Tag Archives: digital technologies

Findings from the Young Australians and Digital Health Project

Digital technologies for health-related topics and practices such as websites, online discussion forums, social media, content-sharing platforms, mobile apps and wearable devices are now available as a means for young people to learn about and promote their health, physical fitness and wellbeing. Young people are often assumed to be ardent users of digital health technologies by virtue of having been born into the age of new digital media. Thus far, however, few social research studies have directed attention to the details of how and why young people use digital technologies for health-related purposes and how other, non-digital sources also contribute to the ways in which they learn about their bodies and health and engage in practices to support their health and wellbeing.

The Young Australians and Digital Health Project, a qualitative interview-based study of 30 young Australians (aged 16 to 25 years) was designed to address these issues. The participants were recruited to ensure equal numbers of female and male participants and a spread of ages, ethnic backgrounds and geographical locations across Australia. The interviews took place in April-May 2018. Participants were asked a series of questions relating to how and why they sourced health and medical information and support, and which of these they found most and least useful and helpful. They were asked if anyone had recommended that they use digital health technologies and whether they had any concerns about their personal health data privacy and security. The final question had a future-oriented perspective, asking participants to imagine and describe an ideal digital health technology for their everyday needs.

The interview questions and analysis of transcripts of participants’ responses were designed to draw attention to the affordances of the actors involved (human and nonhuman), relational connections between these actors, affective forces and agential capacities. The affordances of fleshly human bodies include their sensory perceptions, emotional responsiveness, embodied expertise, memory and the ability to learn and to move in certain ways. The affordances of nonhuman objects such as digital technologies relate to the design features of these technologies and what they potentially allow people to do with them. Relational connections include the ways in which humans interact with and respond to other humans, as well as with nonhumans, and how these relationships contribute to or generate bonds and affects.

As the table below shows, all participants said that they sought information from doctors and other healthcare providers, and most also turned to advice from friends and family members. Very few young people used books for health information, but pamphlets were still read by around a third of participants (usually picked up in doctors’ surgeries while waiting for a consultation). In terms of digital tools and resources, search engines were used by everyone, with health websites a close second. All the participants said that they were routinely online throughout the day and were accustomed to searching the internet as a habitual practice for various purposes. They generally searched between once or twice a week or once a month for health-related topics.

Youtube, online discussion groups and social media groups were fairly well-used, but by less than half of the participants. Participants noted that these sources were often found from an initial search using Google Search. Only five of the 30 participants said that they had signed up to My Health Record (Australia’s nationwide patient electronic medical record), with the remainder noting that they had not heard of it.

Sources of health and medical information used currently

SOURCES

 

 Number of respondents (n=30)
Non-digital sources  
doctors and other health care providers 30
friends and family 21
pamphlets 11
books   5
Digital sources  
search engines 30
health websites 26
YouTube 13
online discussion forums 12
wearable devices 12
social media groups 10
apps   9
digital exercise games (e.g. Wii Fit)   8
electronic medical record (My Health Record)   5
physical activity platforms (e.g. Strava)   6

 

The convenience, accessibility and detail and diversity of information offered by digital media and devices were valued by the participants.

So I would initially just google my query and do a little bit of research on my own but then I would take my problems to a doctor and they would have more detail and more answers for me. I would usually just look up, kind of, symptoms and triggers for certain things. I would mainly just look up information, possibly finding a solution on my own. I like going online for the ease of use, ease of access, variety of information available, all that kind of stuff. (male, 24 years)

The young people also appreciated being able to source others’ personal experiences online by using online discussion forums, social media groups and viewing people’s stories on YouTube. They felt connected to the physically distant others they encountered online through their sharing of experiences and affective responses on these platforms.

Well, probably I just read forums to find information on the forums, the one thing I find useful is that they have allowed people to express their own feelings with different kinds of diseases. And I find that if it relates to me, then I guess it doesn’t make me feel so alone – knowing that what I’m going through, someone else is going through it with it. (male, 24 years)

Apps and wearable devices (mostly Fitbits) were used for mental health and wellbeing and booking medical appointments, as well as for self-tracking sleep, heart rate, steps and other physical activities, and menstrual cycles. Digital exercise games such as Wii Fit and physical activity platforms like Strava were the least used of all the technologies listed. Few participants who did use them did so regularly, with several participants noting that exercise games were too time-consuming to set up.

Doctors were highly valued as the pre-eminent source of health information authority because of their training and expertise. Young people noted that it could be difficult to distinguish between different opinions and details about health and illness expressed online, requiring them to assess which sources were most valid and reliable. By comparison, a doctor’s expertise was individualised to patients’ specific needs and they could offer knowledgeable interpretations based on their training. Young people could then defer to this expertise.

I guess online there’s a lot of different opinions on what something – like, if you think you’ve got a cold or something like that then you go online and I guess you’re not really qualified yourself to go, this is actually what symptoms I’m experiencing and this is what it actually is. Whereas I feel like if you go to a doctor they’re able to pinpoint it quite well. (female, 22 years)

The participants highly valued the capacity of digital technologies to generate detailed information about their bodies and health states and imagined new technologies that would be able to achieve even more detailed personalisation and customisation. However, they expressed little knowledge or concern about how their personal health data may be exploited by other actors or agencies, despite the fact that the interviews took place a matter of weeks after the Facebook/Cambridge Analytics personal data scandal. Several participants said that they had noticed that companies like Facebook and Google were monitoring their online searches and content for advertising purposes, but these practices were accepted as the norm for online engagement.

Obviously, Google, because they’re finding ways to link to merchandise, or that’s what I believe, personally.  If I look up fitness they’ll say, “Oh look at this fitness gear; why don’t you buy it?” I think it’s just society today – I can’t really stop it. (female, 18 years)

The participants’ accounts highlight the importance to this demographic group of the relational and affective dimensions of seeking health-related advice and information. While all the participants went online routinely and regularly to find advice and information, particularly because the internet affords convenience, ready access and a wealth of diverse opinions, it was evident that their connections and relationships with other people, both face-to-face and digitally mediated, were very important. Other key affordances offered by digital technologies included offering material that could be viewed anonymously and unobtrusively.

Feeling understood by and connected to other people was an agential capacity generated through various combinations of humans with each other and with technologies. The ideal digital health technologies that were imagined by the participants also evoked the affordances of convenience and accessibility. These imaginaries also suggested the importance to young people of technologies that could ‘know’ and ‘understand’ them better than those they had already tried.

In summary, these findings highlight that gaining a better knowledge of bodies, illness and healthcare and feeling more in control of health and wellbeing states were important to the young people. They valued face-to-face as well as online relationships and personal connections with other people for providing information and support, including family members and friends as well as medical professionals.

These were the vibrancies that animated the participants’ enactments of seeking and finding health information and support, that kept them googling, reading the content of websites, social media platforms and online forums, watching videos and using apps and wearable devices. While the young people’s consumption of this content may overtly appear to be passive, given that they tended to view rather than create online content, the young people were actively making sense of the material they were accessing and gathering, deciding how relevant or valid it was for their needs, how they would respond to it and whether they needed to seek further advice from doctors or others.

 

 

 

The senses and digital health

I have edited a special issue for the journal Digital Health on the theme of ‘The senses and digital health: sociocultural perspectives’.  Part of the editorial I have just finished for the special issue is excerpted below. The whole preprint of my editorial is here: Preprint of editorial for special issue on senses and digital health

(Edited to note that this editorial has now been published in the journal, and is available open access here.)

A few days before I began writing this editorial, I ran a discussion group with some people who were attending an outpatient cardiovascular rehabilitation program at a hospital in my home city, Canberra. The purpose of the discussion was to discover what sources of information and support people who had recently received hospital treatment for a serious heart condition were using and found valuable. As one of my major areas of research is the social and cultural dimensions of digital health (see, for example, my book Digital Health), I was particularly interested in the digital media and devices they may be using.

I began with general questions about what sources of information the participants had found useful in learning about their heart condition and rehabilitation following their diagnosis and surgery at this hospital. The group members told me that the hospital cardiac rehabilitation sessions were very important to them, not only as a way to learn about recovery and preventive actions they could take to improve their coronary health, but also as an opportunity to interact with other people who had gone through similar experiences. They explained that, together with the sessions they attended as part of this program, the print material (pamphlets and a book) about cardiac rehabilitation that had been given to them by the hospital had been the major contributors to learning about their disease and recovery. They commented that they had been able to discuss aspects of these materials during face-to-face encounters with healthcare staff if they needed to ask questions or receive clarification on any of the information within. Some people had also attended pre-admission group information sessions after their cardiac condition had been diagnosed, which their partner was also encouraged to attend. Others had had no opportunity for this kind of preparation, as they had experienced a sudden heart attack and found themselves in the emergency department receiving medical attention with little warning.

A dominant theme that emerged from the participants’ accounts was their desire to share insights from their experiences about the mysterious and unexpected nature of heart disease or heart failure. Several participants recounted their stories of how they had been diagnosed with heart disease or suffered a heart attack without realising that there was any problem with their hearts. For these people, the best way to share the insights they had gained from their own experiences was to tell their friends and family about it, as a form of warning. For some, friends or family members who had already experienced a heart condition were a source of information. They had listened to these other people recount their experiences and learnt about the symptoms and treatment.

When I moved onto the topic of digital technologies, it was clear that these were not important to most people in this rehabilitation program. Only about half of them even owned a smartphone. Several people said that they used at-home blood pressure and pulse rate monitoring devices as a way of tracking their heart health. They had purchased these from pharmacies, on their own initiative, rather than being encouraged to do so by their doctors. They printed out the data from a spreadsheet they maintained, or recorded their details with pen-and-paper, and showed this information to their doctors on follow-up appointments.

None of the participants used a digital device like a smartphone app or wearable device for monitoring their blood pressure. A small number did use these devices for tracking other body metrics, such physical activity levels. They were all in the younger age group (aged below 60). In terms of online sources of information, very few of the group had searched prior to their diagnosis for information related to any symptoms they may have experienced. About a third of the participants did go online after their diagnosis or surgery to seek information. However, none of the participants had ever used a patient support online forum or social media community for their health condition. When asked what they will do once they have finished the six weeks of the cardiac rehabilitation program, some mentioned that they would join one of their local gyms to continue their exercise routines. None was interested in joining an online patient support group at that point.

Reflecting on this focus group discussion as I write this editorial has highlighted some of the key issues I envisaged the issue as exploring. While my initial focus was digital health, these responses proved enlightening to me in their very de-emphasis and backgrounding of the digital. They provide a compelling counter to the techno-utopian visions that are often put forward by advocates of digital health technologies and the ideal of the ’digitally engaged patient’ that has become so dominant in the technological, medical and public health literature.

Profound affective and sensory aspects of living as a cardiac disease survivor were expressed in the participants’ accounts. For them, a key issue in how information about cardiovascular disease is communicated and shared was finding some way to let others know about the diverse symptoms that are not always recognised as signalling a heart problem. They reflected that they themselves in many cases hadn’t recognised the symptoms when they were living through the experience. The discussion group provided a forum for people to tell stories of hidden illness striking suddenly and catastrophically. They emphasised the uncertainty of not knowing what the physical sensations they were experiencing were, and whether they should be concerned and seek immediate medical attention.

Listening to their heart disease stories, and reading over them later as transcripts, I was reminded of Arthur Frank’s influential book The Wounded Storyteller, in which he discusses how people’s illness and physical suffering are expressed as narratives. Frank describes the wounded storyteller as ‘anyone who has suffered and lived to tell the tale … a guide and companion, a truth teller and trickster. She or he is a fragile human body and a witness to what endures’.

In the face of this uncertainty and experiencing life-threatening illness, major surgery, and then long recovery, the medical care and continuing support provided to the patients were vital to their sense of security and confidence in the integrity of their bodies. The participants’ positive feelings towards the rehabilitation program and what it offered them were obvious in their accounts. While the space and people were unfamiliar to me, I could perceive that the group members felt at ease coming to this space to which they were now habituated through their twice-weekly visits, and with staff who knew them and spoke to them kindly, and the other cardiac disease survivors in the group they had come to know. Compared with the strength of feeling about the face-to-face encounters they had in this program, the support and information offered by digital technologies were very much in the background. They were simply not important in these people’s everyday experiences of recovering from and managing their cardiac conditions.

These people’s experiences as they recounted them with filled with sensation and affect: the intense and sudden pain they experienced when having a heart attack, the surprise they felt at being diagnosed with a heart condition, the relief of having survived a serious medical problem and, in many cases, major surgery, and the comfort and reassurance of being supported during their rehabilitation by hospital staff and other group members. These were people whose everyday routines and assumptions about their bodies had been thrown into disarray. They wanted to be able to convey these sensory and affective experiences to me, and to others to warn them and instruct them on how to interpret their bodily signs and symptoms.

For this group, comprised of people who in many cases were not highly digitally literate or regular users of digital devices, digital technologies were on the margins of their care and support, or simply non-existent in their lifeworlds. It was the health professionals at the hospital, the other group members, the space provided for them to which they had become accustomed, and the print material given to them at the hospital that were the important and trusted elements in lifeworlds which they were moving and recovering their bodily integrity and confidence. The findings from the discussion group raise further questions about what further support should be offered to people once the six weeks of the rehabilitation program are over, and whether this should be mediated via digital technologies or provided in other ways.

New book out – Digital Health: Critical and Cross-Disciplinary Perspectives

9781138123458

My new book Digital Health: Critical and Cross-Disciplinary Perspectives has now been published with Routledge (link to the book is here). I have included excerpts from the book on this blog as I was writing it: see here, here,  here and here.

I did a Q&A session for Routledge, in which I explained some of the background to the book and give some advice for aspiring writers in my field. There is also a link to view the introductory chapter (see here).

 

Four talks in Europe, June 2017

I’ll be giving four talks in Europe in June this year. Here are the details and the links to the events.

Fat, thin and fit bodies in digital media

 

I have just completed an introduction for a special issue of the journal Fat Studies on digital media and body weight, shape and size. Here’s an edited excerpt from the introduction. (Update: the introduction has now been published, and can be viewed here.)

Numerous researchers have called attention to the ways in which often very negative portrayals of fat embodiment circulate in the popular media. Despite the growing presence of attempts to counter these portrayals, online representations of fat bodies that seek to challenge accepted norms and engage in fat activist politics continue to be far outnumbered by those that continue to stigmatize and shame fat people and portray thin bodies as more desirable, healthy and attractive. A content analysis of the representation of “obesity” on YouTube (Yoo and Kim 2012) found that highly negative representations of fat people were common, as were those that attributed personal responsibility for body weight (such as showing fat people eating unhealthy food) and made fun of fat people. Another study of YouTube videos using the search term “fat” (Hussin et al. 2011) revealed that many highly-viewed videos included content that devalued fat people. Men were targeted for fat stigmatization twice as often as women, and white people were the targets far more frequently than other ethnic or racial groups. The antagonists engaging in active shaming or vilification of fat people were also overwhelmingly white men.

My own search for the term “fat people” on YouTube in September 2016 returned many top-ranked videos in which fat people are held up to ridicule and scorn. These bore such titles as “Fat People Fails,” featuring fat people falling over, breaking furniture or otherwise publicly humiliating themselves as well as “The Top Fattest People in the World,” and “Fat People Cringe,” all featuring fat bodies in the style of the freak show. These videos all have millions of views. A Google search for “fat memes” similarly found memes that not only stigmatize fat bodies but are blatantly abusive and often cruel. Just some examples I came across include unflattering images of fat people with texts such as “I’m fat because obesity runs in my family. No-one runs in your family,” “I’m lazy because I’m fat and I’m fat because I’m lazy,” and “Sometimes when I’m sad I like to cut myself … another slice of cheesecake.” When I looked for “fat GIFs” on the GIFY platform, here again were many negative portrayals of fat people, including cartoon characters like Homer Simpson as well as real people, again engaging in humiliating bodily performances. Many of these GIFs showed people jiggling their abdomens or dancing to demonstrate the magnitude of their flesh, belly flopping into swimming pools, eating greedily, smeared with food and so on. Here again, fat white men predominated as targets of ridicule.

Apps are another dominant media form that often focuses on the monitoring, representation and even gamification of human embodiment. As I have argued elsewhere, the ways in which game apps portray social groups can often reproduce and exacerbate negative or misleading stereotypes, including racism, sexism, healthism and norms of feminine embodiment privileging highly-groomed, youthful, physically fit and slim bodies (Lupton 2015, Lupton and Thomas 2015). When I searched the App Annie platform using the term “fat,” a plethora of apps portraying fat bodies in negative ways were identified. These included several game apps that represented fat people as ugly, greedy, lazy and gormless figures of fun who need encouragement to engage in weight-loss activities. Many other apps involve users (who are assumed not to be fat) manipulating images of themselves or others so that they look fat. These include “FatGoo”, marketed by its developers in the following terms: “Gaining weight is now fun! FatGoo is the ultimate app for creating hilarious fat photos of your friends and family.” Others of this ilk include “Fatty – Make Funny Fat Face Pictures,” “Fat You!,” “FatBooth” and “Fatify – Get Fat.” Another fat app genre is that which uses abusive terms to shame people into controlling their diet and lose weight. One example is “CARROT Hunger – Talking Calorie Counter.” It is marketed by its developer as a “judgemental calorie counter” which will “punish you for overindulging.” The app can be used to scan foods for their calorie content. If it judges food as too high in calories, users are abused with insulting epithets such as “flabby meatbags” and even tweets shaming messages about them to their Twitter followers. While such apps may be considered by some as harmless fun, they play a serious ideological role in stigmatizing and rendering abject fatness and fat people.

… Thinspiration is a profoundly gendered discourse. Far more female than male bodies feature in digital images tagged with #thinspiration or #thinspo. I noted earlier that white men tend to be targeted for ridicule in memes and GIFs. Interestingly, my search for “skinny” or “thin” memes and GIFs also hold up white male bodies to derision, this time drawing attention to thin men as lacking appropriate muscular strength. Many memes show half-naked thin men in body-building poses, seeking to highlight their lack of size. When skinny women are featured in memes and GIFS, it is usually in relation to women who falsely claim or complain about being fat or else are sexualized images of young women in swimwear displaying their lean bodies (often tagged in GIFs with #hot #beauty, #perfect and #sexy as well as #thin, #thispo or #skinny). Thin women, these memes suggest, are to be envied because they conform to conventions of female attractiveness. In contrast, thin men are deficient because they fail to achieve ideals of masculine strength and size. The fitspiration or fitspo terms are more recent, but they also take up and reproduce many of the ideals of thinspiration, and similarly have a strong focus on physical appearance and conventional sexual attractiveness. The bodies that are championed in fitspiration are physically toned, active, strong and fit as well as slim (but not emaciated), and are similarly eroticized, with both female and male bodies featuring (Boepple et al. 2016, Boepple and Thompson 2016, Tiggemann and Zaccardo 2016).

References

Boepple, L., Ata, R.N., Rum, R. and Thompson, J.K. (2016) Strong is the new skinny: a content analysis of fitspiration websites. Body Image, 17 132-135.

Boepple, L. and Thompson, J.K. (2016) A content analytic comparison of fitspiration and thinspiration websites. International Journal of Eating Disorders, 49 (1), 98-101.

Hussin, M., Frazier, S. and Thompson, J.K. (2011) Fat stigmatization on YouTube: a content analysis. Body Image, 8 (1), 90-92.

Lupton, D. (2015) Digital Sociology. London: Routledge.

Lupton, D. and Thomas, G.M. (2015) Playing pregnancy: the ludification and gamification of expectant motherhood in smartphone apps. M/C Journal (5). Accessed 22 October 2015. Available from http://journal.media-culture.org.au/index.php/mcjournal/article/viewArticle/1012.

Tiggemann, M. and Zaccardo, M. (2016) ‘Strong is the new skinny’: a content analysis of #fitspiration images on Instagram. Journal of Health Psychology, online ahead of print.

Yoo, J.H. and Kim, J. (2012) Obesity in the new media: a content analysis of obesity videos on YouTube. Health Communication, 27 (1), 86-97.

 

 

Cycling self-tracking and data sense

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This week I am delivering a paper at the joint 4S (Society for the Social Studies of Science) and EASST (European Association for the Study of Science and Technology) conference in Barcelona. The paper is in the track ‘Everyday analytics: the politics and practices of self-monitoring’. In the paper I discuss elements of my Living Digital Data research program and describe one of my research projects, which investigates the self-tracking practices of commuting cyclists who use digital devices to monitor their rides.

The research team (myself and Christine Heyes Labond from the University of Canberra and Sarah Pink and Shanti Sumartojo from RMIT Melbourne) conducted empirical research with 18 participants living in Canberra and Melbourne about their self-tracking practices. We used a combination of interviews, enactments of people getting ready for and completing their cycling trips and footage of the cycling trips themselves taken from the perspective of the cyclists (using a GoPro mini action camera mounted on their helmet).

Here are the slides from the paper, which outlines details of the project and some of the findings. Data sense 4S Barcelona

When data do not make sense

One of my current areas of research interests focuses on how to conceptualise digital data and the ways in which humans make sense of their personal data. Next week I am attending a workshop in Copenhagen run as a part of a series convened by RMIT’s Data Ethnographies Lab. We are addressing the topic of ‘broken data’, or digital data that for some reason do not work, are considered useless or fail to make sense to the people reviewing them.

Drawing on some of my own concepts of digital data, I have produced the following metaphorical alternatives to that of ‘broken data’.

Metaphor 1: if data are liquid, then …

  • there can be blockages in data flows
  • moving data can become stuck
  • contained data can become out of control (like tsunamis or floods)
  • liquid data can become frozen

Metaphor 2: if data are lively, or companion species, then …

  • alive data can die
  • domesticated data can become wild
  • fresh data can decompose
  • healthy data can become sick

Metaphor 3: if data can be eaten/consumed, then …

  • data can become self or considered not-self
  • data can be incorporated or not incorporated
  • data can be digestible or indigestible
  • data can be edible or inedible

 

 

 

 

Lively devices, lively data and lively leisure studies

This is a foreword I wrote for a Leisure Studies special issue on digital leisure cultures (the link to the journal version is here).

In the countries of the Global North, each person, to a greater or lesser degree, has become configured as a data subject. When we use search engines, smartphones and other digital devices, apps and social media platforms, and when we move around in spaces carrying devices the record our geolocation or where there are embedded sensors or cameras recording our movements, we are datafied: rendered into assemblages of digital data. These personal digital data assemblages are only ever partial portraits of us and are constantly changing: but they are beginning to have significant impacts on the ways in which people understand themselves and others and on their life opportunities and chances. Leisure cultures and practices are imbricated within digital and data practices and assemblages. Indeed, digital technologies are beginning to transform many areas of life into leisure pursuits in unprecedented ways, expanding the purview of leisure studies.

These processes of datafication can begin even before birth and continue after death. Proud expectant parents commonly announce pregnancies on social media, uploading ultrasound images of their foetuses and sometimes even creating accounts in the name of the unborn so that they can ostensibly communicate from within the womb. Images from the birth of the child may also become publicly disseminated: as in the genre of the childbirth video on YouTube. This is followed by the opportunity for parents to record and broadcast many images of their babies’ and children’s lives. At the other end of life, many images of the dying and dead bodies can now be found on the internet. People with terminal illnesses write blogs, use Facebook status updates or tweet about their experiences and post images of themselves as their bodies deteriorate. Memorial websites or dedicated pages on social media sites are used after people’s death to commemorate them. Beyond these types of datafication, the data generated from other interactions online and by digital sensors in devices and physical environments constantly work to generate streams of digital data about people. In some cases, people may choose to generate these data; in most other cases, they are collected and used by others, often without people’s knowledge or consent. These data have become highly valuable as elements of the global knowledge economy, whether aggregated and used as big data sets or used to reveal insights into individuals’ habits, behaviours and preferences.

One of my current research interests is exploring the ways in which digital technologies work to generate personal information about people and how individuals themselves and a range of other actors and agencies use these data. I have developed the concept of ‘lively data’, which is an attempt to incorporate the various elements of how we are living with and by our data. Lively data are generated by lively devices: those smartphones, tablet computers, wearable devices and embedded sensors that we live with and alongside, our companions throughout our waking days. Lively data about humans are vital in four main respects: 1) they are about human life itself; 2) they have their own social lives as they circulate and combine and recombine in the digital data economy; 3) they are beginning to affect people’s lives, limiting or promoting life chances and opportunities (for example, whether people are offered employment or credit); and 4) they contribute to livelihoods (as part of their economic and managerial value).

These elements of datafication and lively data have major implications for leisure cultures. Research into people’s use of digital technologies for recreation, including the articles collected here and others previously published in this journal, draws attention to the pleasures, excitements and playful dimensions of digital encounters. These are important aspects to consider, particularly when much research into digital society focuses on the limitations or dangers of digital technology use such as the possibilities of various types of ‘addiction’ to their use or the potential for oppressive surveillance or exploitation of users that these technologies present. What is often lost in such discussions is an acknowledgement of the value that digital technologies can offer ordinary users (and not just the internet empires that profit from them). Perspectives that can balance awareness of both the benefits and possible drawbacks of digital technologies provide a richer analysis of their affordances and social impact. When people are using digital technologies for leisure purposes, they are largely doing so voluntarily: because they have identified a personal use for the technologies that will provide enjoyment, relaxation or some other form of escape from the workaday world. What is particularly intriguing, at least from my perspective in my interest in lively data, is how the data streams from digitised leisure pursuits are becoming increasingly entangled with other areas of life and concepts of selfhood. Gamification and ludification strategies, in which elements of play are introduced into domains such as the workplace, healthcare, intimate relationships and educational institutions, are central to this expansion.

Thus, for example, we now see concepts of the ‘healthy, productive worker’, in which employers seek to encourage their workers to engage in fitness pursuits to develop highly-achieving and healthy employees who can avoid taking time out because of illness and operate at maximum efficiency in the workplace. Fitness tracker companies offer employers discounted wearable devices for their employees so that corporate ‘wellness’ programs can be put in place in which fitness data sharing and competition are encouraged among employees. Dating apps like Tinder encourage users to think of the search for partners as a game and the attractive presentation of the self as a key element in ‘winning’ the interest of many potential dates. The #fitspo and #fitspiration hashtags used in Instagram and other social media platforms draw attention to female and male bodies that are slim, physically fit and well-groomed, performing dominant notions of sexual attractiveness. Pregnancy has become ludified with a range of digital technologies. Using their smartphones and dedicated apps, pregnant women can take ‘belfies’, or belly selfies, and generate time-lapse videos for their own and others’ entertainment (including uploading the videos on social media sites). 3D-printing companies offer parents the opportunity to generate replicas of their foetuses from 3D ultrasounds, for use as display objects on mantelpieces or work desks. Little girls are offered apps which encourage then to perform makeovers on pregnant women or help them deliver their babies via caesarean section. In the education sector, digitised gamification blurs leisure, learning and physical fitness. Schools are beginning to distribute heart rate monitors, coaching apps and other self-tracking devices to children during sporting activities and physical education classes, promoting a culture of self-surveillance via digital data at the same time as teachers’ monitoring of their students’ bodies is intensified. Online education platforms for children like Mathletics encourage users to complete tasks to win medals and work their way up the leaderboard, competing against other users around the world.

In these domains and many others, the intersections of work, play, health, fitness, education, parenthood, intimacy, productivity, achievement and concepts of embodiment, selfhood and social relations are blurred, complicated and far-reaching. These practices raise many questions for researchers interested in digitised leisure cultures across the age span. What are the affordances of the devices, software and platforms that people use for leisure? How do these technologies promote and limit leisure activities? How are people’s data used by other actors and agencies and in what ways do these third parties profit from them? What do people know about how their personal details are generated, stored and used by other actors and agencies? How do they engage with their own data or those about others in their lives? What benefits, pleasures and opportunities do such activities offer, and what are their drawbacks, risks and harms? How are the carers and teachers of children and young people encouraging or enjoining them to use these technologies and to what extent are they are aware of the possible harms as well as benefits? How are data privacy and security issues recognised and managed, on the part both of those who take up these pursuits voluntarily and those who encourage or impose them on others? When does digitised leisure begin to feel more like work and vice versa: and what are the implications of this?

These questions return to the issue of lively data, and how these data are generated and managed, the impact they have on people’s lives and concepts of selfhood and embodiment. As I noted earlier, digital technologies contribute to new ways of reconceptualising areas of life as games or as leisure pursuits that previously were not thought of or treated in those terms. In the context of this move towards rendering practices and phenomena as recreational and the rapidly-changing sociomaterial environment, all social researchers interested in digital society need to be lively in response to lively devices and lively data. As the editors of this special issue contend, researching digital leisure cultures demands a multidisciplinary and interdisciplinary perspective. Several exciting new interdisciplinary areas have emerged in response to the increasingly digitised world: among them internet studies, platform studies, software studies, critical algorithm studies and critical data studies. The ways in which leisure studies can engage with these, as well the work carried out in sub-disciplines such as digital sociology, digital humanities and digital anthropology, have yet to be fully realised. In return, the key focus areas of leisure studies, both conceptually and empirically – aspects of pleasure, performance, politics and power relations, embodiment, selfhood, social relations and the intersections between leisure and work – offer much to these other areas of enquiry.

The articles published in this special issue go some way to addressing these issues, particularly in relation to young people. The contributors demonstrate how people may accept and take up the dominant assumptions and concepts about idealised selves and bodies expressed in digital technologies but also how users may resist these assumptions or seek to re-invent them. As such, this special issue represents a major step forward in promoting a focus on the digital in leisure studies, working towards generating a lively leisure studies that can make sense of the constantly changing worlds of lively devices and lively data.

Review of Social Media for Academics

I have written many times on this blog about my own experiences of using social media and other digital tools for academic work and my research focusing on how other academics are doing this.

One of the people I have encountered along the way is Mark Carrigan, an early career British sociologist. Appropriately enough, we first met on Twitter a few years ago, around the time I began experimenting with various digital tools for professional purposes. Since then, we have had many discussions there and on other online forums, as well as by email, about using social media in universities (and a couple of in-person meetings as well). Mark has now written a book on Social Media for Academics. It is the first book I know of to present a ‘how-to’ manual combined with reflections on the wider implications of  academic social media engagement.

Mark is a great example of someone who has strategically used social media while still in the very early stages of his career (completing his doctorate) to create a high profile for his work. He has now built on this experience not only to work in various positions involving promoting academic journals, departments and organisations, but to produce this book. In its chapters, Mark employs a casual, chatty style to painlessly introduce readers to the art of academic social media.

The book is distinctive because Mark’s sociological training allows him to contextualise the social, cultural and political implications of academic social media use. Yes, he offers  a multitude of helpful tips and advice about how best to communicate online, what platforms and tools are the most effective, how to develop your own voice, how online engagement helps in promoting one’s research and reaching wider audiences outside academia, building networks, curating interesting material you have found on the internet, finding time to use social media and so on. But there are also reflections offered on what academic social media means for professional identities and for academic work in general. In addition there are many pithy remarks drawing on Mark’s observations, for example, of the awkwardness that sometimes accompanies the experience of colleagues meeting in the flesh after having developed a hitherto purely online relationship, or the potential pitfalls of live-tweeting conferences or writing a tweet or blog post in haste and anger that then becomes widely circulated well after the initial irritation has subsided.

This book is highly recommended for higher degree students and faculty staff members who are interested in the possibilities of academic social media for both research and teaching, as well as researchers interested in future directions for the university workplace and academic identities.

 

Digitised dissection: medical procedures on the internet

 

This is an excerpt from my book in progress, Digital Health: Critical Perspectives, to be published by Routledge in 2017.

With the advent of websites, social media platforms and apps, the internal organs and workings of the body have moved from being exclusively the preserve of medical students and surgeons. Digital medical devices have entered into the public arena of the internet, offering new possibilities for lay people to gaze inside the spectacle of the human body. A vast volume of computerised medical images of human life from conception to death are now readily available online. Tapping in such keywords as ‘human anatomy’ will call up many apps on the Apple App Store or Google Play which provide such details. While these apps have been explicitly designed for the use of medical and other healthcare students and trainees, they are readily available to any person who may wish to download them. The Visible Human Project developed by the US National Library of Medicine is an earlier example of how human flesh can be rendered into a digital format and placed on the internet for all to view. The developers of The Visible Human Project used digital technologies to represent in fine detail the anatomical structure of two cadavers (one male and one female). Each body was cross-sectioned transversely from head to toe. Images of the sections of the bodies using MRI and CT scans and anatomical images were uploaded to the Project website. They can also be viewed at the National Museum of Health and Medicine in Washington DC. A similar website, The Visible Embryo, displays images of embryos and foetuses from fertilisation to birth, with a week-by-week display showing the stages of foetal development. The data used for this website were drawn from digitising microscopic cross-sections of human embryo specimens held on slides in The National Institutes of Health’s Carnegie Collection of Embryos as well as from 3D and 4D digital foetal ultrasound images.

Many opportunities are provided on the internet for people who want to view detailed images of surgical and other medical procedures in their full gory detail. YouTube has become a major provider of anatomical and surgical technique videos for medical training. Some medical specialists and surgeons upload images and videos of their work to Snapchat and Instagram, mostly in the effort to promote their services (cosmetic surgeons are in the forefront in this practice). Instagram does not allow users to upload images that are considered too explicit (such as those portraying surgery on breasts or genitals), so some doctors have turned to Snapchat as an alternative forum. One infamous such specialist is Sandra Lee, a dermatologist known as ‘Dr Pimple Popper’. Her Instagram photos and YouTube videos showing her at work have received many millions of views. Perhaps the best-known Snapchatting medical specialist is the cosmetic surgeon ‘Dr Miami’ (Michael Salzhauer), who uploads detailed photos and videos of his surgical procedures (including controversial procedures like labiaplasties, or surgery designed to reshape women’s external genitals). ‘Dr Miami’ is unafraid to Snapchat images of himself brandishing a wad of body fat he has just excised in a tummy tuck. He employs two full-time staff members to manage his social media accounts.

The use of web-streaming services is employed by a number of hospitals to host webcasts of surgical procedures for any interested person to view. The US National Library of Medicine provides a list on its website of several such webcasts with hyperlinks, from numerous different American hospitals. Lay people may now even view live-streamed surgical procedures using a smartphone app and wearing a virtual reality headset to provide a 3D immersive effect, as offered by the Medical Realities company in April 2016. This technology is designed principally for training medical students, but also allows lay people who participate to feel as if they are present in the operating theatre.

Pinterest, an image-curating and sharing platform, features many collections of images related to medical matters. Several of these relate to patient experiences of health, but others are curated by medical and nursing students and practising healthcare providers. Some are humorous, featuring memes, cartoons or other images designed to appeal to medical and nursing students and other trainees in the health professions. Other Pinterest photographs feature novelty commodities, again clearly directed to the same audience (for example, anatomical heart or ECG heart beat cookie cutters, human-organ and stethoscope-shaped jewellery, coffee mugs in the shape of spinal vertebrae). While these images are vastly outnumbered by the serious photographs in Pinterest collections that show anatomical images and other medical information (some of which are explicit photographic images that detail flesh, bone and blood), they offer alternative representations of the ways in which human bodies and the practice of healthcare are represented online.

The major differences offered by the latest digital technologies that document and monitor the human body are the continual nature of the surveillance opportunities they present, their expansion from the clinic into domestic and intimate spaces and relationships and their feedback mechanisms, which allow their subjects to ‘read’ and interpret their own bodies via biometric measurements. Medical practices that were once embodied in the flesh, including the development of doctors’ expertise in touching the patient’s body and determining what is wrong, have increasingly become rendered into software such as the video conferencing services offered in remote telemedicine technologies. Virtual bodies have been developed for medical training purposes, allowing students to conduct virtual surgery. To achieve this virtuality, the processes by which doctors practice – their customs, habits and ways of thinking – are themselves digitised. Both doctors and patients are rendered into ‘informatic “body objects”, digital and mathematical constructs that can be redistributed, technologized, and capitalized’ (Prentice, 2013: 20).

Many digital health technologies are directed at illuminating the exterior or interior of the human body with the use of metrics that may represent features of the body as numbers or graphs. The use of apps to collect information about body functions and movements, for example, generates a continuing set of images that represent the body. Biometric data serves first to fragment the body into digitised pieces of information and then to combine these pieces into a recombinant whole that is usually presented in some kind of visual form. Amoore and Hall (2009: 48) use the term ‘digitised dissection’ to refer to the ways in which biometric whole body scanners at airports operate. This term is even more apposite when adopted to discuss the fragmentation of bodies in the context of digital health. Digital technologies are able to peer into the recesses of the body in ever-finer detail, creating new anatomical atlases.

References

Amoore, L. & Hall, A. (2009) Taking people apart: digitised dissection and the body at the border. Environment and Planning D: Society and Space, 27, 444-64.

Prentice, R. (2013) Bodies in Formation: an Ethnography of Anatomy and Surgery EducationDurham, NC: Duke University Press.