Tag Archives: biomedical

App-ography: A critical perspective on medical and health apps

www.flickr.com/photos/alf/200290221/ by alf eaton + commons.wikimedia.org/wiki/File:Anatomical_position.jpg by Connexions (cnx.org/content/m47807/latest/)

All My Apps by alf eaton +
Anatomical Position by Connexions

I have been thinking and writing about mobile apps recently and how they are used for medical and health purposes. Millions of apps designed for smartphones, tablet computers and other mobile devices have been developed since their first appearance in 2008. Many of these are health and medical apps. In mid-2014 there were over 100,000 health and medical apps listed in the two major app stores, Apple App Store and Google Play, and new ones are being issued every day.

Several health and medical apps feature on Apple’s lists of popular apps, and download figures provided by Google Play show that some health and medical apps on their store have been downloaded hundreds of thousands or even millions of times. In late 2012 a Pew Research Center survey found that 85 per cent of American adults owned a mobile phone. Fifty-three per cent of these were smartphones, and one fifth of smartphone users had used their phone to download a health-related app. The most popular of these apps were related to monitoring exercise, diet and weight. A more recent market research study found that almost one-third of American smartphone users (equivalent to 46 million people) had used apps from the health and fitness category in January 2014Public health researchers have sought to evaluate their use in health promotion campaigns and gathering data on health-related practices. But few researchers have investigated the broader social, cultural, political and ethical dimensions of medical and health apps.

Healthcare practitioners and administrators are also increasingly using apps as part of their professional practice. Hundreds of apps have been developed by hospitals and other healthcare providers. A growing number of medical schools are now offering at least part of their education via apps and require their students to own a tablet computer. In one study that surveyed American doctors, more than two thirds said that they used apps as part of their work. Another survey of medical students and junior doctors in a UK healthcare region found that over half of both students and junior doctors had medical-related apps on smartphones, with apps for medical education purposes the most popular. The medical literature now often refers to ‘prescribing’ apps to patients.

Despite the ever-increasing popularity of apps, very little academic research focused on these devices has been carried out in the social sciences and humanities. Numerous market research reports and medical journal articles have been published that provide some quantitative data on their content, accuracy and use, but these are largely instrumental and descriptive rather than critical.

Apps are digital technology tools, but they are also sociocultural products… active participants that shape human bodies and selves as part of heterogeneous networks, creating new practices and knowledges.

In recent years I have been interested in developing a research agenda in critical digital health studies, including research into medical and health-related apps. I adopt a sociomaterial perspective drawn from science and technology studies to investigate the digital health phenomenon. From this perspective, mobile apps, like all technologies, assume certain kinds of capacities, desires and embodiments; they also construct and configure them. Apps are new digital technology tools but they are also active participants that shape human bodies and selves as part of heterogeneous networks, creating new practices. Indeed apps may be viewed as sociocultural artefacts, the products of human decision-making, underpinned by tacit assumptions, norms and discourses already circulating in the social and cultural contexts in which they are generated, marketed and used. As they not only present information and health and medicine but also often invite users to generate and share digital data about themselves, apps participate as actors in the digital knowledge economy.Read More… App-ography: A critical perspective on medical and health apps

Genes, fruit flies and the Ramones with Julia Serano

picture of Julia SeranoJulia Serano (@juliaserano) may be most well known for her groundbreaking book Whipping Girl: A Transsexual Woman on Sexism and the Scapegoating of Femininity, but she is a person of many talents. In addition to having just released a new book (Excluded: Making Feminist and Queer Movements More Inclusive), did you know that Julia is also a musician, a performer, and a geneticist with a PhD in Biochemistry and Molecular Physics? And although she doesn’t work as an ethnographer, she is an insightful explorer and student of culture.  Her experiences as both an activist and a biologist give her a unique perspective on this month’s theme.

We talked to Julia Serano over beer and french fries in Uptown Oakland.

EM: I don’t know anything about molecular biology, but I was wondering if you could tell me a little bit about your PhD and your research.

I was a life science major in college, and then I went to get my PhD at Columbia. My degree is in biochemistry and molecular biophysics, which is weird because I don’t really do biochemistry or biophysics. A lot of times the specific titles are related to history, when the fields were more separate, but now there’s more interaction between different subfields.

Most of my thesis research is related to developmental biology, and genetics and molecular biology. Developmental biology involves trying to understand how all animals and plants start out as one cell, and then they develop into animals that have different types of tissues and skin cells and nerve cells and muscle cells.

Genetics started out as a field where people found mutations — where, you know, an animal someone was studying became somewhat different. Now genetics is not only about studying mutations, but trying to understand the underlying genes. Molecular biology started out almost as the reverse, where it’s looking at specific molecules, whether they be DNA or proteins, and from there trying to figure out what they do… Mostly what I did as a developmental biologist was study questions related to how cells and embryos develop, using tools to look at the genes that are involved in that process, and trying figure out how genes work.

EM: Were you interested in that growing up?

Sort of. I was generally interested in science as a kid. I remember especially my parents and relatives getting me dinosaur books and outer space books — I was just generally science curious as a kid growing up. But then in high school when you have to start thinking about ‘What am I going to do for a living’, I really had no idea. Biology was the field that I liked the best, so that’s why I majored in it. I didn’t have any idea of what I would necessarily do with a biology degree, but I was just like, well, that’s the class I like the most, so I went into that.

This is all fruit fly stuff

Drawing of fruit fly with text from William Blake's poem "The Fly"

Saint Drosophila, CC BY-SA Sage Ross
(Poem by William Blake)

EM: Your band is called Bitesize, right, and then I saw your paper about “bitesize” (“The Drosophila synaptotagmin-like protein bitesize is required for growth and has mRNA localization sequences within its open reading frame“), so I was curious about that.

Sure yeah, yeah. While I was doing my postdoc, I was also in a band and we were called Bitesize. I remember in the lab — we were studying fruit flies; this is all fruit fly stuff — someone who I worked with had discovered a gene in which, when it’s mutated, the flies are smaller in size than normal flies, or wild-type flies. Generally if you identify a gene, you get to name it. So she was trying to come up with ideas, and I suggested to her “Lilliputian.”

She ended up using that, and then afterwards I’m like, “I should have told her ‘bitesize’! I could have had my band’s name be a name of a gene.” Then one of the genes I was working on, when I finally got mutations in it, it had a similar phenotype in that they were smaller than average. So I used it as a way to have a little inside joke and call it “bitesize.” Especially in drosophila, fruit fly genetics, there’s a tradition of people being creative with their names.

EM: There was something in your paper about protein coding…

Basically when we talk about genes, a gene is a part of DNA that is like a blueprint to do something for the animal. When a gene is turned on in a cell, you make copies of RNA. They’re temporary copies, called mRNAs for Messenger RNA. So then, mRNAs get translated into proteins. Proteins are little machines that more often than not are actually doing things in the cell.

Some RNAs get made and just float around the cell, and some proteins get made. When it’s advantageous for the cell to only make the protein in one area, RNAs can get transported or localized to that particular part of the cell. The whole thing with bitesize was about those RNAs that get localized. Usually the part of the RNA that makes that happen isn’t also the part that makes the protein. But in bitesize, the part that’s responsible for the localization of the RNA is actually in the part that codes for the protein, which is very unusual. So it was esoteric, kind of an intriguing finding — not necessarily like an ‘oh my god’, earth shattering thing. It’s possible, but it’s rare.

Bitesize, the gene

Bitesize, the gene (Figure 3)

The natural/unnatural binary

EM: I wanted to ask about the new book.

Cover of the book "Excluded"The new book is called Excluded: Making Feminist and Queer Movements More Inclusive. It takes off where my last book, Whipping Girl, left off. In Whipping Girl I talked about different types of sexism, and especially my experiences of them as a trans woman. Being a trans woman who’s very active in feminist movements and also in queer or LGBTQ spaces and movements, there’s a long history of those movements — while they’re all trying to fight sexism in certain ways — that sometimes they exclude people who are a part of their own movements. Sometimes the way people are excluded is through — sexism! Or through the idea that certain types of genders and sexualities are more legitimate, real, natural or righteous than others.

Over the years I have been writing as a trans woman, and also as someone who is bisexual, and also as someone who is feminine — all three of which can be seen as suspect. I’ve critiqued those types of exclusive attitudes in the past, but kind of on a one-by-one basis… like explaining why trans women shouldn’t be excluded, or why bisexuals shouldn’t be excluded, and so on. In noticing the parallels between those, with this book I wanted to take a wider view and ask why we create movements that are exclusive. What’s wrong with our theories and our strategies that we create movements where a lot of people, who should feel empowered by these movements, are left out?

EM: Thinking about that, do you have a sense of what people mean when they say “natural”?

In trans politics, people often talk about the gender binary and why the gender binary is bad. I would add to that: lots of binaries are bad, and probably amongst the ones that I would like to see destroyed the most are the real/fake binary or the natural/unnatural binary… In our society we tend to see things that are natural as being automatically healthy or automatically moral, and things that are unnatural as being automatically unhealthy and automatically immoral. People are constantly using the word “natural” in this way, and we buy into it — but there are natural products that will kill you. Snake venom is natural.

As a trans person and as a queer person, whenever I hear things humans do described as natural or unnatural, I’m always a little worried.

Sometimes it’s useful to talk about why things are good or why things are bad; why things are healthy or not healthy. But generally speaking I don’t see that the natural versus unnatural distinction helps us at all. What really hits me, as someone who has training in biology but also is involved in social justice movements, is that the whole idea of “unnatural” is usually used to put people down; to imply that whatever they’re doing in inherently wrong. I’ve always found it weird, because we’re biological beings, right, so isn’t everything we do natural? I just find that the idea of natural is used generally to make certain things seem better than others with no foundational basis… As a trans person and as a queer person, whenever I hear things humans do described as natural or unnatural, I’m always a little worried.Read More… Genes, fruit flies and the Ramones with Julia Serano