Testing in Translation: Conducting Usability Studies With Transnational Users

What do we mean by usability in everyday life? For us, everyday life implies the series of choices and decisions that happen each day as people are trying to get things done. These things are often taken for granted, they might seem mundane, they may be overlooked. Usability inhabits everyday life in the documents used by a Vietnamese mother of two young children, having recently moved to the United States, and navigating the healthcare system in a new country for the first time. Usability shows up again as a Chinese couple considers whether or not to move out of their father’s home in a Seattle neighborhood, but wonder how it might impact the family’s ability to afford health insurance

Expert Yet Vulnerable: Understanding the Needs of Transit Dependent Riders to Inform Policy and Design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Expert yet vulnerable: Understanding the needs of transit dependent riders to inform policy and design

Transportation is a crucial resource that links people to jobs, social networks, community and services. The transit dependent -- those who do not own private vehicles -- occupy a unique position. They are expert in their knowledge of public transportation while vulnerable to the failures and limitations of transit. This paper presents the results of a study that is aimed at understanding the lived experience of transit dependent riders. Using a framework of structuration theory as an analytic lens, we provide a thematic analysis of qualitative data including interviews with socially connected groups of people and video diaries. The results demonstrate the expertise that transit dependent riders have about transit and its policies and how they deploy that expertise in productive and cunning ways to make the system work for them. The analysis of this data resulted in three categories of agency to consider when designing for vulnerable populations: resourcefulness, reciprocity and powerlessness. The paper concludes by advocating for a human-centered approach to designing systems in community informatics and offers a set of guiding questions for designers of information and communication technologies (ICTs) to consider, especially with regards to vulnerable populations

Breakfast and exercise contingently affect postprandial metabolism and energy balance in physically active males

The present study examined the impact of breakfast and exercise on postprandial metabolism, appetite and macronutrient balance. A sample of twelve (blood variables n 11) physically active males completed four trials in a randomised, crossover design comprising a continued overnight fast followed by: (1) rest without breakfast (FR); (2) exercise without breakfast (FE); (3) breakfast consumption(1859 kJ) followed by rest (BR); (4) breakfast consumption followed by exercise (BE). Exercise was continuous, moderate-intensity running (expending approximately 2·9MJ of energy). The equivalent time was spent sitting during resting trials. A test drink (1500 kJ) was ingested on all trials followed 90 min later by an ad libitum lunch. The difference between the BR and FR trials in blood glucose time-averaged AUC following test drink consumption approached significance (BR: 4·33 (SEM 0·14) v. FR: 4·75 (SEM 0·16) mmol/l; P¼0·08); but it was not different between FR and FE (FE: 4·77 (SEM 0·14) mmol/l; P¼0·65); and was greater in BE (BE: 4·97 (SEM 0·13) mmol/l) v. BR(P¼0·012). Appetite following the test drink was reduced in BR v. FR (P¼0·006) and in BE v. FE (P¼0·029). Following lunch, the most positive energy balance was observed in BR and least positive in FE. Regardless of breakfast, acute exercise produced a less positive energy balance following ad libitum lunch consumption. Energy and fat balance is further reduced with breakfast omission. Breakfast improved the overall appetite responses to foods consumed later in the day, but abrogated the appetite suppressive effect of exercise

Community-Based User Experience: Evaluating the Usability of Health Insurance Information With Immigrant Patients

User experience (UX), a common practice in corporate settings, is new for many nonprofit organizations. This case study details a community-based research project between nonprofit staff at a community health center and UX professionals to improve the design and usability of a document designed to help immigrant patients sign up for health insurance. UX professionals may need to adapt and be flexible with their efforts, but can offer valuable skills to community partners. Research questions: (1) What are the information needs and barriers faced by immigrant populations signing up for health insurance? (2) How does a usability study, adapted to meet the needs of immigrant populations, inform the design of a supplemental guidebook about health insurance? (3) What are the challenges and opportunities when engaging in community-based UX research projects? Situating the case: Other community-based research projects in technical communication and UX point to the need for a clear conceptualization of participation, a strong partnership with nonprofits, and the need to develop meaningful and actionable insights. Furthermore, when conducting studies with immigrant populations, the role of the translator on the research team is crucial. Methodology: As a community-based research project focused on the collaborative generation of practical knowledge, we conducted a usability study with 12 participants in two language groups, Chinese and Vietnamese, to evaluate the design and usability of a guidebook designed to provide guidance about enrolling in a health insurance plan. Data were analyzed to identify usability concerns and used to inform a second iteration of the guidebook. About the case: Immigrant populations struggle to sign up for health insurance for a variety of reasons, including limited English and health insurance literacy. As a result, a nonprofit community health center developed a guidebook to support immigrant populations. Version 1 of this guidebook was evaluat- d in a usability study, with results showing that users struggled to correctly choose a plan, determine their eligibility, and interpret abstract examples. As a result, Version 2 was designed to support the in-person experience, reduce visual complexity, and support patients\u27 key questions. Conclusions: Community-based UX collaborations can amplify the expertise of UX and nonprofit professionals. However, UX methods may need to be adapted in community-based projects to better incorporate local knowledge and needs

Development and validation of Australian aphasia rehabilitation best practice statements using the RAND/UCLA appropriateness method

Objectives: To develop and validate a national set of best practice statements for use in post-stroke aphasia rehabilitation. Design: Literature review and statement validation using the RAND/UCLA Appropriateness Method (RAM). Participants: A national Community of Practice of over 250 speech pathologists, researchers, consumers and policymakers developed a framework consisting of eight areas of care in aphasia rehabilitation. This framework provided the structure for the development of a care pathway containing aphasia rehabilitation best practice statements. Nine speech pathologists with expertise in aphasia rehabilitation participated in two rounds of RAND/UCLA appropriateness ratings of the statements. Panellists consisted of researchers, service managers, clinicians and policymakers. Main outcomes measures: Statements that achieved a high level of agreement and an overall median score of 7–9 on a nine-point scale were rated as ‘appropriate’. Results: 74 best practice statements were extracted from the literature and rated across eight areas of care (eg, receiving the right referrals, providing intervention). At the end of Round 1, 71 of the 74 statements were rated as appropriate, no statements were rated as inappropriate, and three statements were rated as uncertain. All 74 statements were then rated again in the face-to-face second round. 16 statements were added through splitting existing items or adding new statements. Seven statements were deleted leaving 83 statements. Agreement was reached for 82 of the final 83 statements. Conclusions: This national set of 82 best practice statements across eight care areas for the rehabilitation of people with aphasia is the first to be validated by an expert panel. These statements form a crucial component of the Australian Aphasia Rehabilitation Pathway (AARP) (http://www.aphasiapathway.com.au) and provide the basis for more consistent implementation of evidence-based practice in stroke rehabilitation

Associations of Alcohol Consumption With Epigenome-Wide DNA Methylation and Epigenetic Age Acceleration : Individual-Level and Co-twin Comparison Analyses

Background DNA methylation may play a role in the progression from normative to problematic drinking and underlie adverse health outcomes associated with alcohol misuse. We examined the association between alcohol consumption and DNA methylation patterns using 3 approaches: a conventional epigenome-wide association study (EWAS); a co-twin comparison design, which controls for genetic and environmental influences that twins share; and a regression of age acceleration, defined as a discrepancy between chronological age and DNA methylation age, on alcohol consumption. Methods Participants came from the Finnish Twin Cohorts (FinnTwin12/FinnTwin16; N = 1,004; 55% female; average age = 23 years). Individuals reported the number of alcoholic beverages consumed in the past week, and epigenome-wide DNA methylation was assessed in whole blood using the Infinium HumanMethylation450 BeadChip. Results In the EWAS, alcohol consumption was significantly related to methylation at 24 CpG sites. When evaluating whether differences between twin siblings (185 monozygotic pairs) in alcohol consumption predicted differences in DNA methylation, co-twin comparisons replicated 4 CpG sites from the EWAS and identified 23 additional sites. However, when we examined qualitative differences in drinking patterns between twins (heavy drinker vs. light drinker/abstainer or moderate drinker vs. abstainer; 44 pairs), methylation patterns did not significantly differ within twin pairs. Finally, individuals who reported higher alcohol consumption also exhibited greater age acceleration, though results were no longer significant after controlling for genetic and environmental influences shared by co-twins. Conclusions Our analyses offer insight into the associations between epigenetic variation and levels of alcohol consumption in young adulthood.Peer reviewe

Pneumococcal carriage following PCV13 delivered as one primary and one booster dose (1 + 1) compared to two primary doses and a booster (2 + 1) in UK infants

In January 2020 the UK changed from a 2 + 1 schedule for 13-valent pneumococcal conjugate vaccine (PCV13) to a 1 + 1 schedule (doses at 3 and 12 months) based on a randomized immunogenicity trial comparing the two schedules. Carriage prevalence measured at the time of booster and 6 months later in 191 of the 213 study infants was 57 % (109/191) and 60 % (114/190) respectively. There were eight episodes of vaccine-type (VT) or vaccine-related 6C carriage in the 2 + 1 and six in the 1 + 1 group; ≥4-fold rises in serotype-specific IgG in 71 children with paired post-booster and follow up blood samples at 21–33 months of age were found in 20 % (7/35) of the 2 + 1 and 15 % (6/41) of the 1 + 1 group. VTs identified in carriage and inferred from serology were similar comprising 3, 19A and 19F. Dropping a priming dose from the 2 + 1 PCV 13 schedule did not increase VT carriage in the study cohort. Ongoing population level carriage studies will be important to confirm this