Performance on clinical outcomes, activities of daily living and user experience on head-mounted displays for people with vision impairment.

PURPOSE: To compare the objective performance, acceptance and usability of head-mounted displays (HMDs) to provide evidence-based data that could be used to increase the efficiency of device referrals based upon a person's vision loss and functional needs. METHODS: A cross-sectional, counterbalanced, individually controlled crossover study was performed on 15 adults with various eye conditions. Performance was measured when using four HMDs: eSight4, Eyedaptic EYE3, Eyedaptic EYE4 and IrisVision Inspire. Performance on clinical visual acuity tests and contrast were assessed, as well as vision-related activities of daily living (ADL) which were divided into three categories: Reading, Searching & Identifying and Eye-hand Coordination. User-experience was also assessed. Logistic regression analyses, Friedman one-way repeated measure analyses of variance by ranks and multivariate permutation testing were used for analysis. RESULTS: There was a significant improvement in visual acuity when using all devices. For contrast tasks, only the eSight4 and Eyedaptic EYE3 improved performance relative to baseline. For most Reading and Searching & Identifying tasks, the odds of being able to perform the tasks were significantly higher while using the devices. However, the actual performance with most devices (e.g., number of words read or reading speed) did not improve significantly over baseline for most tasks. For the Eye-hand Coordination tasks, participants performed equivalent to or significantly poorer than baseline when using the devices. No demographic or clinical predictors of outcomes were identified. Participants expressed dissatisfaction with the devices' effectiveness, acceptability and usability. CONCLUSIONS: While performance on clinical tests was better when using the devices, performance on most real-world ADLs was equal to or worse than baseline. No single device improved performance on all tasks, and performance on any one task was not improved with all the devices. The overall dissatisfaction with the devices paralleled the lack of objective improvement in the performance of real-world tasks.

Aspectos éticos del consentimiento informado: tópico fundamental en la investigación a lo largo de la historia / Ethical aspects of informed consent: fundamental topic of research throughout history

Las vulneraciones de los derechos humanos a lo largo de la historia desarrollaron las directrices éticas de la investigación científica. OBJETIVO: Reflexionar sobre los aspectos y principios éticos involucrados, características y principales conflictos actuales relacionados con el proceso del consentimiento informado (CI). RESULTADOS: Los resultados principales dejaron a la luz los principales conflictos al llevar a cabo investigaciones con poblaciones vulnerables, así como también las barreras asociadas a la aplicación y comprensión del proceso de CI. CONCLUSIÓN: La violación de derechos en seres humanos para la investigación dio pie a la creación del CI como medida ética y legal a quienes participan en ella, cuidando especialmente a poblaciones más vulnerables. Además la incorporación de esta temática a la formación de profesionales permitió defender los derechos de los participantes e impedir que actos crueles vuelvan a ocurrir.

Violations of human rights throughout history developed ethical guidelines for scientific research. AIM: Reflection on the aspects and ethical principles involved, main characteristics and current conflicts related to the process of informed consent (IC). RESULTS: The main results showwhat were the main conflicts in conducting research with vulnerable populations, as well as the barriers associated with the application and understanding of IC process. CONCLUSION: violation of human rights for research gaverise to the creation of CI as an ethical and legal measure to those involved in it, especially caring for vulnerable populations. In addition, the incorporation of this subject to the training of professionals allowed to defend the rights of the participants and to prevent cruel acts from happening again

A demanda espontânea na Estratégia de Saúde da Família: revisão integrativa / Spontaneous demand in the Family Health Strategy: an integrative review / La demanda espontánea en la Estrategia de Salud de la Familia: una revisión integradora

Objetivo: analisar a produção científica que tratem sobre a demanda espontânea na Estratégia de Saúde da Família. Método: revisão integrativa, nos últimos 5 anos, nas bases de dados LILACS e BDENF, com vistas a responder a seguinte questão << Como se dá a integração da demanda espontânea às atividades programadas da Estratégia de Saúde da Família? >> Foram utilizadas combinações entre as palavras-chave: "demanda espontânea", "atenção básica", "estratégia Saúde da Família" e o descritor: "Atenção Primária à saúde". Os dados foram tratados a partir da Técnica de Análise de Conteúdo na modalidade Análise Temática. Resultados: foram analisados sete artigos, todos encontrados na base LILACS. Conclusão: Foi percebida a escassez de material dos últimos cinco anos que discute a temática, sugere-se a continuidade de estudos voltados à demanda espontânea no cenário da Estratégia de Saúde da Família.(AU)

Objective: analyzing the scientific literature that approach about spontaneous demand in the Family Health Strategy. Method: an integrative review, in the last 5 years, the LILACS and BDENF databases, in order to answer the following question << How is the integration of spontaneous demand to the planned activities of the Family Health Strategy? >> Combinations were used between descriptors, "spontaneous demand", "primary care", "Family Health Strategy" and the descriptor: "Primary Health Care". The data were analyzed from the Content Analysis Technique in thematic analysis mode. Results: seven articles were analyzed, all found in the LILACS database. Conclusion: it was perceived shortages of material of the last five years discussing the issue; it suggests the continuity of research turned to spontaneous demand in the scenario of the Family Health Strategy.(AU)

Objetivo: analizar la literatura científica que trata sobre la demanda espontánea en la Estrategia de Salud de la Familia. Método: una revisión integradora, en los últimos 5 años, las bases de datos LILACS y BDENF, con el fin de responder a la siguiente pregunta << ¿Cómo es la integración de la demanda espontánea de las actividades previstas de la Estrategia de Salud de la Familia? >> Las combinaciones se utilizaron entre los descriptores, "demanda espontánea", "atención primaria", "Estrategia de Salud de la Familia" y el descriptor: "Atención Primaria a la Salud". Los datos fueron analizados por la Técnica de Análisis de Conteúdo en el modo de Análisis Temático. Resultados: se analizaron siete artículos, todos se encuentran en la base de datos LILACS. Conclusión: se percibe escasez de material de los últimos cinco años que habla acerca del tema, sugiere la continuidad de la investigación a la demanda espontánea en el escenario de la Estrategia Salud de la Familia.(AU)