"Hey, Can You Add Captions?": The Critical Infrastructuring Practices of Neurodiverse People on TikTok

Accessibility efforts, how we can make the world usable and useful to as many people as possible, have explicitly focused on how we can support and allow for the autonomy and independence of people with disabilities, neurotypes, chronic conditions, and older adults. Despite these efforts, not all technology is designed or implemented to support everyone's needs. Recently, a community-organized push by creators and general users of TikTok urged the platform to add accessibility features, such as closed captioning to user-generated content, allowing more people to use the platform with greater ease. Our work focuses on an understudied population -- people with ADHD and those who experience similar challenges -- exploring the creative practices people from this community engage in, focusing on the kinds of accessibility they create through their creative work. Through an interview study exploring the experiences of creatives on TikTok, we find that creatives engage in critical infrastructuring -- a process of bottom-up (re)design -- to make the platform more accessible despite the challenges the platform presents to them as creators. We present these critical infrastructuring practices through the themes of: creating and augmenting video editing infrastructures and creating and augmenting video captioning infrastructures. We reflect on the introduction of a top-down infrastructure - the implementation of an auto-captioning feature - shifts the critical infrastructure practices of content creators. Through their infrastructuring, creatives revised sociotechnical capabilities of TikTok to support their own needs as well as the broader needs of the TikTok community. We discuss how the routine of infrastructuring accessibility is actually best conceptualized as incidental care work. We further highlight how accessibility is an evolving sociotechnical construct, and forward the concept of contextual accessibility.Comment: To be published in: Proc. ACM Hum.-Comput. Interact. CSCW '2

Maximizing as a predictor of job satisfaction and performance: A tale of three scales

Research on individual differences in maximizing (versus satisficing) has recently proliferated in the Judgment and Decision Making literature, and high scores on this construct have been linked to lower life satisfaction as well as, in some cases, to worse decision-making performance. The current study exported this construct to the organizational domain and evaluated the utility of the three most widely used measures of maximizing in predicting several criteria of interest to organizational researchers: job satisfaction, intentions to quit the organization, performance in the job role, and income. Moreover, this study used relative weight analyses to determine the relative importance of maximizing and two dispositional variables (conscientiousness and core self-evaluations) that are traditionally used to predict these criteria in the organizational literature. Results indicate that relationships between maximizing and these criteria are influenced by the way in which maximizing is measured. Yet, regardless of how it is measured, maximizing is not a particularly strong predictor of these criteria compared to traditional organizational predictors. Limitations and future research directions are discussed

Getting evidence into clinical practice: protocol for evaluation of the implementation of a home-based cardiac rehabilitation programme for patients with heart failure

INTRODUCTION: Cardiac rehabilitation (CR) improves health-related quality of life and reduces hospital admissions. However, patients with heart failure (HF) often fail to attend centre-based CR programmes. Novel ways of delivering healthcare, such as home-based CR programmes, may improve uptake of CR. Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) is a new, effective and cost-effective home-based CR programme for people with HF. The aim of this prospective mixed-method implementation evaluation study is to assess the implementation of the REACH-HF CR programme in the UK National Health Service (NHS). The specific objectives are to (1) explore NHS staff perceptions of the barriers and facilitators to the implementation of REACH-HF, (2) assess the quality of delivery of the programme in real-life clinical settings, (3) consider the nature of any adaptation(s) made and how they might impact on intervention effectiveness and (4) compare real-world patient outcomes to those seen in a prior clinical trial. METHODS AND ANALYSIS: REACH-HF will be rolled out in four NHS CR centres across the UK. Three healthcare professionals from each site will be trained to deliver the 12-week programme. In-depth qualitative interviews and focus groups will be conducted with approximately 24 NHS professionals involved in delivering or commissioning the programme. Consultations for 48 patients (12 per site) will be audio recorded and scored using an intervention fidelity checklist. Outcomes routinely recorded in the National Audit of Cardiac Rehabilitation will be analysed and compared with outcomes from a recent randomised controlled trial: the Minnesota Living with HF Questionnaire and exercise capacity (Incremental Shuttle Walk Test). Qualitative research findings will be mapped onto the Normalisation Process Theory framework and presented in the form of a narrative synthesis. Results of the study will inform national roll-out of REACH-HF. ETHICS AND DISSEMINATION: The study (IRAS 261723) has received ethics approval from the South Central (Hampshire B) Research Ethics Committee (19/SC/0304). Written informed consent will be obtained from all health professionals and patients participating in the study. The research team will ensure that the study is conducted in accordance with the Declaration of Helsinki, the Data Protection Act 2018, General Data Protection Regulations and in accordance with the Research Governance Framework for Health and Social Care (2005). Findings will be published in scientific peer-reviewed journals and presented at local, national and international meetings to publicise and explain the research methods and findings to key audiences to facilitate the further uptake of the REACH-HF intervention. TRIAL REGISTRATION: ISRCTN86234930

The magnetically quiet solar surface dominates HARPS-N solar RVs during low activity

Using images from the Helioseismic and Magnetic Imager aboard the Solar Dynamics Observatory (SDO/HMI), we extract the radial-velocity (RV) signal arising from the suppression of convective blue-shift and from bright faculae and dark sunspots transiting the rotating solar disc. We remove these rotationally modulated magnetic-activity contributions from simultaneous radial velocities observed by the HARPS-N solar feed to produce a radial-velocity time series arising from the magnetically quiet solar surface (the ‘inactive-region radial velocities’). We find that the level of variability in the inactive-region radial velocities remains constant over the almost 7 year baseline and shows no correlation with well-known activity indicators. With an RMS of roughly 1 m s−1, the inactive-region radial-velocity time series dominates the total RV variability budget during the decline of solar cycle 24. Finally, we compare the variability amplitude and timescale of the inactive-region radial velocities with simulations of supergranulation. We find consistency between the inactive-region radial-velocity and simulated time series, indicating that supergranulation is a significant contribution to the overall solar radial velocity variability, and may be the main source of variability towards solar minimum. This work highlights supergranulation as a key barrier to detecting Earth twins

The magnetically quiet solar surface dominates HARPS-N solar RVs during low activity

Using images from the Helioseismic and Magnetic Imager aboard the \textit{Solar Dynamics Observatory} (SDO/HMI), we extract the radial-velocity (RV) signal arising from the suppression of convective blue-shift and from bright faculae and dark sunspots transiting the rotating solar disc. We remove these rotationally modulated magnetic-activity contributions from simultaneous radial velocities observed by the HARPS-N solar feed to produce a radial-velocity time series arising from the magnetically quiet solar surface (the 'inactive-region radial velocities'). We find that the level of variability in the inactive-region radial velocities remains constant over the almost 7 year baseline and shows no correlation with well-known activity indicators. With an RMS of roughly 1 m/s, the inactive-region radial-velocity time series dominates the total RV variability budget during the decline of solar cycle 24. Finally, we compare the variability amplitude and timescale of the inactive-region radial velocities with simulations of supergranulation. We find consistency between the inactive-region radial-velocity and simulated time series, indicating that supergranulation is a significant contribution to the overall solar radial velocity variability, and may be the main source of variability towards solar minimum. This work highlights supergranulation as a key barrier to detecting Earth twins.Comment: 12 pages, 11 figures, accepted to MNRA

A pragmatic effectiveness-implementation study comparing trial evidence with routinely collected outcome data for patients receiving the REACH-HF home-based cardiac rehabilitation programme

BACKGROUND: Cardiac rehabilitation for heart failure continues to be greatly underused worldwide despite being a Class I recommendation in international clinical guidelines and uptake is low in women and patients with mental health comorbidities. METHODS: Rehabilitation EnAblement in CHronic Heart Failure (REACH-HF) programme was implemented in four UK National Health Service early adopter sites ('Beacon Sites') between June 2019 and June 2020. Implementation and patient-reported outcome data were collected across sites as part of the National Audit of Cardiac Rehabilitation. The change in key outcomes before and after the supervised period of REACH-HF intervention across the Beacon Sites was assessed and compared to those of the intervention arm of the REACH-HF multicentre trial. RESULTS: Compared to the REACH-HF multicentre trial, patients treated at the Beacon Site were more likely to be female (33.8% vs 22.9%), older (75.6 vs 70.1), had a more severe classification of heart failure (26.5% vs 17.7%), had poorer baseline health-related quality of life (MLHFQ score 36.1 vs 31.4), were more depressed (HADS score 6.4 vs 4.1) and anxious (HADS score 7.2 vs 4.7), and had lower exercise capacity (ISWT distance 190 m vs 274.7 m). There appeared to be a substantial heterogeneity in the implementation process across the four Beacon Sites as evidenced by the variation in levels of patient recruitment, operationalisation of the REACH-HF intervention and patient outcomes. Overall lower improvements in patient-reported outcomes at the Beacon Sites compared to the trial may reflect differences in the population studied (having higher morbidity at baseline) as well as the marked challenges in intervention delivery during the COVID-19 pandemic. CONCLUSION: The results of this study illustrate the challenges in consistently implementing an intervention (shown to be clinically effective and cost-effective in a multicentre trial) into real-world practice, especially in the midst of a global pandemic. Further research is needed to establish the real-world effectiveness of the REACH-HF intervention in different populations

Proliferation Index: A Continuous Model to Predict Prognosis in Patients with Tumours of the Ewing's Sarcoma Family

The prognostic value of proliferation index (PI) and apoptotic index (AI), caspase-8, -9 and -10 expression have been investigated in primary Ewing's sarcoma family of tumours (ESFT). Proliferating cells, detected by immunohistochemistry for Ki-67, were identified in 91% (91/100) of tumours with a median PI of 14 (range 0–87). Apoptotic cells, identified using the TUNEL assay, were detected in 96% (76/79) of ESFT; the median AI was 3 (range 0–33). Caspase-8 protein expression was negative (0) in 14% (11/79), low (1) in 33% (26/79), medium (2) in 38% (30/79) and high (3) in 15% (12/79) of tumours, caspase-9 expression was low (1) in 66% (39/59) and high (3) in 34% (20/59), and caspase-10 protein was low (1) in 37% (23/62) and negative (0) in 63% (39/62) of primary ESFT. There was no apparent relationship between caspase-8, -9 and -10 expression, PI and AI. PI was predictive of relapse-free survival (RFS; p = 0.011) and overall survival (OS; p = <0.001) in a continuous model, whereas AI did not predict outcome. Patients with tumours expressing low levels of caspase-9 protein had a trend towards a worse RFS than patients with tumours expressing higher levels of caspase-9 protein (p = 0.054, log rank test), although expression of caspases-8, -9 and/or -10 did not significantly predict RFS or OS. In a multivariate analysis model that included tumour site, tumour volume, the presence of metastatic disease at diagnosis, PI and AI, PI independently predicts OS (p = 0.003). Consistent with previous publications, patients with pelvic tumours had a significantly worse OS than patients with tumours at other sites (p = 0.028); patients with a pelvic tumour and a PI≥20 had a 6 fold-increased risk of death. These studies advocate the evaluation of PI in a risk model of outcome for patients with ESFT

Mapping 123 million neonatal, infant and child deaths between 2000 and 2017

Since 2000, many countries have achieved considerable success in improving child survival, but localized progress remains unclear. To inform efforts towards United Nations Sustainable Development Goal 3.2—to end preventable child deaths by 2030—we need consistently estimated data at the subnational level regarding child mortality rates and trends. Here we quantified, for the period 2000–2017, the subnational variation in mortality rates and number of deaths of neonates, infants and children under 5 years of age within 99 low- and middle-income countries using a geostatistical survival model. We estimated that 32% of children under 5 in these countries lived in districts that had attained rates of 25 or fewer child deaths per 1,000 live births by 2017, and that 58% of child deaths between 2000 and 2017 in these countries could have been averted in the absence of geographical inequality. This study enables the identification of high-mortality clusters, patterns of progress and geographical inequalities to inform appropriate investments and implementations that will help to improve the health of all populations