Full Issue: AccessWorld May 2018

AccesWorld News

2018 M-Enabling Summit: June 11–13, 2018

The M-Enabling Summit, the conference and showcase promoting accessible technology and environments for seniors and users of all abilities, will be held on June 11-13, 2018, at the Renaissance Arlington Capital View Hotel, in Washington, DC. It is the annual meeting place for all who create and contribute to accessible ICT products, services and consumer technologies.

With its 2018 theme of "Accessible and Assistive Technologies Innovations: New Frontiers for Independent Living," the M-Enabling Summit sets the stage for focusing on next-generation innovation and breakthrough solutions for all in the accessibility field. It also offers a platform to network with accessibility professionals, organizations, and decision makers seeking to address compliance challenges and market development opportunities.

The Summit's program will focus on accessibility innovations, with over 120 speakers, private sector leaders, developers, policy makers, mobile accessibility experts and disability advocates sharing their knowledge and experience. Confirmed presenters include representatives of leading organizations facilitating the accessible technology market. Dr.Jeff Jaffe, CEO of the World Wide Web Consortium (W3C), will be delivering the opening morning keynote on June 12, 2018. The M-Enabling Summit will also host the FCC Chairman's Awards for Advancement in Accessibility (Chairman's AAA) on June 12th. FCC Chairman Ajit Pai will address Summit participants in his evening keynote.

Highlighted Sessions and Topics: Artificial Intelligence (AI) and Robotics, Augmented and Virtual Reality (AR/VR), Aging in Place: Connected Health and Big Data for Activity Monitoring, Accessible Security, Identification and Privacy Protection, Digital Assistants, Autonomous Mobility, Consumer Technology Products and IoT for Independent Living, and Accessible Smart Cities, Higher Education and Workplaces

Due to the successful addition of the International Association of Accessibility Professionals (IAAP) Pre- Conference Session at last year's M-Enabling Summit; the IAAP Annual Conference has been integrated into the 2018 Summit, where it will be hosting technical and organizational training tracks throughout the 3-day event.

View the complete agenda.

Lighthouse Guild Offers e-Learning Course on Low Vision Assessment for Occupational Therapy

Lighthouse Guild, in partnership with the American Occupational Therapy Association (AOTA,) is offering a two-hour online program designed for occupational therapists in all settings. The course titled "Low Vision Assessment for Occupational Therapy" demonstrates the basic strategies and tools for assessing vision loss. It also reviews how to formulate goals and interventions to address identified vision impairments and improve occupational performance.

The goal of the Lighthouse Guild e-learning curriculum is to prepare occupational therapists and other professionals to identify and address vision issues, refer patients to vision rehabilitation, and improve effectiveness, quality of care, and quality of life for adults and children with vision loss.

"Low Vision Assessment for Occupational Therapy" is approved for .2 AOTA CEU (2.5 NBCOT PDUs/2 contact hours.) For more information or to register visit: eLearning.

The program for occupational therapists is part of an extensive e-learning curriculum being developed by, and available from, Lighthouse Guild for healthcare vision and education professionals, including ophthalmologists, ophthalmology residents, optometrists, nurses, social workers, teachers, and others.

Announcing the Release of Version 3.3.1 of Sendero's iPhone GPS Apps

  • Seeing Eye GPS (subscription in the Americas)
  • RNIB Navigator (subscription in the UK, Ireland, France and Germany)
  • Guide Dogs NSW/ACT (subscription in Australia)
  • Seeing Eye GPS XT (no subscription)

Thanks to continued support from a federal grant from the National Institute of Disability, Independent Living and Rehabilitation Research, Serotek has released version 3.3.1 of the Sendero iPhone GPS apps!? It is also continuing to work on indoor navigation and will be conducting its second field test in Baltimore, MD, at the National Federation of the Blind's Jernigan Institute.

Warning: Before you install the update, share your user points of interest with your email; otherwise, they will be deleted from the app. You can then click on the attachment of the email on your phone to import them into the new version.

What's New in Version 3.3.1

The updates were implemented to ensure app compatibility and stability.? Specifically:

  1. Upgraded the software platform to Swift to ensure future compatibility.
  2. Increased the Google Maps query limit

Countries and regions available as of 2018: USA, Puerto Rico, Virgin Islands, Canada, UK, France, Ireland, New Zealand, Argentina, Australia, Austria, Belgium, Germany, Lithuania, Spain, Switzerland, Turkey, and Israel.

As always, make the most of your phone's portable convenient functionality by using it in conjunction with Sendero Maps on the PC, on the Apex or on the Braille Sense to explore and familiarize yourself with an area. You can find the iPhone apps in the App Store and the other Sendero products on the Sendero website.

Telephone technical support for Sendero iPhone apps is not available; Frequently Asked Questions will address common issues. . Suggestions or questions that are not addressed by the FAQs can be sent to our support team.

National Industries for the Blind Hosts A Great American Workforce, Virtual Event Open to Legally Blind Jobseekers

Event Date: May 9th, 11 am – 2 pm Eastern

Register for the career fair by following this link.

Registration Instructions for Screen Readers

List of Participating Agencies/Employers

For more information: 770-980-0088, NIB@CareerEco.com.

Victor Reader Trek: Another Cool Gadget for Your Bag or Pocket

Over a decade ago, HumanWare took the summer conventions by storm with its new product, the Victor Reader Stream. Similar in size to many cell phones at that time (a bit larger than most smart phones today), the Victor Reader Stream could play books from the National Library Service for the Blind and Physically Handicapped (NLS), books from Audible, and even had an internal text-to-speech capability that meant it could read books from Bookshare or, for that matter, any of your text documents.

The Stream, as most users came to call it, could play your music, too. For many people, it became the recorder and quick note taker of choice, as its built-in microphone produced a remarkably clear recording of quick notes, lectures, or other voice recordings.

Later, a second generation Stream was introduced, this time a bit smaller and offering wireless capabilities. In about 2011, a product with similar physical appearance was released by HumanWare for way-finding. The Trekker Breeze was a fair product, but slow to connect and a bit clunky by today's standards to carry on one's person. Again, we reviewed it in AccessWorld and were happy enough with it for the state of technology at that time.

Technology is a moving target, as we all know, sometimes changing faster than we can even analyze or write about. Looking back, it seems that many of us abandoned our Victor Reader Streams and other devices for the slimmer, sleeker iPhone. When Apple made the iPhone accessible, many blind consumers eventually discovered that it was all they needed. I have used only my phone for on-the-go reading for many years now, using the old Stream only very occasionally for testing purposes.

The Victor Reader Trek is Worth Examination

When HumanWare announced its brand-new Victor Reader Trek last summer, I was intrigued. Packing the power of the Victor Reader Stream (second generation) and the Trekker Breeze into one small package warranted examination. Blind consumers already were very divided regarding this product. While many were using their Victor Streams constantly, others argued that it was wiser somehow to put aside all those "specialty" products and use a mainstream product that everyone else (aka sighted folks) was using as well. Both perspectives have merit. Only spending time with this new product would enable me to figure out which made more sense.

Physical Description of the Reader Trek

HumanWare has a genuine knack for developing products that are esthetically pleasing to hold in your hand, with buttons and switches that are easily identified with or without vision. Even though I had never personally used a second-generation Victor Stream and my original Victor had spent most of its time in a drawer for the past five years, meeting the Victor Trek was something akin to a reunion with an old friend.

Weighing 5 ounces, the Victor Trek rests easily in one hand. The face has three distinctly shaped buttons across the top, a 12-key telephone style key pad, and four keys at the bottom. Most keys have functions in both reader and GPS modes. A boldly raised and easily identifiable line runs across the face of the unit, separating the number keys from the four at the bottom. Immediately below that line is key that serves both as a time and date announcer and as a sleep timer. Below it are the rewind, play/stop, and fast forward keys. On the top edge are the SD card slot and 3.5 mm jack for headphones or an external speaker. The bottom edge holds the micro USB port, used both for powering the unit and attaching other storage devices holding content to be played or copied. The left edge has the power button and up/down volume keys (also used to adjust speed and tone.) The right-hand edge holds the record button. Plenty of tactile markings render it nearly impossible to press the wrong key or even fumble about to find the desired one. The three keys across the top are uniquely shaped and widely spaced. On the number pad, the 5 has two dots, and the edges of the 2, 4, 6, and 8 keys are marked with raised semi-circles. The four keys at the bottom of the front face are also shaped intuitively as left and right arrows, rectangular play/stop, and an oval button for the sleep timer.

The Victor Trek comes in a silicone fitted case and includes a user-replaceable lithium-ion battery, ear buds, USB cable, power adapter, short USB cord for attaching external storage media, lanyard and belt clip. Maps relevant to your location are already on board — all of the United States and Canada for customers in these two countries.

The Trek has both wireless and Bluetooth capacities. Its battery life is reasonably good — lasting about 12 hours in my experience, longer if not using GPS or wireless features.

Features of the Victor Reader Trek

The Victor Trek can play DAISY, ePub, and other book formats. It can play books downloaded from the NLS, Bookshare, Audible, and other MP3 files. Its built-in text-to-speech capabilities allow it to read text and braille files, too.

It can download and play podcasts, stream Internet radio stations, and download all your favorite publications from NFB NEWSLINE.

My previous experience was with the original Victor Reader Stream, which does not have wireless connectivity. Adding wireless to the second-generation Stream was a huge improvement and thus equally welcome in the Victor Trek.

Once you have set up logins to your accounts with NLS BARD, Bookshare, and NFB NEWSLINE, downloading new books, magazines, and newspapers is blissfully simple and efficient.

You can add as many books from any of these sources as you like and they will be added to the download queue. If all of the items in the queue haven't downloaded during a given session, Victor Trek will continue the download process the next time the device is turned on. If you subscribe to a number of podcasts, for example, it is not uncommon to hear a pleasant background chime periodically as you are listening to a book, radio station, or podcast to announce that another download is complete.

You can set bookmarks in your text or audio books. These can be simple place markers inserted into the text. They can also be recorded bookmarks (a comment recorded with your own voice, for example, to remind you what is particularly valuable about a given segment of text), or they can be highlighted bookmarks in which you select a given sentence, phrase, or paragraph to be highlighted.

The Trek will keep your place in all of the books and magazines you are currently reading.

You can navigate books to whatever degree the individual markup of a book allows — chapters, parts, sections, etc. — and can do so easily with the 2, 4, 6, and 8 keys, which act as arrow keys on the number keypad. As indicated earlier, the up and down volume arrows also serve to adjust speed and tone.

The user's guide is always available by pressing and holding the number 1 key. The text-to-speech document can be navigated by major sections and subsections, as well as by screen, line, paragraph, or word. As with all text documents, a word can be spelled by focusing on it and selecting the Spell word option with the up and down arrows.

Podcasts Made Easy

HumanWare gets its customers started with a number of popular podcasts — mostly related to blindness, music, and current events — but searching, browsing, and subscribing to podcasts from the limitless reservoir of news and entertainment is again easy and intuitive. Similarly, the ability to stream thousands of Internet radio stations can provide endless entertainment and enlightenment. Here, too, HumanWare provides a playlist to get you started. Labeled "English North America," it includes a sampling of stations throughout the US and Canada featuring jazz, folk, country, or classical music, and news from various perspectives. (Information stations include the BBC World Service, NPR, C-SPAN, and several blindness related stations.)

Searching for a podcast, a radio station, or a book title is all done with the number pad. The bookmark key is used to change to uppercase, lowercase, or numbers. If, for example, you want to search for the podcast Fresh Air, you your press the 3 key 3 times and hear "D E F" followed by a click to indicate that the letter has been entered. If you want to enter a search string that is all numeric, press the bookmark key until you hear "numeric," indicating that the keys then represent only numbers.

Wherever you are in the Trek's various functions, the pound key is used to confirm and the star key to cancel.

Trekking with the Victor Reader Trek: GPS

To get started with the GPS feature of the Victor Reader Trek, the unit needs to recognize where you are. When the online button, a round button in the center of the top row of buttons is pressed, the Trek announces, "Searching for satellites." This is the most tedious of the device's learning curves — so much so that I initially wondered if this function worked at all. Actually, it just takes several minutes to locate satellites the first time you launch the GPS feature. Subsequent sessions seem to get shorter and shorter, until it is sometimes just a matter of seconds for the Trek to get its bearings.

If the GPS function is not used for a few days, it reverts to the painfully slow process of searching. Once the satellites are seen and location detected, using the Trek feature of the Victor Reader Trek is more or less smooth sailing.

You can simply walk a route and have the Trek record it for later, identifying intersections, landmarks, and points of interest along the way. You can map a route from where you are standing to where you are going, and you can record in your own voice names for landmarks you wish to find again. Victor Reader Trek begins operating in pedestrian mode, but you can switch to vehicle mode when you need information when traveling by car, bus, or train.

Key assignments are often intuitive here, carrying over from the Bookshelf key commands. The number 5 key, for example, is the Where Am I? key when using the GPS function (as it also is when in a book or text file). Press and hold the 5 key and you can hear a list of landmarks nearby.

The excruciating slowness to recognize position, particularly when the unit has not been used for three or more days, was disappointing. Once it detected the position of the device, however, the GPS feature performed well enough and the information was excellent. The Trek provides compass direction, current location, altitude, the speed at which you are walking, and descriptions of intersections. It gives you turn-by-turn navigation and allows you to explore your surroundings. The sometimes several-minute lag in the GPS start up could be a deterrent for customers who will not be using the way-finding functions on a daily basis.

To Trek or Not to Trek

Here are a few examples of how the Victor Trek's various functions can pull together for dazzling access to information:

  • I am listening to a favorite radio station via the Trek's Internet radio function. A brief story about a new Indian restaurant catches my attention. I move to the GPS function (waiting for the Trek to locate satellites and identify my position) and map a route to the restaurant. It is less than five miles from me, so I can plan a future dining excursion!
  • Another time, I hear an interview with an author who, new to me, has written a book of particular interest. I switch to the online bookshelf, navigate to NLS and search for the author's name. Within minutes, I am listening to the prologue.
  • Today, I am reading my local newspaper (via NFB NEWSLINE) and come across an article about Michelle Wolf's remarks at the White House Correspondents' Dinner. Wanting to find out who Michelle Wolf is, I move to the Trek's Wikipedia option to search for more information. Immediately, the text-to-speech voice is reading a full-blown article about the comedian and writer. (At this point, I can also pause to check the spelling of her name.)
  • The newspaper article mentioned an interview with Wolf on Fresh Air, so I move to my podcasts where I quickly locate that interview.

Conclusion

Circling back to that debate regarding mainstream versus specialty products for the blind and visually impaired, I am realizing how much I have appreciated the Trek while studying it for this review. Arguably, all of the Trek's functions might also be accomplished with a smart phone. That said, there are definitely some powerful advantages to using the Trek rather than the mainstream touchscreens offered by smart phones.

First, the Trek is dedicated to downloading, streaming, and playing information relevant to reading and way-finding. You won't get interrupted by phone call, text message, or social media alerts.

Secondly, not all blind and visually impaired people have warmed to smartphone touchscreens. There is a definite comfort factor to tangible buttons you can press. While I personally have not had difficulty mastering the touchscreen concept and use my iPhone for all of the tasks the Victor Reader Trek can perform, it is frequently faster and much more effortless to rotate from books to podcasts to NEWSLINE to GPS and so on with the straightforward and intuitive navigation offered by this specialty product and its authentic buttons. The ability to quickly record a note, record a landmark with your own voice, or insert a recorded or electronic bookmark into any book, document, or podcast you are playing is a wonderfully welcome convenience.

For some, playing braille files on the Trek may well be the only way to access the many books available exclusively in .brf formats.

Although the Victor Reader Trek was announced in the summer of 2017, customers ordering in the summer or fall reported not receiving their units until January and February of 2018. Customer service at HumanWare says that production has caught up with demand and that there are now ample units in stock.

At $699 USD and $895 CAD, the Victor Reader Trek is not a casual purchase for most people. It is, however, a remarkably powerful and versatile device with room to grow that will make an excellent addition to any blind person's collection of valuable tools.

For more information, visit HumanWare on the web or call: 800-722-3393.

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Looking Back on 20 Years of Assistive Technology: Where We've Been and How Far and Fast We've Come

They say the future is coming at us faster than ever, and this is true even for accessibility. I will be 65 years old this July, and (cue grumpy old man voice here) back in my day, we didn't have any of these dang computers and phones were attached to a wall. I threaded large reel-to-reel tapes to listen to my "Recordings for the Blind" textbooks—when they were available—and turned in many a blank page because I didn't realize the ribbon on my manual typewriter had run out of ink. And we liked it that way (exit grumpy old man voice).

If you are 25 years old or younger, you probably don't even remember a time when there wasn't a computer in your home, and when you didn't have at least rudimentary access to it. But as I said above, the future is coming faster than ever, and one of the best ways to gain perspective is to take a quick look back at some of the technologies that are now utterly out of date, and just how few years have passed since they were first introduced.

Five Years Ago

Let's start just five years ago, in the May 2013 issue of AccessWorld. Besides including my second AccessWorld article, it also includes A First Look at the Accessibility of the Google Chrome Operating System by J.J. Meddaugh. In this article, Meddaugh demonstrated the new ChromeVox screen reader using a Google ChromeBox. Yes, a ChromeBox, not a ChromeBook. The ChromeBox was basically a Chrome OS desktop computer, very small and compact, sort of like a Mac Mini in that you had to provide your own keyboard, display, and other USB devices. Meddaugh experienced difficulties with the ChromeVox screen reader, especially when it came to status screens and typing in Google Docs. Also, ironically, the first screen of the ChromeVox tutorial would not speak. Meddaugh concluded his first look this way: "While the web browser and parts of Chrome are quite usable now, much work still needs to be done. We look forward to the results and possible improvements from this beta program and will closely follow its development."

Ten Years Ago

In this current issue Shelly Brisbin offers us a roundup of the 2018 CSUN adaptive technology conference. Ten years ago Deborah Kendrick filed our CSUN roundup, reporting: "One of the hottest products of interest to blind consumers was the KNFB Mobile, a Nokia N82 mobile phone with the Kurzweil reading software on board. HumanWare introduced the Trekker Breeze, a new GPS product, and announced a new upgrade for the Victor Reader Stream that includes, among other features, compatibility with Serotek's System Access Mobile Network."

Fifteen Years Ago

In 2003, AccessWorld was just a pup, mostly limited to accessibility news, such as: "In February 2003, Bonnie O'Day of Alexandria, VA, filed a formal complaint with the FCC (Federal Communications Commission) against Audiovox Communications Corporation, a manufacturer of wireless products, and Verizon Wireless, a service provider, regarding the lack of accessible features in one of their high-end cell phones. This is the first formal complaint to ask the FCC to enforce the rights provided under Section 255 of the Communications Act (as amended by the Telecommunications Act of 1996), which requires telecommunications equipment and services to be accessible to and usable by people with disabilities, if readily achievable."

I wonder how that worked out. Are you reading this article on your iPhone or Android tablet?

20 Years Ago

The May 1998 issue of AccessWorld included an in-depth look at mobility training. There was not a single mention of GPS, because back then the system was US military only. In 1998 Vice President Al Gore announced a plan to make the GPS satellites transmit two additional signals to be used for civilian (non-military) applications, especially to improve aircraft safety. Congress approved the plan (called "GPS III") in 2000.

The issue also included a report of a survey on the availability of accessible alternatives to print materials on college campuses: "Kwan's study of 18 public universities in California revealed that the majority of universities that were surveyed required 2 to 6 days to provide basic instructional materials in braille or electronic text or on audiotape. Five of the universities stated that the braille production of such materials would require more than seven days, and 11 reported that electronic texts were not available."

Need to read that handout your prof just passed out? Open one of several mobile OCR apps and give it a quick scan. Then start Nearby Explorer and head to the closest coffee shop for a cappuccino.

Then…and Can You Hear Me Now?

Perhaps the most profound change in the past 20 years has been the development of mobile technologies.

iPhone

In 2009 the iPhone 3GS was released with a remarkable new accessibility feature: a built in touchscreen reader based on their OS X VoiceOver screen reader. Darren Burton took AccessWorld's first of dozens of looks at this remarkable breakthrough in September of that same year, and here it is worth a look back at his conclusion:

We do not often use the term 'revolutionary' in AccessWorld, but it does apply here. Apple's unique interface for accessing a flat touch-screen interface is not only important for accessing the seemingly unlimited apps that are available for the iPhone, but it proves the point that it can be done. This gives us hope of finding solutions for the many inaccessible touch screens many of us face in our daily lives. The third-party apps open up a myriad of possibilities, and Apple has done a great deal of work to make it possible for developers to design their apps to be compatible with Voiceover. They have created accessible Application Programming Interfaces (APIs) in iPhone OS 3.0, and the iPhone Software Developer Kit (SDK) costs only $99. You can learn more at the iPhone Dev Center [the link provided in the article is no longer active—Ed.]. Perhaps our community can approach these third-party vendors to work with us on the accessibility of their apps.

This is certainly a brand-new concept in accessibility, and there may be a learning curve for many people. However, most blind people I have spoken with about their use of the new iPhone have reported being up and running quickly. I definitely learned to use it quickly, but it is my job to do so, and I do not think the iPhone left my hands in the first two days. Some people may not get it as easily, so the rehabilitation and education professions may need to develop some training systems for using this new iPhone.

Can you hear me now? Yes, and Apple is still listening.

Android Phones

It was just seven years ago when the best access to an Android phone was Mobile Accessibility for Android from Code Factory. It cost $99, and only offered access to a suite of…

…10 homegrown and completely accessible apps, including a phone dialer, contacts manager, alarms, Web browser, mail client, calendar, and a simple GPS app. Other applications on the phone can be launched from the program as well.

Mobile Accessibility uses Nuance Vocalizer as its speech engine. Currently, there are only two voice options—male voices for U.S. and U.K. English—and you must choose your desired voice upon purchase; there is no way to switch between voices.

Can you hear me now? Yes, and Google's free built-in TalkBack touchscreen reader gets better with each release.

Windows Phones

In June of 2011 we reported: "Beginning with the Windows Mobile 5.0 operating system through version 6.5, Windows-based smartphones supported a compatible version of Mobile Speak and a screen reader from Dolphin called Smart Hal." However, as we reported in our December 2010 issue:

…[T]he 2010 release of Microsoft's new Windows Phone 7 operating system does not support any screen readers, and phones built on that operating system have no built-in accessibility to support people with vision loss. Although Microsoft has promised to remedy that situation, in the meantime our choices are limited by this shortcoming

Can you hear me now? What's a Windows phone?

BlackBerry

In May of 2010 Darren Burton took a look at Oratio, a brand new screen reader for the BlackBerry. He concluded:

Oratio's $449 price tag may give some AccessWorld readers sticker shock. That is understandable when you consider the VoiceOver screen reader is available on the iPhone at no extra cost. Oratio is also 50 percent more expensive than the TALKS and Mobile Speak screen readers that many of us use. We of course would like to see the price of Oratio come down, but at least we do now have an access solution for the BlackBerry devices. That is certainly good news for people whose job or potential job requires that they use a BlackBerry.

Can you hear me now? No.

Looking Ahead

Can you even imagine what my next roundup in the year 2038 will bring? I mean besides an even older, even grumpier old man?

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Vision Tech: Recent Retinal Research

Back in our very first Vision Tech article, Four Emerging Vision-Enhancing Technologies, we introduced you to the Argus II artificial retina, developed by Second Sight Medical Products and approved by the FDA in February of 2013 for the treatment of late-stage retinitis pigmentosa (RP). The Argus II uses special eyeglasses with a mounted camera that streams video to a small receiver/computer. This unit encodes the stream and sends the information to a retina-implanted chip, which forwards the signal through tiny electrodes into the optic nerve, and from there to the visual cortex.

In our most recent Vision Tech article, Vision Technology in Clinical Trial Phase: New Approaches to AMD Treatment and Sight Restoration, from the December 2017 issue, we noted the company has now received permission to begin preliminary human clinical trials of a visual prosthesis known as Orion. Orion will use the same type of external glasses and processor as the Argus, but instead of sending the signal to a retinal chip, the signals will be delivered to the visual cortex directly.

Both of these devices require special glasses, an external power supply, and a processing unit.

But what if we could do away with at least two of these? That's the thinking behind a new implant currently in clinical trials from the German company, Retina Implant AG. The device, called the RETINA IMPLANT Alpha AMS is also an implanted microchip, but it works on a different principle than the Argus.

First, to review how the Argus works: the processing unit receives a video stream from the eyeglass camera, then processes and interpolates it. This digital signal is then streamed wirelessly to the retinal chip, which, in turn, stimulates a layer of specialized ganglion cells. These cells forward the electrical signals through the optic nerve to the brain, and viola—vision.

"The German thinking is that we could stimulate these ganglia cells using normal light that enters the eye, without an external processor," says Dr. Samantha De Silva, Honorary Clinical Research Associate at the Nuffield Department of Clinical Neurosciences at Oxford University. This research laboratory has collaborated with Retina Implant AG in clinical trials of the device. "Instead of lying atop the retina, the RI Alpha AMS chip is placed underneath. 1,600 photodiodes are activated by the light, which then stimulates remaining inner retinal cells, such as bipolar cells, along with any still-functioning rods and cones. These signals are passed along to the ganglia cells upon which they rest. Following the natural optical path, the signal is then transmitted to the brain via the optic nerve, with no need for glasses, no outside processing—just a small power supply the user wears behind an ear."

The surgery for implantation of the subretinal chip is complex, however, and De Silva is researching another, simpler way to restore vision in damaged retinas, one that will require a more routine operation.

"RP and other inherited retinal diseases are related to a progressive loss of photoreceptor cells, mostly the rods and cones," she notes. "Rods handle vision in low light, while cones specialize in color vision."

Each of these photoreceptor types uses special proteins, collectively called opsins, which are activated by light and produce a chemical signal. Rods use a protein called rhodopsin, while cones use a variety of opsins with varying sensitivity to red, green, and blue light waves. These chemical signals are forwarded to intermediate cells called bipolar and horizontal cells. Bipolar cells are so named because they accept input from both rods and cones. Horizontal cells are the cells that enable us to adjust vision to varying light levels. Both cell types convert these chemical signals into electrical impulses, which are, in turn, forwarded to the optic nerve.

"The retina also hosts a third, lesser known type of photoreceptive cell, which is a subtype of ganglion cell," says DeSilva. "They are not usually involved in active vision. Instead these are the receptors responsible for using light to help us to set our internal clocks."

The signals are subtle. Only about one percent of ganglion cells respond to light using its own photoreceptor protein, called melanopsin.

DeSilva and other researchers used gene therapy to create a modified virus that expresses melanopsin. They then injected the virus under the retina of mice with induced RP.

"A significant proportion of the bipolar and horizontal cells began expressing melanopsin in the area of the retina where the virus was injected," De Silva reports. "The mice began displaying pupil constriction with light, and their ability to detect a change in visual surroundings returned to that of the control group. And the cells continued to produce melanopsin for the lifetime of the animal."

Melanopsin cannot create color vision, only pixels of black and white. "We can't use either rhodopsin or one of the red, green, or blue color pigments because they require a complex series of reactions to become reabsorbed and regenerate," she says. "But we think with further work we can produce vision which is roughly equivalent to a retinal implant."

De Silva estimates it will take another three years to begin clinical trials. Meanwhile…

Inflammation and Retinal Disease

Also awaiting clinical trials is another retinal treatment being worked on by a team of researchers led by the Massachusetts Eye and Ear Infirmary at Harvard Medical School. These researchers are taking a step back in the AMD process, and looking at one likely regulator of the disease progression: inflammation.

"Lipids are major modulators of inflammation. Some are beneficial and others are deleterious," says team organizer Kip Connor, a vision scientist at Mass. Eye and Ear and Assistant Professor of Ophthalmology at Harvard Medical School. "Several types of lipids can suppress inflammation."

According to Connor, these bioactive lipids—organic molecules derived from fatty acids—can be divided into two broad categories: those that stimulate an immune response and those that dampen it. "In healthy tissue these two types are in relative balance," says Connor, "but due to injuries and other signals, they can get out of balance, leading to inflammation, which, in turn, causes the tissue to attempt to heal by producing—in the eye—more growth factors (e.g. VEGF)."

In preclinical studies Connor and others identified a class of lipids that are able to dampen the immune response, allowing for disease resolution. "We then added back these bioactive metabolites and found that they confer this protective effect by dampening the inflammatory potential of circulating immune cells," he explains.

The team has demonstrated a 40- to 50-percent reduction in disease severity in their preclinical models, but there is still considerable work ahead. "These compounds degrade very quickly in the body, so one of our challenges is finding ways to make them last," Connor explains. Currently, the team has isolated two active agents: 17,18-epoxyeicosatetraenoic acid (EEQ,), and 19,20-epoxydocosapentaenoic acid (EDP), both of which seem to confer protection.

Their German partners have found a way to create synthetic analogs of both compounds, which are not degraded and still confer protection. "These molecules show promising therapeutic potential not only for AMD, but also for other major conditions that involve angiogenesis and inflammation: atherosclerotic cardiovascular disease, diabetes (particularly diabetic retinopathy), cancer, and retinopathy of prematurity, to name a few."

Connor ends by noting: "Given the high prevalence and progressive nature of neovascular eye disease, the ability to stabilize bioactive lipids that mitigate or halt disease is of great and increasing therapeutic significance. It is our hope that emerging technologies and future studies will expand on our work and ultimately lead to safe, targeted, and cost-effective therapies that markedly improve visual outcomes and quality of life for patients suffering from these ocular diseases."

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AccessWorld Is Listening

Lee Huffman

Dear AccessWorld readers,

That's right, we are listening to your comments on articles, reflecting on your questions about both mainstream and access technology, and hearing your thoughts and opinions on the future of braille and braille technology; video description; television programming access; accessible gaming; frustrating and inaccessible apps and feature phones; all the good, the bad, and the ugly with all things Windows, Apple, and Android; and much, much more.

The AccessWorld staff enjoys and, more importantly, very much appreciates hearing from all of you. Quite often a comment or question from a reader turns into an article that, in turn, provides information to the tens of thousands of readers who visit AccessWorld each and every month. In the coming months, the staff and I will rely increasingly on your feedback to drive content decisions we make for AccessWorld.

As you likely know, AFB is in the process of transitioning several of its programs to the American Printing House for the Blind (APH). As part of AFB's transition and re-focusing efforts, there may be some changes to AccessWorld next year. These changes could include expanding into new content areas, including national policy and legislation, research findings from the blindness field, and emerging technologies not yet on the market. In addition, you might see more articles aimed at members of accessibility teams in both large and small corporations and more interviews from thought leaders in the access technology and related fields.

My question to each of you is, "How would you like to have AccessWorld expand or change?" Please be thinking about this over the coming weeks and months, and give us your feedback. The best way to provide feedback is to send a letter to the editor.

In addition to thoughts for the future, we are also looking for both quantitative and qualitative feedback on current articles. Right now, I encourage you to use the "Comment on this article" link at the very bottom of each article to provide feedback, positive comments, and, yes, constructive criticism, for our team. You can also use that link to ask specific questions about each article. If you prefer, you can also send an e-mail directly to me. When you write in, remember that we may choose to publish your letter in the "Letters to the Editor" section of AccessWorld. The staff and I also believe it is important to know who says what. To that end, both first and last names (when available) are published in the "Letters to the Editor" section. If you do not want your name published, just let us know when you write in and we'll refrain from publishing your comments.

This is your opportunity to have your voice heard, so speak up! The AccessWorld staff is listening!

Sincerely,
Lee Huffman, AccessWorld Editor-in-Chief
American Foundation for the Blind

Letters to the Editor

Dear AccessWorld Editor,

This message is in reference to Bill Holton's April 2018 article, Accessible Dictation with Open Source DictationBridge.

I have been eagerly awaiting Dictation Bridge since I heard about it two years ago.

I have a blind student who can really benefit from dictation along with feedback from JAWS. I'm glad you've pointed out missing steps in the documentation because I wasn't sure I was doing it right.

I'll take another crack at it!

Thanks again,

Nancy

Dear AccessWorld Editor,

This message is in reference to Shelly Brisbin's April 2018 article, CSUN 2018 Heralds The Year of Wearables—Unless It Doesn't.

Excellent summaries of the low vision/blind wearable technology.

Did anyone look at the 'AngelEye Smartglasses' by Next VPU?

I have both RP and retina degeneration so [don't have] central or peripheral. The Angel Eye smartglasses are the one product I have come across that provides a range of functionality that would assist me in understanding and navigating my environment.

I would appreciate any information that you may have on this product.

I understand AngelEye smartglasses are only available in Asia, but my understanding is that development is underway to bring them to the North American market.

Thanks in advance,

Mike Moore

Dear AccessWorld Editor,

This message is in response to Bill Holton's April 2018 article, Accessible Dictation with Open Source DictationBridge.

I used Dragon Naturally Speaking version 11.5 in 2012 along with Window-Eyes 4.4, and I found I could complete the "voice training" exercise. I then used Dragon to input many, many pages of material. I was able to make spelling corrections and add to Dragon's word recognition lists successfully. Good luck with future versions of DictationBridge.

Regards,

Liz

ClickList by Kroger Expands Access to Online Grocery Shopping

Even though people with visual impairments often shop in physical grocery stores, online shopping provides a much more efficient experience in many situations. Kroger has recently developed a program called ClickList, which allows customers to shop online and then pick up their groceries without ever entering the store. I started using ClickList when it entered my area during the Beta phase of the service and I've found it invaluable. ClickList has now been integrated into the main Kroger website and the site has seen some major changes since its introduction. For this article, I will be exploring the accessibility of the online shopping site as well as the mobile shopping experience which was recently included in the Kroger app. Primary testing took place using the Firefox web browser paired with the NVDA screen reader, with secondary testing using JAWS paired with Firefox and Internet Explorer. Mobile testing was primarily performed using VoiceOver on iOS but secondary Android testing using the TalkBack screen reader was also included.

Getting Started with ClickList

To shop ClickList, you must first create a Kroger account. From the Kroger website, you can find a link that will allow you to do this just under the heading titled either "Shopping Cart" or "ClickList Shopping Cart." An option to sign into an existing account is also located here. In the app, there is a button in the top left of the "Home" tab where you can either sign in or create an account. The resulting form is preceded by a heading for easy navigation when signing up from the web; as with most apps, the form is the only content on the page if you're creating an account through the mobile app. You must provide a zip code so that Kroger can find local stores near you. Note that not all stores will have ClickList; only one of the three near me has ClickList available, but I can select any of the three during this step. If you don't know if ClickList is in your area, you can use the store locator to find out. In addition to selecting a store, you must also include your name, email address, and your Kroger Plus Card. If you don't have a Plus Card, you will have the option to create one from the account creation page.

Accessible Shopping on the Kroger Website

There are several methods for finding products to add to your cart after signing into the Kroger website. A search field appears just below the Kroger logo close to the top of the page. Just below the field is information about your store and the ability to reserve your pickup time. Following that is an expandable menu containing store departments. Once you choose a department, you can find sub-departments under a heading further down on the page. Note that, conveniently, the cart is always visible no matter what page you are on so you can make adjustments without leaving the page. Main page content such as products or sub-departments appear below the cart under their own heading. A heading called "Start My Cart" will appear on the landing page after signing in and when selecting a sub-department from a department's page. Below this heading you will find various products listed, with those that you have purchased recently at the top. Headings for "Sale Items" and "Recent Purchases" follow. Like the "Start Cart" heading, the "Sale Items" heading prioritizes those products you have purchased previously.

Above any list of products, no matter if they are from a department or a search, you will have filtering options. Each of these is preceded by a heading. The options available are category, brand, and nutrition. The category filter only works correctly when you have searched for items. If you are viewing products by sub department, the categories filter will display all the available departments at your selected store and the number of items in each. If you search for products, only categories containing the products of your search will be displayed. In addition, the categories appear as links so that only one can be selected, while both nutrition and brand use check boxes for options. The brands and nutrition filters also will provide a search field so that if many are available, you can find the specific choice you are looking for more quickly. The filter options can be collapsed and a screen reader will report this correctly, though the content of the filter will remain available to the screen reader even if you have closed it.

Each product entry begins with the product's image followed by the price. The product name follows as a heading and can be activated to display product images and details. Following the product title is the weight or size of the item with buttons for adding the item to the cart or to the shopping list just below. After adding an item to your cart, its "Add to Cart" button will disappear and be replaced with buttons to increase or decrease the quantity and a quantity edit field in the list of products. A product's detail page includes images of the product from different angles. In my tests these images were labeled so you could determine what side of the product was depicted. Some products include nutritional information or ingredients though this was not true for all. For products that include this information, separators were included that aided screen reader navigation.

Checking Out on the Kroger Website

To check out, you must first select the "View Cart" button located just after the last item in your cart. From here, you will choose your pickup time and indicate if you would like to receive substitutes on out-of-stock items. When you do this for the first time, it's possible to miss the substitution options as they are situated further down on the page from the Checkout button. Once you select the Checkout Now button, you will be taken to a page where you can complete your contact information and determine if you would like to receive text message updates about your order. In my experience these come in the form of a reminder message a few hours before you are scheduled to pick up your items. The subsequent page contains a form for entering your payment information. You can select to have Kroger remember your card for faster checkout on subsequent visits. The following page will contain a summary of your order. Your cart items are hidden by default but you can choose to have these shown if you wish. You cannot make changes here but links are provided to make edits to any aspect of the process. Once you choose to submit your order, you will be presented with a confirmation page that also contains a short FAQ regarding the pickup process as well as other aspects of the program.

Shopping Using the Kroger iOS Mobile App

The Kroger app on iOS uses a tabbed interface with the bulk of ClickList features in the Home tab. The home page somewhat resembles the desktop site. At the top of the page is a search field where you can search for products. Below this is a carousel of ads. VoiceOver seems to see multiples of each item, which gives the impression that the carousel is cycling if you attempt to swipe past it. You must touch the elements above or below the carousel to continue navigating efficiently.

Below the carousel is information about your ClickList store and delivery time with options to change both. Following these are the product categories "Sale Items," "Start My Cart," and "Coupons." Unlike the website, these are not labeled as headings. Each section displays a few products with the option to display more if desired.

It is possible to search for products using the app but I could not determine a way to view products by category/department using the app. When you search for products, only the search results are displayed on the screen. Just below the search field are options for viewing either products or Coupons with products selected by default. The app lists the number of items for products and coupons here as well. Products are each listed using two elements. The first is the name of the product, aisle, price, weight, and other details with the second being an "Add to Cart" button. If an item is already in your cart the "Add to Cart" button will be replaced with text alerting you to this fact. It is possible to filter your results by category, brand, or nutrition. To do so you must locate the Filter button. This appeared at the bottom of the search results; I found that the fastest way of finding this was to touch the Home tab and then swipe backwards from it.

If you would like to adjust the quantity of a product or add instructions, you must activate the product's name to do so. This adds an extra step compared with having all product options available on the main page of search results, but the fact that there are far fewer elements per item means that navigation is much faster when using a screen reader.

Checking Out Using the Kroger iOS App

Your cart can be found from the Cart tab located at the bottom of the screen. From here, you can see all of the products in your cart arranged by aisle. Each item appears as a single element with all information such as weight and price contained in the element's label. The quantity of the product is also listed. To make changes, you must activate the product's name where you can adjust quantity and add instructions for the item if desired. A search field is situated at the top of the cart page to make it easier to find items if you have many items in your cart. I would have preferred the quantity to be placed earlier in the list of information for each product or placed as its own item. Having to wait for VoiceOver to read the entire label for each product before I could check the quantity was time consuming.

At the bottom of your cart you will find a "Checkout" button. The checkout page follows a similar process to the website. At the top of the page you will see an element labeled "Pickup" selected followed by your store address. Next are the date and time options. These appear as plain text with the selected option shown as "Selected." The contact information edit fields are situated directly below the time options on the same page. There was an item labeled "Checked" with information on text message alerts below. I gathered that this is similar to the checkbox on the website for choosing if you would like to receive alerts, though the item in the app appeared as plain text and I could not change its status by activating it. Selecting "Continue" will bring you to a page where you can review your cart and choose if you would like substitutions for out-of-stock items. Before this, I was also presented with a screen explaining that my store did not have some of my items and I was given a chance to find other similar items before continuing. Activating each item took me to a screen where I could replace the item. Some items such as coffee had suggestions on what replacements were available but others did not.

Continuing from this page took me to the payment screen; here I was asked to enter my password again for added security. The payment screen is similar to its website counterpart. If you have a saved card it will be available, but if you do not, you will be presented with the fields for entering your card information. The only hiccup I encountered in this process was selecting a state; the combo box for choosing this doubles as an edit field so you can type the first few letters of your state and it will be automatically entered in the field. To actually choose the state you must activate the "Return" button on the keyboard. The app will inform you that the state has been selected. After entering your card details, you can submit your order. After submitting, you will get a confirmation page containing further information about the pickup process.

Picking Up Your ClickList Order at Kroger

You can pick up your ClickList order any time during the hour window you have selected. At the Kroger store, there will be a series of signs guiding you to a specific area for ClickList. There are a set of numbered parking spaces where you can park to await your order. Once in the ClickList area there will be a sign with a phone number for the ClickList department in the store. I found that I was able to get the number using the Short Text channel of the Seeing AI app. When you call the ClickList number for your store they will confirm your name and your space number. When the agent brings your groceries to the vehicle, they will verbally review any substitutions with you and provide you with a printout of your order, which contains information on any item changes. If you wish to have a record of your actual order after substitutions, you can find a listing of your purchases and their actual prices in the Order History section of the website or app.

The Bottom Line

I was impressed with the level of accessibility that Kroger has incorporated in both the website and mobile apps. Strategic use of headings and images provide efficient navigation on the website and all form fields, buttons, and graphics were labeled both on the site and in the app. Screen readers can announce updated totals for the items in your cart when you make changes though the accuracy of this was not always perfect. In addition to using the iOS app, I performed some testing using the Android app and found that it mirrored the iOS experience closely and had a similar level of accessibility. The only issue I encountered was when entering text into certain edit fields on the website. Some fields, such as email address fields, will attempt to alert the user that a complete address has not been entered yet. An error in how screen readers interpret this means that every time you type a letter, your screen reader may say "Alert." This also occurs when navigating to fields that can cut off the screen reader's announcement of the field's name or content. This issue only occurs when using a desktop screen reader. If you have any issues with using ClickList with a screen reader, Kroger has provided a hotline that you can call: 1-800-576-4377. Using ClickList usually includes a $4.95 fee, but Kroger gives you the first couple of ClickList orders free so it is possible to evaluate the service to determine if it will meet your needs. With their ClickList program, Kroger has expanded access to the convenience of online grocery shopping to a wider audience while also creating an exemplary accessible online shopping experience for those with vision loss.

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