Try a new search

Format these results:

Searched for:

person:whs4

Total Results:

186


Association of Psychosocial Factors with Activation Among Patients with Glaucoma

Morse, Alan R; Hark, Lisa A; Gorroochurn, Prakash; Rojas, Rebecca; Seiple, William H; Shukla, Aakriti G; Wang, Yujia; Maruri, Stefania C; Henriquez, Desiree R; Harizman, Noga; Wang, Qing; Liebmann, Jeffrey M; Cioffi, George A
OBJECTIVE:To investigate the association of psychosocial factors with health self-management behaviors and beliefs among patients with POAG. DESIGN/METHODS:Prospective cross-sectional cohort study. PARTICIPANTS/METHODS:Patients (n=202) with mild, moderate, or advanced bilateral POAG. METHODS:Patients (n=1,164) were identified from electronic medical records at a single academic medical center. Letters soliciting participation were mailed to 591 randomly selected potential participants. Psychometric measures and a determinants of health questionnaire were administered by phone to 202 study participants. MAIN OUTCOME MEASURES/METHODS:The NEI VFQ-8 (NEI-VFQ), the Multidimensional Health Locus of Control (MHLC), the Perceived Medical Condition Self-Management Scale-4 (PMCSMS), the Patient Health Questionnaire-9 (PHQ), the Patient Activation Measure-13 (PAM), health literacy and a determinants of health questionnaire. RESULTS:=2.6%, 95% CI= [-0.664,-0.051], p=0.023). On multivariate analysis adjusting for age, sex and race, for each unit increase in PHQ, mean PAM score decreased (95% CI = [0.061,1.35], p=0.032); for each unit increase in MHLC 'Doctors', mean PAM score increased (95% CI=[-1.448,3.453], p<0.001); for each unit increase in MHLC 'Internal', mean PAM score increased (95% CI=[0.639,1.137 ], p<0.001); for each unit increase in MHLC 'Chance' , mean PAM score decreased (95% CI=[-0.685,-0.098], p=0.009). CONCLUSION/CONCLUSIONS:We identified modifiable behavioral factors that could increase patients' self-perceived ability and confidence to manage their own eye care. Locus of control (MHLC), level of depression (PHQ), and self-rated functional vision (NEI-VFQ) were each associated with patient behaviors, attitudes and beliefs needed for health self-management (activation, assessed by the PAM) and may be important determinants of adherence behaviors. Targeting change in patients' care beliefs and behaviors may improve activation and treatment outcomes.
PMID: 38320666
ISSN: 2589-4196
CID: 5632572

Virtual reality as a means to explore assistive technologies for the visually impaired

Ricci, Fabiana Sofia; Boldini, Alain; Ma, Xinda; Beheshti, Mahya; Geruschat, Duane R; Seiple, William H; Rizzo, John-Ross; Porfiri, Maurizio
Visual impairment represents a significant health and economic burden affecting 596 million globally. The incidence of visual impairment is expected to double by 2050 as our population ages. Independent navigation is challenging for persons with visual impairment, as they often rely on non-visual sensory signals to find the optimal route. In this context, electronic travel aids are promising solutions that can be used for obstacle detection and/or route guidance. However, electronic travel aids have limitations such as low uptake and limited training that restrict their widespread use. Here, we present a virtual reality platform for testing, refining, and training with electronic travel aids. We demonstrate the viability on an electronic travel aid developed in-house, consist of a wearable haptic feedback device. We designed an experiment in which participants donned the electronic travel aid and performed a virtual task while experiencing a simulation of three different visual impairments: age-related macular degeneration, diabetic retinopathy, and glaucoma. Our experiments indicate that our electronic travel aid significantly improves the completion time for all the three visual impairments and reduces the number of collisions for diabetic retinopathy and glaucoma. Overall, the combination of virtual reality and electronic travel aid may have a beneficial role on mobility rehabilitation of persons with visual impairment, by allowing early-phase testing of electronic travel aid prototypes in safe, realistic, and controllable settings.
PMCID:10281573
PMID: 37339135
ISSN: 2767-3170
CID: 5542612

Wearables for Persons with Blindness and Low Vision: Form Factor Matters

Han, Yangha Hank; Beheshti, Mahya; Jones, Blake; Hudson, Todd E; Seiple, William H; Rizzo, John-Ross Jr
Based on statistics from the WHO and the International Agency for the Prevention of Blindness, an estimated 43.3 million people have blindness and 295 million have moderate and severe vision impairment globally as of 2020, statistics expected to increase to 61 million and 474 million respectively by 2050, staggering numbers. Blindness and low vision (BLV) stultify many activities of daily living, as sight is beneficial to most functional tasks. Assistive technologies for persons with blindness and low vision (pBLV) consist of a wide range of aids that work in some way to enhance one's functioning and support independence. Although handheld and head-mounted approaches have been primary foci when building new platforms or devices to support function and mobility, this perspective reviews potential shortcomings of these form factors or embodiments and posits that a body-centered approach may overcome many of these limitations.
PMID: 37115821
ISSN: 1949-3614
CID: 5465582

The BLV App Arcade: a new curated repository and evaluation rubric for mobile applications supporting blindness and low vision

Liu, Bennett M; Beheshti, Mahya; Naeimi, Tahareh; Zhu, Zhigang; Vedanthan, Rajesh; Seiple, William; Rizzo, John-Ross
PURPOSE/UNASSIGNED:Visual impairment-related disabilities have become increasingly pervasive. Current reports estimate a total of 36 million persons with blindness and 217 million persons with moderate to severe visual impairment worldwide. Assistive technologies (AT), including text-to-speech software, navigational/spatial guides, and object recognition tools have the capacity to improve the lives of people with blindness and low vision. However, access to such AT is constrained by high costs and implementation barriers. More recently, expansive growth in mobile computing has enabled many technologies to be translated into mobile applications. As a result, a marketplace of accessibility apps has become available, yet no framework exists to facilitate navigation of this voluminous space. MATERIALS AND METHODS/UNASSIGNED:We developed the BLV (Blind and Low Vision) App Arcade: a fun, engaging, and searchable curated repository of app AT broken down into 11 categories spanning a wide variety of themes from entertainment to navigation. Additionally, a standardized evaluation metric was formalized to assess each app in five key dimensions: reputability, privacy, data sharing, effectiveness, and ease of use/accessibility. In this paper, we describe the methodological approaches, considerations, and metrics used to find, store and score mobile applications. CONCLUSION/UNASSIGNED:The development of a comprehensive and standardized database of apps with a scoring rubric has the potential to increase access to reputable tools for the visually impaired community, especially for those in low- and middle-income demographics, who may have access to mobile devices but otherwise have limited access to more expensive technologies or services.
PMID: 36927193
ISSN: 1748-3115
CID: 5495902

A Smart Service System for Spatial Intelligence and Onboard Navigation for Individuals with Visual Impairment (VIS4ION Thailand): study protocol of a randomized controlled trial of visually impaired students at the Ratchasuda College, Thailand

Beheshti, Mahya; Naeimi, Tahereh; Hudson, Todd E; Feng, Chen; Mongkolwat, Pattanasak; Riewpaiboon, Wachara; Seiple, William; Vedanthan, Rajesh; Rizzo, John-Ross
BACKGROUND:ION (Visually Impaired Smart Service System for Spatial Intelligence and Onboard Navigation), an advanced wearable technology, to enable real-time access to microservices, providing a potential solution to close this gap and deliver consistent and reliable access to critical spatial information needed for mobility and orientation during navigation. METHODS:ION. In addition, we will test another cohort of students for navigational, health, and well-being improvements, comparing weeks 1 to 4. We will also conduct a process evaluation according to the Saunders Framework. Finally, we will extend our computer vision and digital twinning technique to a 12-block spatial grid in Bangkok, providing aid in a more complex environment. DISCUSSION/CONCLUSIONS:Although electronic navigation aids seem like an attractive solution, there are several barriers to their use; chief among them is their dependence on either environmental (sensor-based) infrastructure or WiFi/cell "connectivity" infrastructure or both. These barriers limit their widespread adoption, particularly in low-and-middle-income countries. Here we propose a navigation solution that operates independently of both environmental and Wi-Fi/cell infrastructure. We predict the proposed platform supports spatial cognition in BLV populations, augmenting personal freedom and agency, and promoting health and well-being. TRIAL REGISTRATION/BACKGROUND:ClinicalTrials.gov under the identifier: NCT03174314, Registered 2017.06.02.
PMCID:9990238
PMID: 36879333
ISSN: 1745-6215
CID: 5432642

Network-Aware 5G Edge Computing for Object Detection: Augmenting Wearables to &#x201C;See&#x201D; More, Farther and Faster

Yuan, Zhongzheng; Azzino, Tommy; Hao, Yu; Lyu, Yixuan; Pei, Haoyang; Boldini, Alain; Mezzavilla, Marco; Beheshti, Mahya; Porfiri, Maurizio; Hudson, Todd; Seiple, William; Fang, Yi; Rangan, Sundeep; Wang, Yao; Rizzo, J. R.
Advanced wearable devices are increasingly incorporating high-resolution multi-camera systems. As state-of-the-art neural networks for processing the resulting image data are computationally demanding, there has been a growing interest in leveraging fifth generation (5G) wireless connectivity and mobile edge computing for offloading this processing closer to end-users. To assess this possibility, this paper presents a detailed simulation and evaluation of 5G wireless offloading for object detection in the case of a powerful, new smart wearable called VIS4ION, for the Blind-and-Visually Impaired (BVI). The current VIS4ION system is an instrumented book-bag with high-resolution cameras, vision processing, and haptic and audio feedback. The paper considers uploading the camera data to a mobile edge server to perform real-time object detection and transmitting the detection results back to the wearable. To determine the video requirements, the paper evaluates the impact of video bit rate and resolution on object detection accuracy and range. A new street scene dataset with labeled objects relevant to BVI navigation is leveraged for analysis. The vision evaluation is combined with a full-stack wireless network simulation to determine the distribution of throughputs and delays with real navigation paths and ray-tracing from new high-resolution 3D models in an urban environment. For comparison, the wireless simulation considers both a standard 4G-Long Term Evolution (LTE) sub-6-GHz carrier and high-rate 5G millimeter-wave (mmWave) carrier. The work thus provides a thorough and detailed assessment of edge computing for object detection with mmWave and sub-6-GHz connectivity in an application with both high bandwidth and low latency requirements.
SCOPUS:85126309496
ISSN: 2169-3536
CID: 5189272

Reduction in Mammography Screening for Breast Cancer Among Visually Impaired Women

Wu, Annie M; Morse, Alan R; Seiple, William H; Talwar, Nidhi; Hansen, Sean O; Lee, Paul P; Stein, Joshua D
PURPOSE/OBJECTIVE:Timely receipt of mammograms to screen for breast cancer in accordance with the United States Preventive Services Task Force (USPSTF) recommendations can substantially reduce morbidity and mortality. The purpose of this study is to assess whether odds of receiving screening mammograms are similar for women with and without visual impairment. DESIGN/METHODS:Retrospective longitudinal cohort study. PARTICIPANTS/METHODS:1044 females, 65-72 years of age, enrolled in fee-for-service Medicare from January 1, 2008 to December 31, 2015. METHODS:We matched patients with no vision loss (NVL), partial vision loss (PVL), and severe vision loss (SVL) 1:1:1 based on age, race, time in Medicare, urbanicity of residence, and overall health. Women with pre-existing breast cancer were excluded. Multivariable conditional logistic regression modeling compared the odds of receiving screening mammography within a 2-year follow-up period among the 3 groups. MAIN OUTCOMES MEASURES/METHODS:Proportion receiving mammography and adjusted odds ratios (OR) of receiving mammography within 2 years of follow-up among the groups. RESULTS:A total of 1044 patients were matched (348 in each group). The mean ± SD age at the index date was 69.0 ± 1.5 years for all 3 groups. The proportion of women receiving ≥ 1 mammogram within the 2-year follow-up period was 69.0% (n=240), 56.9% (n=198), and 56.0% (n=195) for the NVL, PVL and SVL groups, respectively (p=0.0005). The mean ± SD number of mammograms received per patient during the 5-year period (3-year look-back plus 2-year follow-up period) was 3.1 ± 2.0, 2.5 ± 2.0, and 2.3 ± 2.1 for the NVL, PVL and SVL groups, respectively (p<0.0001). Women with SVL had 42% decreased odds (OR=0.58; 95% CI: 0.37-0.90, p=0.01), and those with PVL had 44% decreased odds (OR=0.56; CI:0.36-0.87, p=0.009) of receiving mammography during the follow-up period compared to those with NVL. CONCLUSIONS:Women with visual impairment were significantly less likely to receive mammography to screen for breast cancer than their non-visually-impaired counterparts. Clinicians should look for ways to help ensure that patients with visual impairment receive mammograms and other preventive screenings as recommended by the USPSTF.
PMID: 32682837
ISSN: 1549-4713
CID: 4531812

The global crisis of visual impairment: an emerging global health priority requiring urgent action [Editorial]

Rizzo, John-Ross; Beheshti, Mahya; Hudson, Todd E; Mongkolwat, Pattanasak; Riewpaiboon, Wachara; Seiple, William; Ogedegbe, Olugbenga G; Vedanthan, Rajesh
PMID: 33332166
ISSN: 1748-3115
CID: 4718052

ASSIST: Evaluating the Usability and Performance of an Indoor Navigation Assistant for Blind and Visually Impaired People

Nair, Vishnu; Olmschenk, Greg; Seiple, William H; Zhu, Zhigang
This paper describes the interface and testing of an indoor navigation app - ASSIST - that guides blind & visually impaired (BVI) individuals through an indoor environment with high accuracy while augmenting their understanding of the surrounding environment. ASSIST features personalized interfaces by considering the unique experiences that BVI individuals have in indoor wayfinding and offers multiple levels of multimodal feedback. After an overview of the technical approach and implementation of the first prototype of the ASSIST system, the results of two pilot studies performed with BVI individuals are presented - a performance study to collect data on mobility (walking speed, collisions, and navigation errors) while using the app, and a usability study to collect user evaluation data on the perceived helpfulness, safety, ease-of-use, and overall experience while using the app. Our studies show that ASSIST is useful in providing users with navigational guidance, improving their efficiency and (more significantly) their safety and accuracy in wayfinding indoors. Findings and user feedback from the studies confirm some of the previous results, while also providing some new insights into the creation of such an app, including the use of customized user interfaces and expanding the types of information provided.
PMID: 32790580
ISSN: 1949-3614
CID: 4556612

Decreasing Avoidable Vision Loss: Identifying Antecedents of Adherence

Morse, Alan R; Seiple, William H
Adherence to medication treatment protocols and active participation by individuals in their medical care are important for all patients, but especially for those with chronic conditions such as vision loss. Adherence is crucial for decreasing avoidable vision loss. Failure to take medications as prescribed and keep scheduled appointments reduces treatment effectiveness, increases complications and results in poorer outcomes. Reasons for nonadherence vary by diagnosis and include not understanding the importance of adherence, low health literacy, lack of adequate self-efficacy, low level of activation and behavioral issues including depression. Patients may lack information about their condition and its prognosis, available treatment alternatives, and other essential information such as how to monitor their eye condition, what to do if vision deteriorates and how to get needed community-based help. Each of these factors impedes patients' ability to engage with their physician and participate in their own care. The ability of individuals with vision loss to actively and effectively manage their health care, ie, activation, has been understudied. When patients are involved with their own care, their care experience, and most importantly, their outcomes, are improved. Identifying antecedents of adherence may help provide disease- and patient-specific pathways to reduce avoidable vision loss.
PMCID:7648526
PMID: 33173271
ISSN: 1177-5467
CID: 4665132