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A health equity approach to obesity efforts: proceedings of a workshop / Emily A. Callahan, rapporteur ; Roundtable on Obesity Solutions, Food and Nutrition Board, Health and Medicine Division, the National Academies of Sciences, Engineering, Medicine

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Criteria for selecting the Leading Health Indicators for Healthy People 2030 / Committee on Informing the Selection of Leading Health Indicators for Healthy People 2030, Board on Population Health and Public Health Practice, Health and Medicine Division

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Improving healthcare services: coproduction, codesign and operations / Sharon J. Williams, Lynne Caley

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The art and science of filler injection: based on clinical anatomy and the pinch technique / Giwoong Hong, Seungmin Oh, Bongcheol Kim, Yongwoo Lee

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The caring heirs of Dr. Samuel Bard: profiles of selected distinguished graduates of Columbia University, College of Physicians and Surgeons / Peter Wortsman

Hayden Library - R690.W67 2019




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Quality measures: the revolution in patient safety and outcomes / Deeb N. Salem, editor ; Karen M. Freund, Saul N. Weingart, associate editors

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Therapeutics of digestive endoscopic tunnel technique / Enqiang Linghu, editor

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A documentary history of public health in Hong Kong / edited by Yip Ka-che, Wong Man-kong and Leung Yuen-sang

Hayden Library - RA990.H65 D63 2018




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Dimensions on nursing teaching and learning: supporting nursing students in learning nursing / Sheila Cunningham, editor

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Others' milk: the potential of exceptional breastfeeding / Kristin J. Wilson

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Unaffordable: American healthcare from Johnson to Trump / Jonathan Engel

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Multilingual healthcare: a global view on communicative challenges / Christiane Hohenstein, Magdalène Lévy-Tödter, editors

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Advanced Practice Nursing Leadership: A Global Perspective edited by Susan B. Hassmiller, Joyce Pulcini

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Children and drug safety: balancing risk and protection in twentieth century America / Cynthia A. Connolly

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History of professional nursing in the United States: toward a culture of health / Arlene W. Keeling, Michelle C. Hehman, John C. Kirchgessner

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Gastric bypass: bariatric and metabolic surgery perspectives / João Ettinger, Euler Ázaro, Rudolf Weiner, Kelvin D. Higa, Manoel Galvão Neto, Andre Fernandes Teixeira, Muhammad Jawad, editors

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Carving a niche: the medical profession in Mexico, 1800-1870 / Luz María Hernández Sáenz

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Uncertainty, anxiety, frugality: dealing with leprosy in the Dutch East Indies, 1816-1942 / Leo van Bergen

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The Artificial Knee: an Ongoing Evolution / by Peter S. Walker

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Perspectives in Performing Arts Medicine Practice: A Multidisciplinary Approach / edited by Sang-Hie Lee, Merry Lynn Morris, Santo V. Nicosia

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Medicine, religion, and magic in early Stuart England: Richard Napier's medical practice / Ofer Hadass

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Lower limb deformities: deformity correction and function reconstruction / Sihe Qin, Jiancheng Zang, Shaofeng Jiao, Qi Pan, editors

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Mental conditioning to perform common operations in general surgery training: a systematic approach to expediting skill acquisition and maintaining dexterity in performance / edited by Raul J. Rosenthal, Armando Rosales, Emanuele Lo Menzo, Fernando D. Di

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Pediatric gender identity: gender-affirming care for transgender & gender diverse youth / edited by Michelle Forcier, Gerrit Van Schalkwyk, Jack L. Turban

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Lasers in oral and maxillofacial surgery Stefan Stübinger, Florian Klämpfl, Michael Schmidt, Hans-Florian Zeilhofer, editors

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Heaviest element could have fascinating atomic and nuclear spectra

Simulations suggest oganesson has extremely smooth electron and nucleon distributions




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Nuclear excitation by electron capture seen at long last

Breakthrough could lead to new type of energy source




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Wood-based 'supermaterial' is stronger and tougher than steel

New material is made by compressing treated wood




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Create a Modal Window Login Form Effect Using jQuery

The hidden modal window technique is a great solution for dealing with interface elements which are not particularly necessary on the page. Social networks can use modal windows for private messages and forms which are only being used by members of the site. This is also true for blogs and magazines which have an author […]




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Coding an Ajax-Style Paged Document Viewer With jQuery

Recently, I’ve have seen a number of websites using this JavaScript-powered paged document interface. Users are presented a multi-page document set starting on the first page, and they have the ability to switch between pages dynamically. This can be a much better solution than linking directly to a PDF document. Or this may even be […]




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25 Useful Resources for Creating Tooltips With JavaScript or CSS

Tooltips are awesome, there’s simply no denying it. They provide a simple, predictable and straightforward way to provide your users with useful, context-sensitive information, and they look cool to boot. We all agree on how great tooltips are, but how we go about implementing them can differ dramatically. If you’re at square one, looking for […]




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How to Build a Dynamic Imgur Upload App Using jQuery & PHP

Many new online web services are providing backend APIs for developers. These allow anyone to connect into a web app and pull out specific information (or push or change bits of data). Today we’re specifically looking at the API for Imgur. In this tutorial I want to demonstrate how we can remotely mirror an image […]




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Code a Single-Page Sliding Website Layout With Fixed Navigation

When constructing a simple webpage, it can often make sense to fit the content into a single layout rather than multiple pages. These single-page websites are beneficial when you have a small project or portfolio which needs some online presence. If you split up content into neat sections, then visitors might use a small sliding […]




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Build a Sliding Client Testimonials Carousel With jQuery

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Creating Instagram-Style Photo Filters With jQuery

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Getting Started with CSS Shapes: Wrapping content around custom paths

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The Hobbit Experience 2014: Adding WebRTC gameplay to the Hobbit Experience

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Rolling out Public Key Pinning with HPKP Reporting




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Tab Discarding in Chrome: a Memory-Saving Experiment




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Accessibility for Vestibular Disorders: How My Temporary Disability Changed My Perspective

Accessibility can be tricky. There are plenty of conditions to take into consideration, and many technical limitations and weird exceptions that make it quite hard to master for most designers and developers.

I never considered myself an accessibility expert, but I took great pride in making my projects Web Content Accessibility Guidelines (WCAG) compliant…ish. They would pass most automated tests, show perfectly in the accessibility tree, and work quite well with keyboard navigation. I would even try (and fail) to use a screen reader every now and then.

But life would give me a lesson I would probably never learn otherwise: last October, my abled life took a drastic change—I started to feel extremely dizzy, with a constant sensation of falling or spinning to the right. I was suffering from a bad case of vertigo caused by labyrinthitis that made it impossible to get anything done.

Vertigo can have a wide range of causes, the most common being a viral infection or tiny calcium crystal free floating in the inner ear, which is pretty much our body’s accelerometer. Any disruption in there sends the brain confusing signals about the body’s position, which causes really heavy nausea, dizziness, and headaches. If you’ve ever felt seasick, it’s quite a similar vibe. If not, think about that feeling when you just get off a rollercoaster…it’s like that, only all day long.

For most people, vertigo is something they’ll suffer just once in a lifetime, and it normally goes away in a week or two. Incidence is really high, with some estimates claiming that up to 40% of the population suffers vertigo at least once in their lifetime. Some people live all their lives with it (or with similar symptoms caused by a range of diseases and syndromes grouped under the umbrella term of vestibular disorders), with 4% of US adults reporting chronic problems with balance, and an additional 1.1% reporting chronic dizziness, according to the American Speech-Language-Hearing Association.

In my case, it was a little over a month. Here’s what I learned while going through it.

Slants can trigger vestibular symptoms

It all started as I was out for my daily jog. I felt slightly dizzy, then suddenly my vision got totally distorted. Everything appeared further away, like looking at a fun house’s distortion mirror. I stumbled back home and rested; at that moment I believed I might have over-exercised, and that hydration, food, and rest were all I needed. Time would prove me wrong.

What I later learned was that experiencing vertigo is a constant war between one of your inner ears telling the brain “everything is fine, we’re level and still” and the other ear shouting “oh my God, we’re falling, we’re falling!!!” Visual stimuli can act as an intermediary, supporting one ear’s message or the other’s. Vertigo can also work in the opposite way, with the dizziness interfering with your vision.

I quickly found that when symptoms peaked, staring at a distant object would ease the falling sensation somewhat.

In the same fashion, some visual stimuli would worsen it.

Vertical slants were a big offender in that sense. For instance, looking at a subtle vertical slant (the kind that you’d have to look at twice to make sure it’s not perfectly vertical) on a webpage would instantly trigger symptoms for me. Whether it was a page-long slant used to create some interest beside text or a tiny decoration to mark active tabs, looking at anything with slight slants would instantly send me into the rollercoaster.

Horizontal slants (whatever the degree) and harder vertical slants wouldn’t cause these issues.

My best guess is that slight vertical slants can look like forced perspective and therefore reinforce the falling-from-height sensation, so I would recommend avoiding vertical slants if you can, or make them super obvious. A slight slant looks like perspective, a harder one looks like a triangle.

Target size matters (even on mouse-assisted devices)

After a magnetic resonance imaging (MRI) scan, some tests to discard neurological conditions, and other treatments that proved ineffective, I was prescribed Cinnarizine.

Cinnarizine is a calcium channel blocker—to put it simply, it prevents the malfunctioning inner ear “accelerometer” from sending incorrect info to the brain. 
And it worked wonders. After ten days of being barely able to get out of bed, I was finally getting something closer to my normal life. I would still feel dizzy all the time, with some peaks throughout the day, but for the most part, it was much easier.

At this point, I was finally able to use the computer (but still unable to produce any code at all). To make the best of it, I set on a mission to self-experiment on accessibility for vestibular disorders. In testing, I found that one of the first things that struck me was that I would always miss targets (links and buttons).

I’m from the generation that grew up with desktop computers, so using a mouse is second nature. The pointer is pretty much an extension of my mind, as it is for many who use it regularly. But while Cinnarizine helped with the dizziness, it has a common side effect of negatively impacting coordination and fine motor skills (it is recommended not to drive or operate machinery while under treatment). It was not a surprise when I realized it would be much harder to get the pointer to do what I intended.

The common behavior would be: moving the pointer past the link I intended to click, clicking before reaching it at all, or having to try multiple times to click on smaller targets.

Success Criterion 2.5.5 Target Size (Level AAA) of the World Wide Web Consortium (W3C)’s WCAG recommends bigger target sizes so users can activate them easily. The obvious reason for this is that it’s harder to pinpoint targets on smaller screens with coarser inputs (i.e., touchscreens of mobile devices). A fairly common practice for developers is to set bigger target sizes for smaller viewport widths (assuming that control challenges are only touch-related), while neglecting the issue on big screens expected to be used with mouse input. I know I’m guilty of that myself.

Instead of targeting this behavior for just smaller screen sizes, there are plenty of reasons to create larger target sizes on all devices: it will benefit users with limited vision (when text is scaled up accordingly and colors are of sufficient contrast), users with mobility impairments such as hand tremors, and of course, users with difficulty with fine motor skills.

Font size and spacing

Even while “enjoying” the ease of symptoms provided by the treatment, reading anything still proved to be a challenge for the following three weeks.

I was completely unable to use mobile devices while suffering vertigo due to the smaller font sizes and spacing, so I was forced to use my desktop computer for everything.

I can say I was experiencing something similar to users with mild forms of dyslexia or attention disorders: whenever I got to a website that didn’t follow good font styling, I would find myself reading the same line over and over again.

This proves once again that accessibility is intersectional: when we improve things for a particular purpose it usually benefits users with other challenges as well. I used to believe recommendations on font styles were mostly intended for the nearsighted and those who have dyslexia. Turns out they are also critical for those with vertigo, and even for those with some cognitive differences. At the end of the day, everybody benefits from better readability.

Some actions you can take to improve readability are:

  • Keep line height to at least 1.5 times the font size (i.e., line-height: 1.5).
  • Set the spacing between paragraphs to at least 2.0 times the font size. We can do this by adjusting the margins using relative units such as em.
  • Letter spacing should be at least 0.12 times the font size. We can adjust this by using the letter-spacing CSS property, perhaps setting it in a relative unit.
  • Make sure to have good contrast between text and its background.
  • Keep font-weight at a reasonable level for the given font-family. Some fonts have thin strokes that make them harder to read. When using thinner fonts, try to improve contrast and font size accordingly, even more than what WCAG would suggest.
  • Choose fonts that are easy to read. There has been a large and still inconclusive debate on which font styles are better for users, but one thing I can say for sure is that popular fonts (as in fonts that the user might be already familiar with) are generally the least challenging for users with reading issues.

WCAG recommendations on text are fairly clear and fortunately are the most commonly implemented of recommendations, but even they can still fall short sometimes. So, better to follow specific guides on accessible text and your best judgement. Passing automated tests does not guarantee actual accessibility.

Another issue on which my experience with vertigo proved to be similar to that of people with dyslexia and attention disorders was how hard it was for me to keep my attention in just one place. In that sense…

Animations are bad (and parallax is pure evil)

Val Head has already covered visually-triggered vestibular disorders in an outstanding article, so I would recommend giving it a good read if you haven’t already.

To summarize, animations can trigger nausea, dizziness, and headaches in some users, so we should use them purposely and responsibly.

While most animations did not trigger my symptoms, parallax scrolling did. I’d never been a fan of parallax to begin with, as I found it confusing. And when you’re experiencing vertigo, the issues introduced by parallax scrolling compound.

Really, there are no words to describe just how bad a simple parallax effect, scrolljacking, or even background-attachment: fixed would make me feel. I would rather jump on one of those 20-G centrifuges astronauts use than look at a website with parallax scrolling.

Every time I encountered it, I would put the bucket beside me to good use and be forced to lie in bed for hours as I felt the room spinning around me, and no meds could get me out of it. It was THAT bad.

Though normal animations did not trigger a reaction as severe, they still posed a big problem. The extreme, conscious, focused effort it took to read would make it such that anything moving on the screen would instantly break my focus, and force me to start the paragraph all over. And I mean anything.

I would constantly find myself reading a website only to have the typical collapsing navigation bar on scroll distract me just enough that I’d totally lose count of where I was at. Autoplaying carousels were so annoying I would delete them using dev tools as soon as they showed up. Background videos would make me get out of the website desperately.

Over time I started using mouse selection as a pointer; a visual indication of what I’d already read so I could get back to it whenever something distracted me. Then I tried custom stylesheets to disable transforms and animations whenever possible, but that also meant many websites having critical elements not appear at all, as they were implemented to start off-screen or otherwise invisible, and show up on scroll.

Of course, deleting stuff via dev tools or using custom stylesheets is not something we can expect 99.99% of our users to even know about.

So if anything, consider reducing animations to a minimum. Provide users with controls to turn off non-essential animations (WCAG 2.2.3 Animation from Interactions) and to pause, stop, or hide them (WCAG 2.2.2 Pause, Stop, Hide). Implement animations and transitions in such a way that if the user disables them, critical elements still display.

And be extra careful with parallax: my recommendation is to, at the very least, try limiting its use to the header (“hero”) only, and be mindful of getting a smooth, realistic parallax experience. My vertigo self would have said, “just don’t freaking use parallax. Never. EVER.” But I guess that might be a hard idea to sell to stakeholders and designers.

Also consider learning how to use the prefers-reduced-motion feature query. This is a newer addition to the specs (it’s part of the Media Queries Level 5 module , which is at an early Editor’s Draft stage) that allows authors to apply selective styling depending on whether the user has requested the system to minimize the use of animations. OS and browser support for it is still quite limited, but the day will come when we will set any moving thing inside a query for when the user has no-preference, blocking animations from those who choose reduce.

After about a week of wrestling websites to provide a static experience, I remembered something that would prove to be my biggest ally while the vertigo lasted:

Reader mode

Some browsers include a “reader mode” that strips the content from any styling choices, isolates it from any distraction, and provides a perfect WCAG compliant layout for the text to maximize readability.

It is extremely helpful to provide a clear and consistent reading experience throughout multiple websites, especially for users with any kind of reading impairment.

I have to confess: before experiencing my vestibular disorder, I had never used Reader Mode (the formal name varies in browsers) or even checked if my projects were compatible with it. I didn’t even think it was such a useful feature, as a quick search for “reader mode” actually returned quite a few threads by users asking how to disable it or how to take the button for it out of Firefox’s address bar. (It seems some people are unwittingly activating it…perhaps the icon is not clear enough.)

Displaying the button to access Reader Mode is toggled by browser heuristics, which are based on the use (or not) of semantic tags in a page’s HTML. Unfortunately this meant not all websites provided such a “luxury.”

I really wish I wouldn’t have to say this in 2019…but please, please use semantic tags. Correct conversational semantics allow your website to be displayed in Reader Mode, and provide a better experience for users of screen readers. Again, accessibility is intersectional.

Reader Mode proved to be extremely useful while my vertigo lasted. But there was something even better:

Dark color schemes

By the fourth week, I started feeling mostly fine. I opened Visual Studio Code to try to get back to work. In doing so, it served me well to find one more revelation: a light-text-on-dark-background scheme was SO much easier for me to read. (Though I still was not able to return to work at this time.)

I was quite surprised, as I had always preferred light mode with dark-text-on-light-background for reading, and dark mode, with light-text-on-dark for coding. I didn’t know at the time that I was suffering from photophobia (which is a sensitivity to light), which was one of the reasons I found it hard to read on my desktop and to use my mobile device at all.

As far as I know, photophobia is not a common symptom of vestibular disorders, but there are many conditions that will trigger it, so it’s worth looking into for our projects’ accessibility.

CSS is also planning a media query to switch color schemes. Known as prefers-color-scheme, it allows applying styles based on the user’s stated preference for dark or light theming. It’s also part of the Media Queries Level 5 spec, and at the time of writing this article it’s only available in Safari Technology Preview, with Mozilla planning to ship it in the upcoming Firefox 67. Luckily there’s a PostCSS plugin that allows us to use it in most modern browsers by turning prefers-color-schemequeries into color-index queries, which have much better support.

If PostCSS is not your cup of tea, or for whatever reason you cannot use that approach to automate switching color schemes to a user’s preference, try at least to provide a theming option in your app’s configuration. Theming has become extremely simple since the release of CSS Custom Properties, so implementing this sort of switch is relatively easy and will greatly benefit anyone experiencing photophobia.

Moving on

After a month and some days, the vertigo disappeared completely, and I was able to return to work without needing any meds or further treatment. It should stay that way, as for most people it’s a once-in-a-lifetime occurrence.

I went back to my abled life, but the experience changed my mindset for good.

As I said before, I always cared for making my projects compatible for people using keyboard navigation and screen readers. But I learned the hard way that there are plenty of “invisible conditions” that are just as important to take into consideration: vestibular disorders, cognitive differences, dyslexia, and color blindness, just to name a few. I was totally neglecting those most of the time, barely addressing the issues in order to pass automated tests, which means I was unintentionally annoying some users by making websites inaccessible to them.

After my experience with vertigo, I’ve turned to an accessibility-first approach to design and development. Now I ask myself, “am I leaving anyone behind with this decision?,” before dropping a single line of code. Accessibility should never be an afterthought.

Making sure my projects work from the start for those with difficulties also improves the experience for everyone else. Think about how improving text styles for users with dyslexia, vertigo, or visual problems improves readability for all users, or how being able to control animations or choose a color scheme can be critical for users with attention disorders and photophobia, respectively, while also a nice feature for everybody.

It also turned my workflow into a much smoother development experience, as addressing accessibility issues from the beginning can mean a slower start, but it’s also much easier and faster than trying to fix broken accessibility afterwards.

I hope that by sharing my personal experience with vertigo, I’ve illustrated how we can all design and develop a better web for everybody. Remember, we’re all just temporarily abled.





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Nothing Fails Like Success

A family buys a house they can’t afford. They can’t make their monthly mortgage payments, so they borrow money from the Mob. Now they’re in debt to the bank and the Mob, live in fear of losing their home, and must do whatever their creditors tell them to do.

Welcome to the internet, 2019.

Buying something you can’t afford, and borrowing from organizations that don’t have your (or your customers’) best interest at heart, is the business plan of most internet startups. It’s why our digital services and social networks in 2019 are a garbage fire of lies, distortions, hate speech, tribalism, privacy violations, snake oil, dangerous idiocy, deflected responsibility, and whole new categories of unpunished ethical breaches and crimes.

From optimistically conceived origins and message statements about making the world a better place, too many websites and startups have become the leading edge of bias and trauma, especially for marginalized and at-risk groups.

Why (almost) everything sucks

Twitter, for instance, needs a lot of views for advertising to pay at the massive scale its investors demand. A lot of views means you can’t be too picky about what people share. If it’s misogynists or racists inspiring others who share their heinous beliefs to bring back the 1930s, hey, it’s measurable. If a powerful elected official’s out-of-control tweeting reduces churn and increases views, not only can you pay your investors, you can even take home a bonus. Maybe it can pay for that next meditation retreat.

You can cloak this basic economic trade-off in fifty layers of bullshit—say you believe in freedom of speech, or that the antidote to bad speech is more speech—but the fact is, hate speech is profitable. It’s killing our society and our planet, but it’s profitable. And the remaining makers of Twitter—the ones whose consciences didn’t send them packing years ago—no longer have a choice. The guy from the Mob is on his way over, and the vig is due.

Not to single out Twitter, but this is clearly the root cause of its seeming indifference to the destruction hate speech is doing to society…and will ultimately do to the platform. (But by then Jack will be able to afford to meditate full-time.)

Other companies do other evil things to pay their vig. When you owe the Mob, you have no choice. Like sell our data. Or lie about medical research.

There are internet companies (like Basecamp, or like Automattic, makers of WordPress.com, where I work) that charge money for their products and services, and use that money to grow their business. I wish more internet companies could follow that model, but it’s hard to retrofit a legitimate business model to a product that started its life as free.

And there are even some high-end news publications, such as The New York Times, The Washington Post, and The Guardian, that survive on a combination of advertising and flexible paywalls. But these options are not available to most digital publications and businesses.

Return with me to those Halcyon days…

Websites and internet startups used to be you and your friends making cool stuff for your other friends, and maybe building new friendships and even small communities in the process. (Even in 2019, that’s still how some websites and startups begin—as labors of love, fashioned by idealists in their spare time.)

Because they are labors of love; because we’ve spent 25 years training people to believe that websites, and news, and apps, and services should be free; because, when we begin a project, we can scarcely believe anyone will ever notice or care about it—for these reasons and more, the things we make digitally, especially on the web, are offered free of charge. We labor on, excited by positive feedback, and delighted to discover that, if we keep at it, our little community will grow.

Most such labors of love disappear after a year or two, as the creators drift out of touch with each other, get “real” jobs, fall in love, start families, or simply lose interest due to lack of attention from the public or the frustrations of spending weekends and holidays grinding away at an underappreciated site or app while their non-internet friends spend those same hours either having fun or earning money.

Along came money

But some of these startup projects catch on. And when they do, a certain class of investor smells ROI. And the naive cofounders, who never expected their product or service to really get anywhere, can suddenly envision themselves rich and Zuckerberg-famous. Or maybe they like the idea of quitting their day job, believing in themselves, and really going for it. After all, that is an empowering and righteous vision.

Maybe they believe that by taking the initial investment, they can do more good—that their product, if developed further, can actually help people. This is often the motivation behind agreeing to an initial investment deal, especially in categories like healthcare.

Or maybe the founders are problem solvers. Existing products or services in a given category have a big weakness. The problem solvers are sure that their idea is better. With enough capital, and a slightly bigger team, they can show the world how to do it right. Most inventions that have moved humankind forward followed exactly this path. It should lead to a better world (and it sometimes does). It shouldn’t produce privacy breaches and fake medicine and election-influencing bots and all the other plagues of our emerging digital civilization. So why does it?

Content wants to be paid

Primarily it is because these businesses have no business model. They were made and given away free. Now investors come along who can pay the founders, buy them an office, give them the money to staff up, and even help with PR and advertising to help them grow faster.

Now there are salaries and insurance and taxes and office space and travel and lecture tours and sales booths at SXSW, but there is still no charge for the product.

And the investor seeks a big return.

And when the initial investment is no longer enough to get the free-product company to scale to the big leagues, that’s when the really big investors come in with the really big bucks. And the company is suddenly famous overnight, and “everybody” is using the product, and it’s still free, and the investors are still expecting a giant payday.

Like I said—a house you can’t afford, so you go into debt to the bank and the Mob.

The money trap

Here it would be easy to blame capitalism, or at least untrammeled, under-regulated capitalism, which has often been a source of human suffering—not that capitalism, properly regulated, can’t also be a force for innovation which ameliorates suffering. That’s the dilemma for our society, and where you come down on free markets versus governmental regulation of businesses should be an intellectual decision, but these days it is a label, and we hate our neighbors for coming down a few degrees to the left or right of us. But I digress and oversimplify, and this isn’t a complaint about late stage capitalism per se, although it may smell like one.

No, the reason small companies created by idealists too frequently turn into consumer-defrauding forces for evil has to do with the amount of profit each new phase of investor expects to receive, and how quickly they expect to receive it, and the fact that the products and services are still free. And you know what they say about free products.

Nothing fails like success

A friend who’s a serial entrepreneur has started maybe a dozen internet businesses over the span of his career. They’ve all met a need in the marketplace. As a consequence, they’ve all found customers, and they’ve all made a profit. Yet his investors are rarely happy.

“Most of my startups have the decency to fail in the first year,” one investor told him. My friend’s business was taking in several million dollars a year and was slowly growing in staff and customers. It was profitable. Just not obscenely so.

And internet investors don’t want a modest return on their investment. They want an obscene profit right away, or a brutal loss, which they can write off their taxes. Making them a hundred million for the ten million they lent you is good. Losing their ten million is also good—they pay a lower tax bill that way, or they use the loss to fold a company, or they make a profit on the furniture while writing off the business as a loss…whatever rich people can legally do under our tax system, which is quite a lot.

What these folks don’t want is to lend you ten million dollars and get twelve million back.

You and I might go, “Wow! I just made two million dollars just for being privileged enough to have money to lend somebody else.” And that’s why you and I will never have ten million dollars to lend anybody. Because we would be grateful for it. And we would see a free two million dollars as a life-changing gift from God. But investors don’t think this way.

We didn’t start the fire, but we roasted our weenies in it

As much as we pretend to be a religious nation, our society worships these investors and their profits, worships companies that turn these profits, worships above all the myth of overnight success, which we use to motivate the hundreds of thousands of workers who will work nights and weekends for the owners in hopes of cashing in when the stock goes big.

Most times, even if the stock does go big, the owner has found a way to devalue it by the time it does. Owners have brilliant advisers they pay to figure out how to do those things. You and I don’t.

A Christmas memory

I remember visiting San Francisco years ago and scoring an invitation to Twitter’s Christmas party through a friend who worked there at the time. Twitter was, at the time, an app that worked via SMS and also via a website. Period.

Some third-party companies, starting with my friends at Iconfactory, had built iPhone apps for people who wanted to navigate Twitter via their newfangled iPhones instead of the web. Twitter itself hadn’t publicly addressed mobile and might not even have been thinking about it.

Although Twitter was transitioning from a fun cult thing—used by bloggers who attended SXSW Interactive in 2007—to an emerging cultural phenomenon, it was still quite basic in its interface and limited in its abilities. Which was not a bad thing. There is art in constraint, value in doing one thing well. As an outsider, if I’d thought about it, I would have guessed that Twitter’s entire team consisted of no more than 10 or 12 wild-eyed, sleep-deprived true believers.

Imagine my surprise, then, when I showed up at the Christmas party and discovered I’d be sharing dinner with hundreds of designers, developers, salespeople, and executives instead of the handful I’d naively anticipated meeting. (By now, of course, Twitter employs many thousands. It’s still not clear to an outsider why so many workers are needed.)

But one thing is clear: somebody has to pay for it all.

Freemium isn’t free

Employees, let alone thousands of them, on inflated Silicon Valley engineer salaries, aren’t free. Health insurance and parking and meals and HR and travel and expense accounts and meetups and software and hardware and office space and amenities aren’t free. Paying for all that while striving to repay investors tenfold means making a buck any way you can.

Since the product was born free and a paywall isn’t feasible, Twitter must rely on that old standby: advertising. Advertising may not generate enough revenue to keep your hometown newspaper (or most podcasts and content sites) in business, but at Twitter’s scale, it pays.

It pays because Twitter has so many active users. And what keeps those users coming back? Too often, it’s the dopamine of relentless tribalism—folks whose political beliefs match and reinforce mine in a constant unwinnable war of words with folks whose beliefs differ.

Of course, half the antagonists in a given brawl may be bots, paid for in secret by an organization that wants to make it appear that most citizens are against Net Neutrality, or that most Americans oppose even the most basic gun laws, or that our elected officials work for lizard people. The whole system is broken and dangerous, but it’s also addictive, and we can’t look away. From our naive belief that content wants to be free, and our inability to create businesses that pay for themselves, we are turning our era’s greatest inventions into engines of doom and despair.

Your turn

So here we are. Now what do we do about it?

It’s too late for current internet businesses (victims of their own success) that are mortgaged to the hilt in investor gelt. But could the next generation of internet startups learn from older, stable companies like Basecamp, and design products that pay for themselves via customer income—products that profit slowly and sustainably, allowing them to scale up in a similarly slow, sustainable fashion?

The self-payment model may not work for apps and sites that are designed as modest amusements or communities, but maybe those kinds of startups don’t need to make a buck—maybe they can simply be labors of love, like the websites we loved in the 1990s and early 2000s.

Along those same lines, can the IndieWeb, and products of IndieWeb thinking like Micro.blog, save us? Might they at least provide an alternative to the toxic aspects of our current social web, and restore the ownership of our data and content? And before you answer, RTFM.

On an individual and small collective basis, the IndieWeb already works. But does an IndieWeb approach scale to the general public? If it doesn’t scale yet, can we, who envision and design and build, create a new generation of tools that will help give birth to a flourishing, independent web? One that is as accessible to ordinary internet users as Twitter and Facebook and Instagram? Tantek Çelik thinks so, and he’s been right about the web for nearly 30 years. (For more about what Tantek thinks, listen to our conversation in Episode № 186 of The Big Web Show.)
Are these approaches mere whistling against a hurricane? Are most web and internet users content with how things are? What do you think? Share your thoughts on your personal website (dust yours off!) or (irony ahoy!) on your indie or mainstream social networks of choice using hashtag #LetsFixThis. I can’t wait to see what you have to say.




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Everyday Information Architecture: Auditing for Structure

Just as we need to understand our content before we can recategorize it, we need to understand the system before we try to rebuild it.

Enter the structural audit: a review of the site focused solely on its menus, links, flows, and hierarchies. I know you thought we were done with audits back in Chapter 2, but hear me out! Structural audits have an important and singular purpose: to help us build a new sitemap.

This isn’t about recreating the intended sitemap—no, this is about experiencing the site the way users experience it. This audit is meant to track and record the structure of the site as it really works.

Setting up the template

First, we’re gonna need another spreadsheet. (Look, it is not my fault that spreadsheets are the perfect system for recording audit data. I don’t make the rules.)

Because this involves building a spreadsheet from scratch, I keep a “template” at the top of my audit files—rows that I can copy and paste into each new audit (Fig 4.1). It’s a color-coded outline key that helps me track my page hierarchy and my place in the auditing process. When auditing thousands of pages, it’s easy to get dizzyingly lost, particularly when coming back into the sheet after a break; the key helps me stay oriented, no matter how deep the rabbit hole.

Fig 4.1: I use a color-coded outline key to record page hierarchy as I move through the audit. Wait, how many circles did Dante write about?

Color-coding

Color is the easiest, quickest way to convey page depth at a glance. The repetition of black text, white cells, and gray lines can have a numbing effect—too many rows of sameness, and your eyes glaze over. My coloring may result in a spreadsheet that looks like a twee box of macarons, but at least I know, instantly, where I am.

The exact colors don’t really matter, but I find that the familiar mental model of a rainbow helps with recognition—the cooler the row color, the deeper into the site I know I must be.

The nested rainbow of pages is great when you’re auditing neatly nested pages—but most websites color outside the lines (pun extremely intended) with their structure. I leave my orderly rainbow behind to capture duplicate pages, circular links, external navigation, and other inconsistencies like:

  • On-page navigation. A bright text color denotes pages that are accessible via links within page content—not through the navigation. These pages are critical to site structure but are easily overlooked. Not every page needs to be displayed in the navigation menus, of course—news articles are a perfect example—but sometimes this indicates publishing errors.
  • External links. These are navigation links that go to pages outside the domain. They might be social media pages, or even sites held by the same company—but if the domain isn’t the one I’m auditing, I don’t need to follow it. I do need to note its existence in my spreadsheet, so I color the text as the red flag that it is. (As a general rule, I steer clients away from placing external links in navigation, in order to maintain a consistent experience. If there’s a need to send users offsite, I’ll suggest using a contextual, on-page link.)
  • Files. This mostly refers to PDFs, but can include Word files, slide decks, or anything else that requires downloading. As with external links, I want to capture anything that might disrupt the in-site browsing experience. (My audits usually filter out PDFs, but for organizations that overuse them, I’ll audit them separately to show how much “website” content is locked inside.)
  • Unknown hierarchy. Every once in a while, there’s a page that doesn’t seem to belong anywhere—maybe it’s missing from the menu, while its URL suggests it belongs in one section and its navigation scheme suggests another. These pages need to be discussed with their owners to determine whether the content needs to be considered in the new site.
  • Crosslinks. These are navigation links for pages that canonically live in a different section of the site—in other words, they’re duplicates. This often happens in footer navigation, which may repeat the main navigation or surface links to deeper-but-important pages (like a Contact page or a privacy policy). I don’t want to record the same information about the page twice, but I do need to know where the crosslink is, so I can track different paths to the content. I color these cells gray so they don’t draw my attention.

Note that coloring every row (and indenting, as you’ll see in a moment) can be a tedious process—unless you rely on Excel’s formatting brush. That tool applies all the right styles in just two quick clicks.

Outlines and page IDs

Color-coding is half of my template; the other half is the outline, which is how I keep track of the structure itself. (No big deal, just the entire point of the spreadsheet.)

Every page in the site gets assigned an ID. You are assigning this number; it doesn’t correspond to anything but your own perception of the navigation. This number does three things for you:

  1. It associates pages with their place in the site hierarchy. Decimals indicate levels, so the page ID can be decoded as the page’s place in the system.
  2. It gives each page a unique identifier, so you can easily refer to a particular page—saying “2.4.1” is much clearer than “you know that one page in the fourth product category?”
  3. You can keep using the ID in other contexts, like your sitemap. Then, later, when your team decides to wireframe pages 1.1.1 and 7.0, you’ll all be working from the same understanding.

Let me be completely honest: things might get goofy sometimes with the decimal outline. There will come a day when you’ll find yourself casually typing out “1.2.1.2.1.1.1,” and at that moment, a fellow auditor somewhere in the universe will ring a tiny gong for you.

In addition to the IDs, I indent each level, which reinforces both the numbers and the colors. Each level down—each digit in the ID, each change in color—gets one indentation.

I identify top-level pages with a single number: 1.0, 2.0, 3.0, etc. The next page level in the first section would be 1.1, 1.2, 1.3, and so on. I mark the homepage as 0.0, which is mildly controversial—the homepage is technically a level above—but, look: I’ve got a lot of numbers to write, and I don’t need those numbers to tell me they’re under the homepage, so this is my system. Feel free to use the numbering system that work best for you.

Criteria and columns

So we’ve got some secret codes for tracking hierarchy and depth, but what about other structural criteria? What are our spreadsheet columns (Fig 4.2)? In addition to a column for Page ID, here’s what I cover:

  • URL. I don’t consistently fill out this column, because I already collected this data back in my automated audit. I include it every twenty entries or so (and on crosslinks or pages with unknown hierarchy) as another way of tracking progress, and as a direct link into the site itself.
  • Menu label/link. I include this column only if I notice a lot of mismatches between links, labels, and page names. Perfect agreement isn’t required; but frequent, significant differences between the language that leads to a page and the language on the page itself may indicate inconsistencies in editorial approach or backend structures.
  • Name/headline. Think of this as “what does the page owner call it?” It may be the H1, or an H2; it may match the link that brought you here, or the page title in the browser, or it may not.
  • Page title. This is for the name of the page in the metadata. Again, I don’t use this in every audit—particularly if the site uses the same long, branded metadata title for every single page—but frequent mismatches can be useful to track.
  • Section. While the template can indicate your level, it can’t tell you which area of the site you’re in—unless you write it down. (This may differ from the section data you applied to your automated audit, taken from the URL structure; here, you’re noting the section where the page appears.)
  • Notes. Finally, I keep a column to note specific challenges, and to track patterns I’m seeing across multiple pages—things like “Different template, missing subnav” or “Only visible from previous page.” My only caution here is that if you’re planning to share this audit with another person, make sure your notes are—ahem—professional. Unless you enjoy anxiously combing through hundreds of entries to revise comments like “Wow haha nope” (not that I would know anything about that).
Fig 4.2: A semi-complete structural audit. This view shows a lot of second- and third-level pages, as well as pages accessed through on-page navigation.

Depending on your project needs, there may be other columns, too. If, in addition to using this spreadsheet for your new sitemap, you want to use it in migration planning or template mapping, you may want columns for new URLs, or template types. 

You can get your own copy of my template as a downloadable Excel file. Feel free to tweak it to suit your style and needs; I know I always do. As long as your spreadsheet helps you understand the hierarchy and structure of your website, you’re good to go.

Gathering data

Setting up the template is one thing—actually filling it out is, admittedly, another. So how do we go from a shiny, new, naive spreadsheet to a complete, jaded, seen-some-stuff spreadsheet? I always liked Erin Kissane’s description of the process, from The Elements of Content Strategy:

Big inventories involve a lot of black coffee, a few late nights, and a playlist of questionable but cheering music prominently featuring the soundtrack of object-collecting video game Katamari Damacy. It takes quite a while to exhaustively inventory a large site, but it’s the only way to really understand what you have to work with.

We’re not talking about the same kind of exhaustive inventory she was describing (though I am recommending Katamari music). But even our less intensive approach is going to require your butt in a seat, your eyes on a screen, and a certain amount of patience and focus. You’re about to walk, with your fingers, through most of a website.

Start on the homepage. (We know that not all users start there, but we’ve got to have some kind of order to this process or we’ll never get through it.) Explore the main navigation before moving on to secondary navigation structures. Move left to right, top to bottom (assuming that is your language direction) over each page, looking for the links. You want to record every page you can reasonably access on the site, noting navigational and structural considerations as you go.

My advice as you work:

  • Use two monitors. I struggle immensely without two screens in this process, which involves constantly switching between spreadsheet and browser in rapid, tennis-match-like succession. If you don’t have access to multiple monitors, find whatever way is easiest for you to quickly flip between applications.
  • Record what you see. I generally note all visible menu links at the same level, then exhaust one section at a time. Sometimes this means I have to adjust what I initially observed, or backtrack to pages I missed earlier. You might prefer to record all data across a level before going deeper, and that would work, too. Just be consistent to minimize missed links.
  • Be alert to inconsistencies. On-page links, external links, and crosslinks can tell you a lot about the structure of the site, but they’re easy to overlook. Missed on-page links mean missed content; missed crosslinks mean duplicate work. (Note: the further you get into the site, the more you’ll start seeing crosslinks, given all the pages you’ve already recorded.)
  • Stick to what’s structurally relevant. A single file that’s not part of a larger pattern of file use is not going to change your understanding of the structure. Neither is recording every single blog post, quarterly newsletter, or news story in the archive. For content that’s dynamic, repeatable, and plentiful, I use an x in the page ID to denote more of the same. For example, a news archive with a page ID of 2.8 might show just one entry beneath it as 2.8.x; I don’t need to record every page up to 2.8.791 to understand that there are 791 articles on the site (assuming I noted that fact in an earlier content review).
  • Save. Save frequently. I cannot even begin to speak of the unfathomable heartbreak that is Microsoft Excel burning an unsaved audit to the ground.  

Knowing which links to follow, which to record, and how best to untangle structural confusion—that improves with time and experience. Performing structural audits will not only teach you about your current site, but will help you develop fluency in systems thinking—a boon when it comes time to document the new site.




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  • Graphics And Interactive Applications

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