginaries are identified, described, and interpreted: the biomedicalization imaginary, decriminalization imaginary, legalization imaginary, and sacramental imaginary. These imaginaries diverge and converge around several politics: politics of access, politics of responsibility, politics of naming, politics of assimilation and social change, and politics of epistemic credibility. Contemporary socio-psychedelic imaginaries are co-evolving, mutually shaping, and amplifying each other. Together they function as societal corrective to the politically motivated prohibition of psychedelics. Although enacted by humans, the radical imagination expressed in socio-psychedelic imaginaries has its roots in human-psychedelics entanglements.

In 2012, the World Health Organization guidelines for HIV prevention recommended the decriminalisation of sex work as their number one good practice. Although human rights language played a key role in the international scientific and activist endorsement of the WHO policies, since then there have been few initiatives in terms of advancing the kinds of structural and political changes endorsed. In this Commentary, we reflect on sex work's place in the broader field of the biomedicalization of responses to HIV. The analysis is based on literature reviews and our research trajectories, including preliminary results from a qualitative study on the implementation of PrEP in Rio de Janeiro, Brazil. We argue that sex workers occupy an ambiguous and less visible role in current AIDS policies, and that such policies are increasingly characterised by their prioritisation of biomedical approaches over structural factors. These shifts should be understood as part of a broader, global hegemony of clinical responses to HIV prevention and the continuation of a neoliberal discourse around human rights, without adequate investment in the material conditions necessary to guarantee these rights. [ABSTRACT FROM AUTHOR]

While the French protectorate tried unsuccessfully to medicalize childbirth in Cambodia through the creation of midwifery schools, the opening of maternity wards and financial incentives, global health policies strongly relayed in the early 2000s led to an extremely rapid biomedicalization of childbirth in Cambodia, causing an unprecedented medical and social disruption in the country. Based on a doctoral research conducted between 2013 and 2016 and mobilizing a mixed methodology (qualitative and quantitative), the article shows that today, the use of biotechnology is massive in the capital Phnom Penh. The practice of episiotomy is systematic, the use of perineorraphy (aimed at tightening women’s vagina) is frequent, and caesarean section rates are increasing rapidly, responding to a socially constructed demand. If this biomedicalization of childbirth has undeniably contributed to the recent and spectacular decrease in the maternal mortality rate in Cambodia, it also contributes to the shaping of women’s bodies and to the construction of a female body that meets social and conjugal norms.

There is growing emphasis for primary care clinicians to initiate and engage in end-of-life (EOL) conversations with medically frail older adults. However, EOL conversations happen most often when death is imminent or are avoided altogether. The objective of this study was to understand the socio-political forces shaping EOL conversations between clinicians, medically frail older adults and/or their care partners within an urban primary care setting, a Family Health Team in Ontario, Canada. We conducted an eight-month critical ethnography in 2019 involving observations and interviews of clinicians, patients, and care partners (n ​= ​35). Analyzing this data for discourses and power-knowledge systems we found that two discourses, frailty and more life shape EOL conversations in this setting. More life discourse disrupts EOL conversations by making it more difficult to talk about decline and dying as well as personal goals. Biomedicine and clinical practice guidelines comprised the two major power-knowledge systems that increase the influence of more life in this setting as well as the norm of seeking longevity. Improving EOL conversations is complex and requires addressing the power-knowledge systems that perpetuate more life as well as a discursive shift towards prioritizing relationships and people's life worlds. Primary care as a specialty can critically reflect on the ways it is entrenched in a culture of care that valorizes more life and (re)create clinical practice guidelines and evaluations to align with person-centredness more meaningfully. Future research should involve patients, care-partners, and interprofessional clinicians to co-create approaches to care that can better accommodate frailty talk.

Background: Sweden has provided around 300 youth clinics (YCs) to address the health needs of young people since the 1970s. During the last few years, and as part of an effort to strengthen mental healthcare for young people, YCs' role in the provision of mental healthcare has been widely debated. With such debates as background, the aim of this study is to analyse Swedish YCs' responses to the mental (ill) healthcare needs of young people, from the perspective of national level stakeholders.Methods: We used thematic analysis of interviews with eight national level stakeholders in the field of youth mental health in Sweden. Building upon the concept of biomedicalization we examined the discourses on mental (ill) health, healthcare and youth that such responses reproduce.Results: YCs engage in the three simultaneous, but at times contradictory, responses of protecting, managing and bending boundaries. Remaining true to their mission as a health-promotion service compels them to protect their boundaries and limit the type of mental health issues they address. However, the perceived malfunctioning of specialized services has led them to bend these boundaries to allow in more young people with severe mental health problems. Caught between protecting and bending boundaries, the response of managing boundaries to decide who should be allowed in and who should be sent elsewhere has emerged as a middle-way response. However, it is not free from conflicts.Conclusion: Building upon the concept of biomedicalization, this study poses two questions. The first relates to whether it is possible to support young people and their health without reinforcing discourses that represent young people as collectively at risk, and if so how this can be done. The second relates to the provision of mental healthcare for young people, and the need to identify conditions for integrating diagnosis and treatment within YCs, without hindering their holistic and youth-centred approach. [ABSTRACT FROM AUTHOR]

Since the emergence of in-vitro fertilization (IVF), a specific set of technologies has been developed to address the problem of the ‘biological clock’. The medical extension of fertility time is accompanied by promissory narratives to help women synchronize conflicting biological and social temporalities. This possibility also has a transgressive potential by blurring one of the biological landmarks – the menopause – by which reproductive lives are organized and governed. These new ways of managing, measuring and controlling reproductive time have renewed debates on the age limits of motherhood and the moral legitimacy of medical intervention into age-related fertility decline. Building on Amir’s feminist concept of biotemporality, this paper questions what happens when the ontological foundations of age-limited motherhood are disrupted by technologies which allow fertility to be extended. It discusses the reconfigurations of the ontological boundaries of the facts of life in the light of literature on reproductive technologies and temporality. Through the Swiss experience, the paper shows how medical experts are drawn into negotiating the ontological boundaries of age-limited motherhood along the binaries of the normal/pathological and the biological/social. Questioning the purpose of medical interventions in what are seen as facts of life, they produce different configurations of moral reasoning where what is natural undergoes shifts which both reinforce the normative order and subvert it. [ABSTRACT FROM AUTHOR]

After decades of criminalization, psychedelic substances such as psilocybin and LSD are experiencing their comeback in science and Western culture more broadly. While psychedelic plants and fungi have a long history of use in Indigenous cultures, the Western prohibitionist reality instantiated around 1970 has stigmatized psychedelics as medically useless and a threat to society. Yet studies are increasingly demonstrating their potential to treat widespread mental health conditions such as PTSD, depression, or anxiety in combination with psychotherapy. Most of this research is currently taking place in the US, where additionally decriminalization and legalization efforts and religious exemptions have paved the way to make psychedelics legally accessible. Based on 3 years of ethnographic research in the US (both in-person and virtual), this article explores contemporary US-American socio-psychedelic imaginaries, i.e., collective visions articulated and enacted to reintegrate psychedelics legally and responsibly into society. Four socio-psychedelic imaginaries are identified, described, and interpreted: the biomedicalization imaginary, decriminalization imaginary, legalization imaginary, and sacramental imaginary. These imaginaries diverge and converge around several politics: politics of access, politics of responsibility, politics of naming, politics of assimilation and social change, and politics of epistemic credibility. Contemporary socio-psychedelic imaginaries are co-evolving, mutually shaping, and amplifying each other. Together they function as societal corrective to the politically motivated prohibition of psychedelics. Although enacted by humans, the radical imagination expressed in socio-psychedelic imaginaries has its roots in human-psychedelics entanglements. [ABSTRACT FROM AUTHOR]

This article examines human papillomavirus (HPV) self‐sampling as an approach to cervical cancer prevention and the ways self‐sampling kits are promoted directly to consumers in the United States. Public health, biomedicine and health tech have increasingly imagined self‐sampling, which allows individuals to collect their own vaginal specimen, mail to a laboratory for testing and receive delivered results, as a component of cervical cancer prevention and sexual health promotion. This article examines the scientific and biomedical claims used to configure the problem in need of this solution and the ways persons, publics and markets are established. We analyse scientific literature, interviews with clinicians and other key actors, and websites of directly to consumers (DTC) companies. HPV self‐sampling is constructed as both a solution to inequities and gaps in cervical cancer screening and a solution to the wants and needs of those already engaged in self‐projects of body monitoring and risk reduction. These multidirectional biomedical tendencies also reveal how sexuality and sexual health and cervical cancer prevention and sexual health promotion are entangled objects. While we do not want to undermine the potential of HPV self‐sampling, we encourage a focus on equity and care and not commodified markets that reinforce notions of 'good' patients monitoring their health. [ABSTRACT FROM AUTHOR]

This article examines how cryopreserved ovarian tissue is potentiated as a menopausal prevention and/or treatment cure. Based on a multi-sited ethnographic study, the article empirically foregrounds scientific accounts and interviews with Danish female cancer patients who had ovarian tissue preserved. Using situational analysis as a methodological approach along with analytical perspectives on potentiality, we identify three framings revealing how cryotechnology intervenes with women’s reproductive aging: Cryopreservation as a risk management technology, as an optimizing technology, and as a synchronization technology. The article shows how the ability to cryopreserve ovarian tissue in order to reverse menopause draws upon an understanding of menopause as not only controllable but of cryopreservation as a resource-wise technology that manages women’s aging bodies. Suggesting “cryomedicalization” as a term, the article highlights how cryopreserved ovarian tissue (re)constitutes normative temporalities, produces new understandings of cryo-restoration and raises questions related to the cryopolitics of women’s aging.

Abstract Background This study examined physicians’ perspectives on sexuality in later life. Methods In-depth interviews were conducted among 38 physicians with various specialties and they were asked to discuss sexuality in later life within the medical context. Results Perceptions on older adult’s sexuality emerged from the interviews were organized into three themes: What, why and how. What, referred to physician’s definition to what role sexuality plays in later life and what is considered sex. Why, referred to the reasons why physicians assumed older adults experience sexual difficulties, and how these assumptions effect the diagnostic process. How, referred to how sexual difficulties were treated by physicians. Physicians employed a bio-medical approach when treating older, as compared to young adults with sexual dysfunction. Conclusions The findings highlight a potential for differential treatment of older adults, based on age, rather than on other objective reasons.

The discourse of Undetectability, referring to the effect of HIV viral suppression on forward sexual transmission, is at the heart of the current paradigm of Treatment-as-Prevention and is invested with hopes of eliminating stigma. But ethnographic examination of the way HIV-positive gay and bisexual men in four major Indian cities experience Undetectability reveals a more complicated picture. Rather than resolve the problem of HIV stigma, Undetectability enables new ways of managing it, including ethical non-disclosure in the face of social danger. This reveals three paradoxes inherent in the universalism of Treatment-as-Prevention and its reliance on biomedical solutions. [ABSTRACT FROM AUTHOR]

Copyright of Nomadas (01217550) is the property of Universidad Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Croatian Journal of Ethnology & Folklore Research / Narodna Umjetnost is the property of Institute of Ethnology & Folklore Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In the past decade, social scientists and bioethicists have produced a significant body of work tracking the technical, legal, ethical, and sociocultural development and implications of human egg freezing. What began as a treatment to "preserve" the fertility of cancer patients has transformed into a technology enabling delayed childbearing. We provide an overview of four research areas that have received the most attention in the sociological and anthropological literature of egg freezing: medicalization, gender, temporality and risk, and markets. What emerges from much of the research is the sense that egg freezing has become entangled with cultural imperatives to take future‐oriented responsibility for one's own health, financial, social, and reproductive needs through self‐management, risk reduction, calculation, and optimization. Throughout, we consider the implications of this novel reproductive technology within national and transnational "reproflows" that stratify reproduction along raced and classed lines. [ABSTRACT FROM AUTHOR]

Menstrual tracking and fertility apps have gained popularity in recent years, often sold as tools for self-empowerment through self-knowledge. While critics tend to focus on the gendered design of these apps, this article examines the self-tracking and analytic features of the popular apps, Flo and Clue, to argue that menstrual tracking and fertility apps reinforce discourses of menstrual concealment and bodily alienation. Beginning with an analysis of the daily log interface, the author situates the humorous icons in discourses of menstrual jokes and euphemisms to show how these apps participate in the suppression of menstruation. The author then turns to the analytics features to demonstrate how these apps encourage users to understand their lives through their menstrual cycle. The article ends with a call for collaborations between humanists, scientists, and designers to revise and mobilize these apps to explore under-explored issues of sexual and reproductive health. [ABSTRACT FROM AUTHOR]

Background: Women's empowerment, and maternal and neonatal health are important targets of the Sustainable Development Goals. Our objective is to examine the relationship between women's empowerment and elective cesarean section (ECS), focusing on Vietnam, a country where the use of CS has increased rapidly in recent decades, which raises public health concerns.Methods: We hypothesized that in the context of the developing biomedicalization of childbirth, women's empowerment increases the use of ECS due to a woman's enhanced ability to decide her mode of delivery. By using microdata from the 2013-2014 Multiple Indicator Clusters Survey, we conducted a multivariate analysis of the correlates of ECS. We studied a representative sample of 1343 institutional single birth deliveries. Due to higher ECS rates among multiparous (18.4%) than primiparous women (10.1%) and the potential interaction between parity and other correlates, we used separate models for primiparous and multiparous women.Results: Among the indicators of women's external resources, which include a higher level of education, having worked during the previous 12 months, and having one's own mobile phone, only education differed between primiparous and multiparous women, with a higher level among primiparous women. Among primiparous women, no resource indicator was significantly linked to ECS. However, considering women's empowerment facilitated the identification of the negative impact of having had fewer than 3 antenatal care visits on the use of ECS. Among multiparous women, disapproval of intimate partner violence (IPV) was associated with a doubled likelihood of undergoing ECS (odds ratio = 2.415), and living in an urban area also doubled the likelihood of ECS. The positive association with living in the richest household quintile was no longer significant when attitude towards IPV was included in the model. In both groups, being aged 35 or older increased the likelihood of undergoing ECS, and this impact was stronger in primiparous women.Conclusions: These results underline the multidimensionality of empowerment, its links to other correlates and its contribution to clarifying the influence of these correlates, particularly for distinguishing between medical and sociocultural determinants. The results advocate for the integration of women's empowerment into policies aimed at reducing ECS rates. [ABSTRACT FROM AUTHOR]

This paper explores the characteristics of the professional identity of the Doctors of Korean Medicine (KMD), a medical profession in South Korea practicing traditional East Asian medicine. They play a primary care role in healthcare, notwithstanding the legally limited purview of their clinical and public health roles. This mainstream position came their way through biomedicalization that occurred in the profession in the context of the country's private sector-led health system. Based on data gathered among KMDs and in state-level policymaking scenes as an insider, this paper aims to illustrate the characteristics of KMDs' identity by attending to multiple levels of their presence as modern medical profession. In doing so, it draws on works that explored medical identity, Simon Sinclair's (1997) Making Doctors: An Institutional Apprenticeship in particular, to show that despite their similarities to biomedical practitioners, KMDs exhibit discriminating characteristics in their professional consciousness. [ABSTRACT FROM AUTHOR]

Copyright of Revista Estudos Feministas is the property of Revista Estudos Feministas and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

In 2014, Denmark abolished the castration requirement that had been in place since the 1950s in order to obtain legal gender reassignment. As a self-declaration model was introduced, the law was amended to enable everyone with a uterus to retain access to pregnancy care and assisted reproduction. Combining Science and Technology Studies with critical transgender scholarship, this paper explores how the legal reforms, which sought to separate legal gender status from the healthcare system, have shaped the emergence of reproductive transmasculinities and the institutionalization of reproductive citizenship for trans men. Drawing on the concept of sociotechnical imaginaries (­Jasanoff, 2015), I discuss how specific understandings of coherence between bodies, gender and parenthood organize and restrict the reproductive practices of trans men. For example, men who give birth are still registered as mothers. Through the framework of biomedicalization (Clarke et al., 2010), I extend my discussion of reproductive autonomy to fertility preservation access. I discuss why, in Denmark, sperm can be frozen in relation to gender- affirmative treatment, but eggs cannot, and in doing so I highlight how this disparity is not only shaped by normative practices of risk prediction, but also by the political opposition to surrogacy in Denmark.

Background: Opioids are one of the most prescribed treatments for chronic pain (CP). However, their long‐term use (>3 months) has been surrounded by controversy, due to loss of beneficial effects. Objective: To explore the experiences of people with chronic non‐malignant low back pain in Spain undergoing long‐term treatment with opioids. Design: Qualitative study. Setting and participants: We conducted 15 semi‐structured interviews at the Pain Clinic with persons taking opioid treatment. Methods: The interviews were analysed by qualitative content analysis as described by Graneheim and Lundman, and developed categories and themes discussed in light of a biomedicalization framework. Main results: We developed one overarching theme—Living with opioids: dependence and autonomy while seeking relief—and three categories: The long pathway to opioids due to the invisibility of pain; Opioids: from blind date to a long‐term relationship; and What opioids cannot fix. Discussion: The long and difficult road to find effective treatments was a fundamental part of coping with pain, involving long‐term relationships with the health system. This study reflects the benefits, and drawbacks of opioids, along with struggles to maintain autonomy and make decisions while undergoing long‐term treatment with opioids. The paper also highlights the consequences of pain in the economy, family and social life of patients. Conclusions: Patients' experiences should be considered to a greater extent by health‐care professionals when giving information about opioids and setting treatment goals. Greater consideration of the social determinants of health that affect CP experiences might lead to more effective solutions to CP. [ABSTRACT FROM AUTHOR]

This article examines how cryopreserved ovarian tissue is potentiated as a menopausal prevention and/or treatment cure. Based on a multi-sited ethnographic study, the article empirically foregrounds scientific accounts and interviews with Danish female cancer patients who had ovarian tissue preserved. Using situational analysis as a methodological approach along with analytical perspectives on potentiality, we identify three framings revealing how cryotechnology intervenes with women's reproductive aging: Cryopreservation as a risk management technology, as an optimizing technology, and as a synchronization technology. The article shows how the ability to cryopreserve ovarian tissue in order to reverse menopause draws upon an understanding of menopause as not only controllable but of cryopreservation as a resource-wise technology that manages women's aging bodies. Suggesting "cryomedicalization" as a term, the article highlights how cryopreserved ovarian tissue (re)constitutes normative temporalities, produces new understandings of cryo-restoration and raises questions related to the cryopolitics of women's aging. [ABSTRACT FROM AUTHOR]