HUI: Beautiful scars.

This article is the written account of a discussion between a group of indigenous women (trained both in Western and Indigenous knowledge systems), on the relevance of diagnosis in their conceptualisations of health and illness.

Between the Spaces: graphic diagnosis.

This illustrated essay describes the graphic diagnosis memoir as a form of illness narrative that uses a different way of telling stories than standard prose. A cartoon is broken into sequenced segments that ask the reader to jump across the gaps between the panels at the same time as they bridge the images and text assembled in each panel. To be successful in presenting a graphic story, the artist must be able to express an idea, but also must be able to project, or imagine, how readers will be able link ideas, images, and words. The cartoon diagnosis story makes the diagnosis relevant and visible. It does so by recognizing what reader and artist share, then adding, between the spaces, what separates them.

Past, present and imaginary: Pathography in all its forms.

Diagnosis is a profoundly social phenomenon which, while putatively identifying disease entities, also provides insights into how societies understand and explain health, illness and deviance. In this paper, we explore how diagnosis becomes part of popular culture through its use in many non-clinical settings. From historical diagnosis of long-deceased public personalities to media diagnoses of prominent politicians and even diagnostic analysis of fictitious characters, the diagnosis does meaningful social work, explaining diversity and legitimising deviance in the popular imagination. We discuss a range of diagnostic approaches from paleopathography to fictopathography, which all take place outside of the clinic. Through pathography, diagnosis creeps into widespread and everyday domains it has not occupied previously, performing medicalisation through popularisation. We describe how these pathographies capture, not the disorders of historical or fictitious figures, rather, the anxieties of a contemporary society, eager to explain deviance in ways that helps to make sense of the world, past, present and imaginary.

Uncertainty and the inconvenient facts of diagnosis.

One common contemporary usage of the term "diagnostic uncertainty" is to refer to cases for which a diagnosis is not, or cannot, be applied to the presenting case. This is a paradoxical usage, as the absence of diagnosis is often as close to a certainty as can be a human judgement. What makes this sociologically interesting is that it represents an "epistemic defence," or a means of accounting for a failure of medicine's explanatory system. This system is based on diagnosis, or the classification of individual complaints into recognizable diagnostic categories. Diagnosis is pivotal to medicine's epistemic setting, for it purports to explain illness via diagnosis, and yet is not always able to do so. This essay reviews this paradoxical use, and juxtaposes it to historical explanations for non-diagnosable illnesses. It demonstrates how representing non-diagnosis as uncertainty protects the epistemic setting by positioning the failure to locate a diagnosis in the individual, rather than in the medical paradigm.

Fighting Words in the Antipodes.

In this commentary, written in two bursts-the first completed in April 2020, and the second at the end of July-we explore how media metaphors of COVID-19 constitute the pandemic in Australia and New Zealand. We argue that the media's rhetorical strategies play an important role not only in describing the illness, but in influencing and shaping individual and collective responses to the pandemic, with significant consequences for mental health and well-being in the context of crisis. We align this commentary with the tenets of the sociology of diagnosis, which argue that even though there are material realities of disease, their social form and consequence cannot be separated from the tangible nature of illness and its management. We also lean on Derrida's approach to metaphor, which underlines how even observable viral entities such as COVID-19 are simultaneously material, abstract, and in flux. We describe the metaphors used by local media to describe the pandemic-including combat, bush fires, earthquakes, and other natural disasters-and we explore how and why these metaphors construct the pandemic locally and farther afield.

Animals, veterinarians and the sociology of diagnosis.

While sociologists of medicine have focused their efforts on understanding human health, illness, and medicine, veterinary medical practice has not yet caught their attention in any sustained way. In this critical review article, we use insights from the sociology of diagnosis literature to explore veterinary practice, and aim to demonstrate the importance of animals to sociological understandings of health, illness and disease. As in human medicine, our analysis shows the importance of diagnosis in creating and maintaining the power and authority of the veterinary professional. However, we then explore how diagnosis operates as a kind of dance, where professional authority can be challenged, particularly in light of the complex ethical responsibilities and clinical interactions that result from the triad of professional/owner/animal patient. Finally, we consider diagnosis via the precept of entanglement, and raise the intriguing possibility of interspecies health relations, whereby decision-making in human health care may be influenced by experiences in animal health care and vice-versa. In our conclusion, we argue that this analysis provides opportunities to scholars researching diagnosis in human health care, particularly around the impact of commercial drivers; has implications for veterinary and public health practitioners; and should help animate the emerging sociology of veterinary medicine.

More than a "touch of the flu": a response to Mayrhuber et al's ""with fever it's the real flu I would say": laypersons' perception of common cold and influenza and their differences - a qualitative study in Austria, Belgium and Croatia".

This short reply contests two assumptions made by the authors of Mayrhuber et al's. "With fever it's the real flu I would say." The first is that there is influenza can be reliably defined by a medical case definition. The second is that this small qualitative study can be generalisable. However, it does underline the important point that technical diagnostic terms may be used on different registers by a variety of actors in the medical setting.

Diagnosis: a critical social reflection in the genomic era.

Diagnosis is a pivotal tool for the work of medicine as they categorise and classify individual ailments via a generalised schema. However diagnosis is also a profoundly social act, which reflects society, its values and how it makes sense of illness and disease. Considering diagnosis critically, as well as practically, is an important job of the sociologist. This paper reviews how a social model can provide a critical tool for viewing diagnosis in the genomic era. It explores how the formulation of diagnosis, be it via genetic explanations or microbiological ones, are the product of social discovery, negotiation, and consensus.

Diagnosis: a critical social reflection in the genomic era / Diagnóstico: uma reflexão social crítica na era genômica

Abstract Diagnosis is a pivotal tool for the work of medicine as they categorise and classify individual ailments via a generalised schema. However diagnosis is also a profoundly social act, which reflects society, its values and how it makes sense of illness and disease. Considering diagnosis critically, as well as practically, is an important job of the sociologist. This paper reviews how a social model can provide a critical tool for viewing diagnosis in the genomic era. It explores how the formulation of diagnosis, be it via genetic explanations or microbiological ones, are the product of social discovery, negotiation, and consensus.

Resumo O diagnóstico é uma ferramenta essencial para o trabalho da medicina, uma vez que categoriza e classifica o padecimento do indivíduo por meio de um esquema genérico. No entanto, o diagnóstico também é um profundo ato social, o qual reflete a sociedade, seus valores e como dá sentido para o sofrimento e a doença. Considerar o diagnóstico de maneira crítica, assim como prática, é um trabalho importante dos sociólogos. Este artigo analisa como um modelo social pode fornecer uma ferramenta crítica para vermos o diagnóstico na era genômica. Explora como a formulação do diagnóstico, seja através de explicações genéticas ou microbiológicas, é o produto da descoberta social, negociação e consenso.

'The expertness of his healer': Diagnosis, disclosure and the power of a profession.

Diagnosis is one of medicine's most important tools. It structures the relationship between patient and diagnostician, organises illness and provides access to resources. In this article, I reveal how the manner in which a serious diagnosis is revealed creates a kind of 'epistemic posture' reinforcing the power of medical knowledge, and contributing to medical authority. To achieve this, I explore historical material written by and for doctors about the disclosure of difficult diagnoses. Using historical data for sociological purposes follows Zerubavel, who asserts that phenomena should be studied across eras, media and cultures. I have chosen to focus on how diagnostic disclosure, as described by mid-19th to mid-20th century doctors, serves to promote the profession of medicine. The means of revealing a diagnosis served as a demonstration of, and a means for deflecting threats to, medicine's esoteric nature. The historical data provide a novel approach for understanding how diagnosis operates, even today, to confirm the professional status of the doctor.

Healthcare-seeking behaviour of people with sexually transmitted infection symptoms attending a Sexual Health Clinic in New Zealand.

AIMS: Untreated sexually transmitted infections (STIs) can lead to serious health complications and may be transmitted to uninfected individuals. Therefore, the early detection and subsequent management of STIs is crucial to control efforts. Time to presentation for STI symptoms and risk of transmission in this period has not been assessed in New Zealand to date. METHODS: All new clients presenting to an urban sexual health clinic (SHC) were invited to complete a questionnaire, which included demographic information, sexual health history, and details about the clinic visit. RESULTS: Of 331 people approached, 243 (73.4%) agreed to complete the questionnaire. Four incomplete questionnaires were excluded, leaving 239 participants (47.3% female and 52.7% male, 43.8% under the age of 25). The most common reason for seeking healthcare was experiencing symptoms (39.4%) and 41.7% of people with symptoms waited more than seven days to seek healthcare. Around a third (30.6%) of people with symptoms had sex after they first thought they may need to seek healthcare. Infrequent condom use was reported more often by people who had sex with existing partners (84.6%) than by people who had sex with new partners (10.0%). CONCLUSIONS: This is the first study to quantify healthcare-seeking behaviour for STI in New Zealand. Delayed healthcare-seeking (defined as waiting more than seven days) was common and almost a third of people reported engaging in sex while symptomatic. Enabling prompt healthcare-seeking is crucial to minimise transmission risk. Structural barriers such as the financial cost of STI tests must be removed and education around symptom recognition and healthcare system navigation should be provided.

What influences university students to seek sexually transmitted infection testing?: A qualitative study in New Zealand.

OBJECTIVE: Untreated sexually transmitted infections (STIs) can lead to serious health complications, increase susceptibility to contracting further STIs including human immunodefiniceny virus (HIV), and can be transmitted to others. The early diagnosis and treatment of STIs is therefore central to comprehensive STI management and prevention, but this relies on those at risk of STIs presenting for testing. In order to understand STI testing behaviours in view of their improvement, this study aimed to elucidate why people seek STI testing. METHODS: Qualitative semi-structured interviews were conducted with 24 university students who had recently had an STI test. Resulting data were analysed employing a qualitative thematic analysis method to produce a final set of themes. RESULTS: Five drivers for STI testing were identified from the data: crisis, partners, clinicians, routines, and previous knowledge. The final driver, previous knowledge, intersected with the previous four, particularly in relation to routines. Many participants acknowledged that the more they knew about STIs the more likely they were to undertake routine tests. However, at the same time, many participants felt they did not have a good knowledge base and that their school-based sex education had been lacking. CONCLUSION: This study highlights important drivers for STI testing, which may aid the design of public health campaigns. It also underlines that school-based education could provide stronger foundations with regards to STIs and their prevention.

Patient-Identified Needs Related to Seeking a Diagnosis in the Emergency Department.

STUDY OBJECTIVE: Although diagnosis is a valuable tool for health care providers, and often the reason patients say they are seeking care, it may not serve the same needs for patients as for providers. The objective of this study is to explore what patients specifically want addressed when seeking a diagnosis at their emergency department (ED) visit. We propose that understanding these needs will facilitate a more patient-centered approach to acute care delivery. METHODS: This qualitative study uses semistructured telephone interviews with participants recently discharged from the ED of a large urban academic teaching hospital to explore their expectations of their ED visit and postdischarge experiences. RESULTS: Thirty interviews were analyzed. Many participants reported wanting a diagnosis as a primary reason for seeking emergency care. When further asked to identify the functions of a diagnosis, they described wanting an explanation for their symptoms, treatment and guidance for symptoms, and clear communication about testing, treatment, and diagnosis. For many, a diagnosis was viewed as a necessary step toward achieving these goals. CONCLUSION: Although diagnosis may not be a feasible outcome of every acute care visit, addressing the needs associated with seeking a diagnosis may be achievable. Reframing acute care encounters to focus on addressing specific patient needs, and not just identifying a diagnosis, may lead to more effective transitions home and improved patient outcomes.

Barriers to sexually transmitted infection testing in New Zealand: a qualitative study.

OBJECTIVE: To investigate the barriers that prevent or delay people seeking a sexually transmitted infection (STI) test. METHODS: Qualitative in-depth interviews were conducted with 24 university students, who are a group prone to behaviours putting them at risk of STIs, to understand the factors that had prevented or delayed them from going for an STI test in the past. Resulting data were thematically analysed employing a qualitative content analysis method, and a final set of themes identified. RESULTS: There were three main types of barrier to STI testing. These were: personal (underestimating risk, perceiving STIs as not serious, fear of invasive procedure, self-consciousness in genital examination and being too busy); structural (financial cost of test and clinician attributes and attitude); and social (concern of being stigmatised). Conclusions and implications for public health: These data will help health providers and policy-makers provide services that minimise barriers and develop effective strategies for improving STI testing rates. The results of this study suggest a holistic approach to encouraging testing is required, which includes addressing personal beliefs, working with healthcare providers to minimise structural barriers and developing initiatives to change social views about STIs.

'Deal with It. Name It': the diagnostic moment in film.

The moment a serious diagnosis is announced creates an important crisis for a patient, as it shifts their sense of self and of their future potential. This essay discusses the creative representation and use of this diagnostic moment in film narratives. Using Still Alice, A Late Quartet, Wit and Cléo from 5 to 7 as examples, we describe how each of these uses the diagnostic moment in relation to narrative construction and characterisation in recognisable ways. We associate the diagnostic moment with certain narrative and visual devices that are frequently implemented in films as means for character development, and for managing the audience's empathy. This is the case whether or not the diagnosis is contested or accepted, and whether the diagnostic moment is the frame for the narrative, or a closing device. By analysing its representation in film, we emphasise the cultural significance of diagnosis as a life-transforming event.