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What’s Next in Health Care Apps?

Health Care AppsRising costs and access to health care are issues that weigh heavily on Americans and their families. These issues deepen when it comes to mental health. Common mental illnesses can be extraordinarily disabling, and yet, many patients do not receive treatment.

Stephen Smith ’17 believes technology will be part of the solution.

After winning his own battle with obsessive compulsive disorder (OCD), the economics grad has used his experience to help others by creating a smart-phone app that provides on-the-go treatment to fight the condition.

The app, which he dubbed nOCD, records real-time data, offers guided cognitive behavioral exercises and allows people with OCD to join in-app support communities at any hour of any day. With this technology, users get 24/7 clinically approved care and are connected to a community that understands them.

“People are always wondering how you’re going to treat mental illness, given the shortage of licensed mental health clinicians,” says Smith. “And the answer is through technology.”

Smith sees this technology trend not only for mental health but for healthcare overall.

“The healthcare industry today is going ‘more mobile’ and ‘more digital’ given that technology offers consumers an always-on, personalized treatment experience,” he says. “Since the majority ‘at-risk’ populations are already actively engaged in technology, utilizing digital solutions to deliver care can have both an immediate clinical as well as an economic impact for both the patient and provider.”

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What’s Next in Treating Mental Illness?

People in confusion. Concept of fusion of thoughtsWhat’s next in the treatment of mental illness will be a direct outcome of what’s now, according to Pomona College Professor of Psychology Sara Masland. Two developments in the field may, over time, transform treatment of psychological disorders.

The name of the first development sounds tricky to understand, but it’s really pretty straightforward. The National Institute of Mental Health started a framework called RDoC (Research Domain Criteria) that encourages researchers not to stick strictly to the textbook—or in psychological cases, standard diagnostic manuals—when studying disorders. Instead, they look more carefully at a person in all their complexities.

“We now have a good deal of information that suggests that the lines we draw are not always appropriate,” says Masland. “This framework seeks to take a step back and understand differences in the functioning of basic human processes across multiple levels and units of analysis.” By levels of analysis she means genes and behavior, and she’s talking about processes like reward processing and basic cognition.

More nuanced diagnoses dovetail with a second development: research that uses mathematical models to understand which symptoms and experiences are central and which may be caused by these primary symptoms.

“As a clinician, I might see a patient come in who reports five symptoms, and I can conclude that they co-occur,” says Masland. “But what is hard to get a good sense of is how these symptoms contribute to one another. Which came first? Does the presence of one cause or exacerbate the presence of another?”

If a psychologist can see a map of symptoms, she says, treatment can be more targeted.

These two developments offer a lot of promise for the future. Masland foresees the possibility of a move away from relying on flawed (yet still useful) diagnostic categories toward a more empirical approach. Over time, she hopes this will destigmatize psychological disorders and build compassion as well as clarity. With the new model of symptom mapping, Masland says targeted treatment will become more personalized and efficient.

Masland also believes both of these approaches will change how we understand the basic mechanisms of psychopathology. That change in understanding will, in turn, change the treatment landscape. Ultimately, her hope is that “they will lead to better understanding of human experience more broadly.”

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What’s Next in Big Data?

dataFor many of us, the words “big data” have taken on sinister connotations, evoking stories of data breaches, manipulation and abuse. But in medicine and pharmacology, Jan Lethen ’93 believes big data is already saving lives—and in the future, it’s going to get even bigger and save many more.

As director of statistical programming in observational research at the biopharmaceutical firm Amgen, Lethen works with a storehouse of anonymous data from over 100 million patients worldwide. Statistical research based on that data, he says, permits companies like Amgen “to support product safety, to profile diseases, to design more effective clinical trials and to forecast populations that would most benefit from our drugs.”

As a sign of the future, Lethen points to a new app that pairs with Apple’s iWatch, enabling patients to link their health records to their biometric data, potentially making that linked data available for researchers. “We’re seeing more and more types of data being brought together and linked together,” he says. “So that might include genetic data, which is critical in fields like oncology.”

He also points to an NIH-funded initiative called “All of Us,” which seeks to collect genetic data and other health data from a million Americans for research purposes. “These data sets are going to get ever more complex, ever more extensive, ever more complete in the history of the patient,” he says.

Indeed, the ability to tailor medicine to the patient may become so exact that drug companies may charge only for successful treatments. “That’s a move that a number of pharma companies are currently working on with payers,” Lethen says. “They can say, ‘Hey, if you give our drug to these patients with these characteristics and it doesn’t work, you don’t have to pay for the drug.’ That will be a new business model that will continue to expand.”

The ultimate goal, he says, will be medicines tailored to a single individual. “Especially with oncology, you could say, ‘Hey, if you use this therapy in conjunction with these two other things, we are confident it’s going to work for you. The level of detail that we have on each patient right now doesn’t allow us to do that, but as we build out those genetic profiles for each patient and they become more and more unique, we’ll be able to build profiles that actually do get down to very small patient cells, and perhaps, eventually, to a patient level of one.”

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What’s Next for the Blind?

blindThe 1970s TV show The Six Million Dollar Man (which now seems quaintly underpriced in today’s dollars) brought the word “bionic” into general use, with sci-fi connotations that it has never completely shed. But one area of prosthetics where fact has begun to overtake fiction is in the world of bionic vision. In 2015, the Honolulu-based ophthalmologist Dr. Gregg Kokame ’78 was the first physician in the Asia-Pacific region to implant a bionic eye, giving a patient who had been blind from hereditary retinal disease the gift of sight.

The process involves inserting into the eye a 60-microelectrode implant, which transfers impulses from a tiny camera attached to a pair of glasses directly to the patient’s retina. “It does not allow people to recover reading vision,” he explains, “but they do recover the ability to ambulate, the ability to see figures, the ability to see somebody come into a room. They can even pick out patterns. So they can do a lot more than they could do before.”

Future bionic eyes, Kokame says, may permit patients to see in color or to read a book, but first researchers will have to break the brain’s code for color vision and develop even tinier and cooler microelectrodes so that more of them can be added to the matrix without overheating the eye. “Amazingly,” he adds, “for patients whose eyes or optic nerves are not working at all, they are trying to bypass the eye completely and implant electrodes directly on the brain.”

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What’s Next in Biodiversity?

extinctionWe are in the middle of a mass extinction event, says Professor of Biology Nina Karnovsky, and, this time, it’s our fault.

“It’s called the Anthropocene Era because it’s being caused by humans,” says Karnovsky, who specializes in the study of seabirds. “The warming of our planet, the destruction of habitat, pollution and other contaminants are causing widespread extinctions. It is really grim. I don’t think I would be able to cope if I didn’t try every day to do something to ameliorate this overwhelming thing that’s happening around us.”

Paying attention is one way to make a difference, says Karnovsky, who assigns her students to keep journals and record their observations.

“It’s extremely important to be a great naturalist and to keep track of what you’re seeing around you, and to notice and document that,” she says. “If you aren’t really noticing the change in the species, then you won’t notice when they’re gone.”

In fact, many species that we didn’t know about are already lost, says Karnovsky. It’s not just about climate change, but habitat destruction, harvesting, oil spills and other things that are causing a “vortex of extinction.” And when a population gets impacted and can’t recover, that affects other species, including humans.

“It’s not esoteric. It’s a social justice issue,” says Karnovsky. “There isn’t enough food to eat because the ice has changed; the marine mammals aren’t coming into the fjords where they used to come and people used to hunt them. So for these communities, this is life or death.”

Compounding the problems in identifying and studying endangered species are cuts to research made by the current administration, making it harder for researchers to keep up sustained studies, where they return to the same locations to test for changes that show a species has become more vulnerable.

For Karnovsky, the warnings are clear and call for some big decisions about what direction we’re going. “We need to tell our leaders, and it has to be a multi-pronged approach.” She says. “We have to be active on political fronts, but also in our daily lives.’

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What’s Next for the Sagehen?

SagehenPomona College’s mascot, the sagehen—the sage grouse in the real world—needs a “lek” up.

A rare collaboration between conservation and energy interests came together to protect the sage grouse’s mating habitat—known as leks. But the U.S. Interior Department led by Secretary Ryan Zinke is now re-examining the plan in order to prioritize energy development, leading to an uncertain future for our beloved mascot.

Jessica Blickley ’02, an ecologist at Pasadena City College, studied the sage grouse as a graduate student at UC Davis and lays out the history, present and potential future of Cecil’s brethren.

Historically, the sage grouse’s habitat spanned the western United States, but as grazing land overtook wild land, as invasive grasses crept over native sagebrush, as wildfires grew in ferocity and frequency, and as natural gas, oil and wind developments popped up, the sage grouse’s domain has shrunk. And with shrinking domains, explains Blickley, there’s less space for the sage grouse to puff up their chests and attract mates. That means shrinking populations.

That’s why, a few years ago, a diverse group of concerned stakeholders, from state governments to private landowners, came together to craft a large-scale sage grouse conservation plan focused on protecting the bird’s natural habitat. In 2015, this multi-state effort led the U.S. Fish and Wildlife Service to keep the sage grouse off the Endangered Species Act (ESA), a decision the Audubon Society saw as a nod to the ongoing success of the plan.

“The conservation plan seemed to be working well until 2017 when Zinke decided he was going to put this conservation plan under review and change it,” says Blickley. “In addition, there is currently a bill in Congress that would specifically prevent future listing of the sage grouse under ESA. Due to these federal actions, the future of the sage grouse is much less certain than just a few years ago.”

But Blickley hasn’t lost hope. “My hope comes from the state level. In the state of Wyoming, where 40 percent of the sage grouse are found, the Republican governor believes strongly in the collaborative conservation plan, so hopefully many of the state level regulations will go into place.”

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What’s Next for Science Museums?

Two kids looking at a science exhibit, back viewScience museums are not just science lessons for kids any more.

As president and CEO of the Science Museum of Minnesota, Alison Brown ’80 says science museums are becoming something more—more contemplative, more thought-provoking, more people-oriented. “I’m leading a team that is helping us move away from the idea that museums curate only the facts and tell you what’s what,” says Brown, who is also a vice chair of the Board of Trustees of Pomona College. “We will always do real science. We also want our museum to be the place where you’re having two-way conversations and contributing your experience to the collective understanding—all while you’re having fun.”

In the ‘70s, she says, science museums were noisy with hands-on interactives and gadgets. “As people start seeing science museums not just as places for pushing buttons and pulling levers, but as places where they’re engaged in conversation and joining us in creating experiences that are worth their time—that’s an exciting future.”

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What’s Next in Space Exploration?

space explorationAs we near the 50th anniversary of the first moonwalk, Colleen Hartman ’77 believes the next chapter in human space exploration is not far away. “When I talk to high-school and younger groups, I always tell them that I’ll be alive when the first human puts her foot down on Mars, and they always laugh,” she says.

But what brings Hartman to work each day as director of the Sciences and Exploration Directorate of NASA’s Goddard Space Flight Center is the extraordinary science that continues to be done through spacecraft with no astronauts aboard. As an example, she points to a couple of new spaceborne telescopes that are likely to kick the search for exoplanets—planets circling other stars—into high gear.

Although the number of confirmed exoplanets has exploded into the thousands since the launch of the Kepler spacecraft in 2009, we still know next to nothing about them. With the launch of TESS (the Transiting Exoplanet Survey Satellite) in April 2018 and the planned launch of the James Webb Space Telescope in 2020, NASA hopes to change that, Hartman says. “Whereas Kepler looked at only a tiny fraction of the sky,” she explains, “TESS will look for extrasolar planets all around our closer neighborhood, where hopefully, we can have follow-up observations with the James Webb Space Telescope.” Those observations, she says, should give us our first detailed analysis of the chemical makeup of an exoplanet’s atmosphere.

Other upcoming NASA missions of particular note include:

  • The Parker Solar Probe (Planned launch: August 2018)—This probe’s orbit will carry it to within 3.8 million miles of the sun, which is actually inside the sun’s corona. Able to withstand temperatures of up to 2,500 degrees Fahrenheit, the probe will study such things as the solar wind and mass ejections. “This mission will help us understand the relationship between the sun and the Earth in ways we never could before,” Hartman says.
  • The Wide Field infrared Survey Telescope or WFIRST (Planned launch: 2020)—WFIRST will join in the search for exoplanets, but it will also play a key role in the effort to solve the most baffling mystery in astrophysics today. “Approximately three quarters of the universe is made of something we call dark energy, because it doesn’t interact with anything and we don’t really understand what it is,” she says. “WFIRST will be looking for clues about dark energy as well.”
  • The Europa Clipper (Planned launch: sometime in the 2020s)—This probe will investigate the habitability of Jupiter’s icy moon Europa. “To me, this is one of the most exciting things at NASA,” Hartman says. “When we’re looking for life on other planets, we’re looking for water, but it turns out that here in our own solar system, you can have a frozen icy moon, and under the frozen surface, a liquid ocean. That’s Europa. I like to joke that if there’s life in that liquid ocean, they’re not going to be very good astronomers.”

One thing Hartman says she can’t predict is the practical benefits that will accrue from continued exploration of the solar system and beyond, but she’s sure there will be many of them. “There’s plenty to discover and investigate, and I do think there’ll be a lot of practical output from some of these investigations, but you don’t necessarily know beforehand what the spinoffs will be. It’s serendipitous, and that’s part of the joy.”

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What’s Next in Social Media?

Social MediasWhen he’s traveling, Eric Oldrin ‘95 likes to make his kids laugh by connecting with them on Facebook Messenger with bunny ears and a cute little bunny mask on his nose. Of course, Facebook’s head of emerging platforms doesn’t really put on a bunny mask—it all happens in cyberspace, using augmented reality (AR).

AR is the digital technology that made Pokémon Go such a sensation. Today, it’s bringing a touch of fantasy to the world of social media, and Oldrin thinks we’ve only skimmed the surface of what’s to come. For instance, a variety of brands—from Sephora to Nike—are using AR in their marketing, for both playful and practical reasons. As an example, he cites a new Messenger experience that allows potential drivers to see what a car from Kia might look like in their driveway. The possibilities, he believes, are wide open

And then, of course, there’s virtual reality (VR), which requires a bit more equipment, such as Facebook’s newly released Oculus Go—a headset that allows you to step into a digitally created world. Oldrin is intrigued by VR’s potential to make people feel like they’re in a room together, even when they’re actually oceans apart.

“In VR, there’s an incredible opportunity to defy distance and to create a sense of presence across borders,” he says. “Let’s say, you and I decide we’re going to go see U2 in Sao Paulo together. We’ll be able to do that by being there at the same time in this virtual space. I probably would never go to Sao Paulo to see a concert in real life, but in virtual reality, I’ll have that opportunity.”

Indeed, for Oldrin, that’s what the future of Facebook and other social media is all about—the ongoing search for better and more compelling ways to bring people together.

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What’s Next in Cyber-Threats?

Cyber ThreatsWhen Professor of Media Studies Mark Andrejevic started writing about what he calls “the surveillance economy” back in 2001, “I was considered to be a very angry, cranky, dystopian naysayer,” he recalls. “But recently—and especially in this past year—it’s become a commonplace that we live in a surveillance society in which our information is leveraged for profit. And so, it’s a weird feeling of vindication and, also, helplessness.”

Vindication because his dire warnings have clearly come true as companies and institutions comb our interactive lives to build bigger and more intrusive profiles.

Helplessness because he thinks it may already be too late to do anything about it.

That’s partly because sites like Amazon and Facebook have become a way of life, and partly because new technologies are creating bold new ways for information to be gathered, marketed and leveraged—not just to anticipate what we might buy, but to parse how we think, what our vulnerabilities are and how they can be exploited.

One concern, he says, is the proliferation of “smart” devices—from speakers that answer our queries and play our favorite music to appliances that know how we like our toast or coffee. “These are very convenient devices,” he admits. “At the same time, they are a new frontier in data and information collection. There are already patents floating around for how to use the information that can be picked up through smart speakers in the home in order to anticipate consumer desires and craft marketing campaigns. And as those interfaces become increasingly interactive, they generate new forms of monitoring and surveillance. Do we really want our washing machines and microwaves keeping track of the rhythms of our daily lives?”

Another assault on our privacy, he says, involves advances in such technologies as facial recognition, gait recognition and license-plate reading. “We’ve always thought of public space as being associated with the anonymity of the crowd,” he says, “but that’s fast eroding. You’re no longer moving in a space where your identity is largely unknown and the traces of your activities ephemeral. Soon every action you take walking down the street will be linked to your identity.”

How might that look? Consider the times you’ve searched for something on a website, then found ads for it everywhere you went online. Now imagine that happening as you pass signs in a mall or even billboards on the highway.

One device that Andrejevic worries about in particular is the fitness tracker, which is constantly gathering information about your health and storing it online. Sounds great, until you think about that information in the hands of your insurance company. “As Obamacare gets dismantled, which seems to be the case, insurers will be able to discriminate based on pre-existing conditions again,” he says. “And, you know, this type of information is very useful for companies who want to do that type of screening.”

Meanwhile, in the world of politics, the use of voter profiles to manipulate the vote is the wave of the future. “Now campaigns know so much about voters that they can custom-tailor messaging, both to rally supporters and to attempt to suppress the participation of opponents’ supporters,” Andrejevic notes. “I don’t believe that Cambridge Analytica had anywhere near the influence they claim for themselves, but the political model they embraced will continue to get more sophisticated.”

To date, Andrejevic says, many of his dystopic predictions have come true, which makes him deeply pessimistic about the future. “But working with the students here actually makes me quite optimistic because our students are wonderful,” he says. “If there’s any hope, it’s the students. I have those moments when I’m thinking, ‘Can you guys take over now? Because we need you.’”

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