Search results

The chapters PJ McGann and David J. Hutson have assembled for this volume are not only timely, coinciding with the appearance of DSM-V, but mark a defining moment in which a new subfield of medical sociology has emerged. Diagnosis, which refers both to diagnostic categories and the process of creating and applying them, is a central feature (Blaxter, 1978) – if not the central feature of medical work. Annemarie Jutel, who has done much to build the sociology of diagnosis, has described the wide array of “work” diagnosis performs in the medical world:Diagnosis is integral to medicine and the way it creates social order. It organizes illness: identifying treatment options, predicting outcomes, and providing an explanatory framework. Diagnosis also serves an administrative purpose as it enables access to services and status, from insurance reimbursement to restricted-access medication, sick leave and support group membership and so on… (Jutel, 2009, p. 278)

Throughout the late 19th and early 20th centuries, one of the many techniques used by physicians and psychiatrists to diagnose patients involved external and highly public examination. Typically conducted as a lecture to other medical experts and students, the patient was placed in the center of a round room with onlookers arranged in tiered seating to guarantee an unobstructed view. As the lead physician detailed the list of symptoms, using the patient's body as an illustration, observers witnessed the behavioral signs for themselves and discussed the possible underlying conditions or pathologies. This process of consultation and naming worked to increase the relative reliability among experts and bolster the professional reputations of medicine and psychiatry alike (Conrad & Schneider, 1992; Gillis, 2006; Grob & Horwitz, 2010). As researchers have noted (Aronowitz, 2001; Foucault, 1973), this change from focusing on disparate, idiosyncratic symptoms as expressions of individual illness to a system that recognized disease states comprised of symptom clusters marks a historical turning point in the history of medicine. The shift toward a classification scheme that linked medicine with science and technology bolstered medical authority and the power of physicians. In addition to professional credentials, accumulated knowledge, and institutional legitimacy, the authority of modern medicine both rests on and is expressed by medicine's decisive power to name and categorize through diagnosis (Jutel, 2009). Even as medical prestige has eroded, ceding some of its power to other entities,¹ physicians remain the final arbiter of official medical categories (Pescosolido, 2006), judges of what is, and what is not, a “real” diagnosis. In the diagnostic process, one looks within to reveal the nature of disease from without – empirical observation becomes immutable fact. Of course, as critical perspectives on medicine have long pointed out (Conrad & Schneider, 1992; Zola, 1972), the scientific “fact” of one time and place is the mythology or ignorance of another. Diagnosis, as both category and process (Blaxter, 1978), is infused with all manner of things social, historical, and cultural. This volume explores some of these infusions. In so doing, it aims to clarify and contribute to the emerging sociology of diagnosis – an endeavor first called for by Brown (1990), but more recently revived by Jutel (2009).

In the contemporary US, pregnant women must navigate competing ideas about their bodies, including expectations for weight gain. Given that there are few social spaces where women may gain weight without disapproval, pregnancy represents a period when women are allowed to put on weight. However, gaining weight means doing so within the context of the obesity “epidemic” and increased medical surveillance of the body. To explore how women navigate the medicalization of pregnancy weight, I draw on data from in-depth interviews with 40 pregnant and recently pregnant women. Findings indicate that women reframe the meaning of pregnancy weight as “baby weight,” rather than body weight. This allows them to view it as a temporary condition that is “for the baby,” while holding two concurrent body images – a pregnant and a non-pregnant version of themselves. Women also resist the quantification of their maternity weight, either by not keeping track or not looking at scales in the doctor’s office. Doing so prevented baby weight from turning back into body weight – a concrete and meaningful number on the scale. Such resistance to quantification is often accomplished with the help of doctors and healthcare professionals who do not explicitly discuss weight gain with their patients. These findings suggest that women rely on a variety of strategies to navigate the medicalization of pregnancy weight, and provides another lens through which to understand how and why women may make similar choices about other medicalized aspects of their pregnancy (or pregnancy experiences).

High‐frequency transducer arrays that can operate at frequencies above 30 MHz are needed for high‐resolution medical ultrasound imaging. The fabrication of such devices is challenging not only because of the fine‐scale piezocomposite fabrication typically required but also because of the small size of arrays and their interconnects. The purpose of this paper is to present an overview of research to develop solutions for several of the major problems in high‐frequency ultrasound array fabrication.

Net‐shape 1‐3 piezocomposites operating above 40 MHz are developed. High‐quality surface finishing makes photolithographic patterning of the array electrodes on these fine scale piezocomposites possible, thus establishing a fabrication methodology for high‐frequency kerfless ultrasound arrays.

Structured processes are developed and prototype components are made with them, demonstrating the viability of the selected fabrication approach. A 20‐element array operating at 30 MHz is patterned and characterised. Furthermore, an electrode pattern suitable for a 20‐element array operating at 100 MHz is created to demonstrate the state of the art of photolithography processing directly on piezocomposite.

The work reported suggests that ultrasound arrays for real‐time biomedical imaging will be viable at higher frequencies than presently available commercially or previously reported in the research literature.

The main elements of a novel, fully mask‐based process for high‐frequency ultrasound transducer array fabrication are presented in outline in this paper.