Design considerations for the ideal low vision aid: insights from de-brief interviews following a real-world recording study

PURPOSE: Low Vision Aids (LVAs) can have a transformative impact on people living with sight loss, yet the everyday requirements for developing such devices remain poorly understood and defined. This study systematically explored LVA requirements through a structured de-brief interview following a real-world self-recording study. The purpose of this work was to define the actual needs of those living with sight loss so that low vision services can better address them in future. METHODS: Thirty-two visually impaired volunteers with varying levels of previous LVA experience participated in a de-brief interview centred around a structured questionnaire. The de-brief followed a one-week real-world study during which participants used recoding spectacles to capture and narrate all situations in which they would use a ‘perfect sight aid’. Content and thematic analyses were used to analyse interviews which had the purpose of contextualising these recordings and exploring requirements around psychological, functional and design factors. CONCLUSIONS: There is a substantial opportunity for new LVAs to address visual needs that traditional devices and coping strategies cannot support. Functional, psychological and design factors require careful consideration for future LVAs to be relevant and widely adopted

Are wearable electronic vision enhancement systems (wEVES) beneficial for people with age-related macular degeneration? A scoping review

INTRODUCTION: Age-related macular degeneration (AMD) is the most common cause of irreversible visual impairment in the United Kingdom. It has a wide-ranging detrimental impact on daily living, including impairment of functional ability and quality of life. Assistive technology designed to overcome this impairment includes wearable electronic vision enhancement systems (wEVES). This scoping review assesses the usefulness of these systems for people with AMD. METHODS: Four databases (Cumulative Index to Nursing and Allied Health Literature, PubMed, Web of Science and Cochrane CENTRAL) were searched to identify papers that investigated image enhancement with a head-mounted electronic device on a sample population that included people with AMD. RESULTS: Thirty-two papers were included: 18 studied the clinical and functional benefits of wEVES, 11 investigated use and usability and 3 discussed sickness and adverse effects. CONCLUSIONS: Wearable electronic vision enhancement systems provide hands-free magnification and image enhancement producing significant improvements in acuity, contrast sensitivity and aspects of laboratory-simulated daily activity. Adverse effects were infrequent, minor and spontaneously resolved with the removal of the device. However, when symptoms arose, they sometimes persisted with continued device usage. There are multi-factorial influences and a diversity of user opinions on promotors to successful device use. These factors are not exclusively driven by visual improvement and incorporate other issues including device weight, ease of use and inconspicuous design. There is insufficient evidence of any cost-benefit analysis for wEVES. However, it has been shown that a user's decision to make a purchase evolves over time, with their estimates of cost falling below the retail price of the devices. Additional research is needed to understand the specific and distinct benefits of wEVES for people with AMD. Further patient-centred research should assess the benefits of wEVES in user-led activities when directly compared with alternative coping strategies, allowing professionals and users to make better prescribing and purchasing decisions

Design considerations for the ideal low vision aid: insights from de‐brief interviews following a real‐world recording study

Purpose Low Vision Aids (LVAs) can have a transformative impact on people living with sight loss, yet the everyday requirements for developing such devices remain poorly understood and defined. This study systematically explored LVA requirements through a structured de‐brief interview following a real‐world self‐recording study. The purpose of this work was to define the actual needs of those living with sight loss so that low vision services can better address them in future. Methods Thirty‐two visually impaired volunteers with varying levels of previous LVA experience participated in a de‐brief interview centred around a structured questionnaire. The de‐brief followed a one‐week real‐world study during which participants used recoding spectacles to capture and narrate all situations in which they would use a ‘perfect sight aid’. Content and thematic analyses were used to analyse interviews which had the purpose of contextualising these recordings and exploring requirements around psychological, functional and design factors. Results Participants reported that 46% of tasks which they had recorded were most important to them. Of these tasks, 82% were encountered frequently. Few tasks emerged as very important across many participants, the remaining tasks reflecting individual lifestyles or circumstances. Every participant used at least one LVA in their everyday life and 72% identified further coping strategies. Current LVAs identified as consistently poor were distance LVAs, with all other devices receiving mixed or only positive feedback. Around two‐thirds of participants would prefer LVA use on an ad‐hoc / quick access basis rather than over long periods of time, and just over half would prefer to carry it rather than wearing it all day. Lack of consistency in these responses illustrated potentially different user clusters with divergent design needs. Two‐thirds of participants emphasised the desire for a discreet LVA that does not attract attention. However, since half of all participants felt self‐conscious in public or in front of other people when wearing the small recording spectacles, this may not be technically achievable. Conclusions There is a substantial opportunity for new LVAs to address visual needs that traditional devices and coping strategies cannot support. Functional, psychological and design factors require careful consideration for future LVAs to be relevant and widely adopted

Head-mounted displays and dynamic text presentation to aid reading in macular disease

The majority of individuals living with significant sight loss have residual vision which can be enhanced using low vision aids. Smart glasses and smartphone-based headsets, both increasing in prevalence, are proposed as a low vision aid platform. Three novel tests for measuring the visibility of displays to partially sighted users are described, along with a questionnaire for assessing subjective preference. Most individuals tested, save those with the weakest vision, were able to see and read from both a smart glasses screen and a smartphone screen mounted in a headset. The scheme for biomimetic scrolling, a text presentation strategy which translates natural eye movement into text movement, is described. It is found to enable the normally sighted to read at a rate five times that of continuous scrolling and is faster than rapid serial visual presentation for individuals with macular disease. With text presentation on the smart glasses optimised to the user, individuals with macular disease read on average 65% faster than when using their habitual optical aid. It is concluded that this aid demonstrates clear benefit over the commonly used devices and is thus recommended for further development towards widespread availability

Medicaid 1915(c) home and community-based services waivers across the states.

This article provides State-level data on the Medicaid 1915(c) home and community-based services (HCBS) waivers program. Medicaid 1915(c) waiver participants were 32 percent of the Medicaid participants in institutional care in 1997. These data document wide interstate variation in organizational oversight and program policies for the waivers. Many structural barriers to HCBS waiver growth existed. Case management services, in some form, were normative for most HCBS waiver participants, but formal mechanisms to assess client satisfaction and service quality were less common. Substantial new growth in this program may require fundamental changes in HCBS waiver policies

Southwest Research Institute assistance to NASA in biomedical areas of the technology

Significant applications of aerospace technology were achieved. These applications include: a miniaturized, noninvasive system to telemeter electrocardiographic signals of heart transplant patients during their recuperative period as graded situations are introduced; and economical vital signs monitor for use in nursing homes and rehabilitation hospitals to indicate the onset of respiratory arrest; an implantable telemetry system to indicate the onset of the rejection phenomenon in animals undergoing cardiac transplants; an exceptionally accurate current proportional temperature controller for pollution studies; an automatic, atraumatic blood pressure measurement device; materials for protecting burned areas in contact with joint bender splints; a detector to signal the passage of animals by a given point during ecology studies; and special cushioning for use with below-knee amputees to protect the integrity of the skin at the stump/prosthesis interface

Remediating Learners with Learning Challenges Resulting from Obvious Physiologically –Influenced Special Needs in the Regular Classroom Setting

Learning as a dynamic task requires the synergy of various factors in order for the learner to benefit from the instruction being passed. Several factors could however impede on the successful transmission of ideas, as well as effective learning, among which is the learner’s innate ability, learning style, cultural background and emotional status. Also, an important factor affecting learning is the learner’s physiological makeup - some conditions that at times could present as a special need area and would require effective management for adequate learning to transpire. The author examined how learners with physiological peculiarities could be helped to learn appropriately in the classroom setting, and their learning poblems ameliorated. Keywords: classroom, learner, learning, special needs

Taking Nonprofits at Their Word: The Role of Conflict over Mission in Organizational Change and Response to Environmental Pressures

Central to any nonprofit is a mission; a defining purpose and set of values that provide its exempt purpose, differentiate it and motivate action by the organization and others on its behalf. Even the most formal and established mission is subject to redefinition, interpretation and different ideas over achieving it. This dissertation addresses the question of what role these interpretations of mission play in the processes by which nonprofits change, not just mission but also leadership, strategy and structure. Two distinct theoretical models are examined for fit with empirical results: (1) change processes as a response to external pressure moderated by organizational characteristics, from organization theory and nonprofit management research, and (2) change processes as internal contests over ideas, adapted from global and national level advocacy and policy process theories. Mixed methods are used to address this research question and evaluate the two models. Logistic regression of panel data on 152 internationally active nonprofits over 14 years is used to identify factors correlated with various changes. Through process tracing, narratives of change for a series of four case studies on similar nonprofits are developed. Comparisons within cases, across the four, between the qualitative and quantitative elements, and with theory are used to explore the fit between results and the two models of change. This dissertation proposes and finds evidence of two new concepts: (1) personal mission conceptions, the different interpretations of mission held by individuals or groups within a nonprofit; and (2) dominant mission conceptions, the consensus interpretation at a particular time. Evidence from both forms of analysis provide little support for the organization theory model of change, while the case studies establish support for a potential model of internal politics wherein coalitions form around common mission conceptions, compete with the status quo or other coalitions, and push for particular changes