“Hesitating and Puzzling”: The Experiences and Decision Process of Acute Ischemic Stroke Patients with Prehospital Delay after the Onset of Symptoms

Despite campaigns to increase public awareness of stroke symptoms by advocating FAST (Face-Arms-Speech-Time), some stroke patients still show delays in the recognition of and response to stroke symptoms and miss the golden first 4.5 h to receive rt-PA (recombinant tissue plasminogen activator) treatment. The aim of this study was to explore how acute ischemic stroke patients with prehospital delay seek help and undergo the decision process before arriving at the hospital. A qualitative approach using a grounded theory was applied. There were 24 ischemic stroke patients recruited by purposive sampling. Our main findings were: “Hesitating and puzzling” was the core category to describe and guide the process of acute ischemic stroke patients with prehospital delay. During the process, “Awareness the sudden change of physical sensation and/or function” was the antecedent category. In the prehospital delay experience, the following five interaction categories were identified: (1) “Self-judgment and interpretation according to previous experience,” (2) “Puzzling and doubting—it may only be a minor problem,” (3) “Self-treatment or seeking medical attention nearby,” (4) “Unexpected symptoms getting worse” needing immediate advanced medical help and (5) “Rushing to ER with different transportation—self-alerting that serious disease is coming.” Eventually, the patients “Regret to delay seeking treatment and become a disable person.” The process of prehospital delay provides some hidden cues for patients to increase their knowledge about strokes. The study emphasizes the importance of educating community residents about identifying stroke symptoms, breaking the myth of folk therapy, and seeking medical attention immediately. These results will assist healthcare providers by offering references for designing patient-centric educational strategies for preventing stroke prehospital delay to improve the quality of stroke medical care.

Protecting Visually Impaired Peoples’ Rights in Casting Votes in Malaysia

Election is a process to choose an individual or a government by a citizen to manage a country. Freedom of expression is considered a natural right; one which belongs to everyone, by virtue of them being human. This freedom evident especially when one cast a vote in the General Election to choose the best candidate to represent him or her in Parliament. Therefore, there is doubt on such freedom of expression given to disable person especially people visually impairment. The objective of this research is to study about efficiency of Persons with Disabilities Act 2008 and Elections Act 1958 for protecting people with visual impairments’ rights in casting votes. The outcome of this study will help to enhance the existing election process and Acts in order to protect the interests of people visually impairment in Malaysia.

“Hesitating and puzzling”: The experiences and decision process of acute ischaemic stroke patients with prehospital delay after the onset of symptoms

Background Despite campaigns to increase public awareness of stroke symptoms by advocating FAST(Face-Arms-Speech-Time), some stroke patients still show delays in the recognition of and response to stroke symptoms and miss the golden first 4.5 hours to receive rt-PA treatment. The aim of this study was to explore how acute ischaemic stroke patients with prehospital delay seek help and undergo the decision process before arriving at the hospital. Methods A qualitative approach using a grounded theory was applied. There were 24 ischaemic stroke patients recruited by purposive sampling. Results “Hesitating and puzzling” was the core category to describe and guide the process of acute ischaemic stroke patients with prehospital delay. During this process, “Sudden loss of physical limbs sensation and dysfunction” was identified as the antecedent condition. This process would be marked by action and interaction among the following categories: “Self-judgement and self-rationalization”, “Self-treatment and seek medical attention nearby”, “Puzzling and doubting-it may only be a minor problem”, “Worse symptoms” needing immediate advanced medical help and “Rush to nearby ER-self-alerting that serious disease is coming”. Eventually, the patients would be informed that they were admitted to the ER too late to receive rt-PA and would become sad, melancholy and regretful about becoming a disable person. Conclusions The study emphasizes the importance of educating the community residents about identifying stroke symptoms and seeking medical attention immediately. These results will assist the healthcare providers by offering references for designing patient-centric educational strategies for preventing stroke pre-hospital delay to improve the quality of stroke medical care.

Impact of Disabled Driver’s Mass Center Location on Biomechanical Parameters during Crash

Adapting a car for a disable person involves adding additional equipment to compensate for the driver’s disability. During this process, the change in the driver’s position and kinematics and their impact on safety levels during crash is not considered. There is also a lack of studies in the literature on this problem. This paper describes a methodology for conducting a study of the behavior of a disabled driver during a crash using the finite element method, based on an explicit time integration method. A validated car model and a commercial dummy model were used. The results show that the use of a handle on the steering wheel and a hand control unit causes dangerous lateral displacements relative to the seat. Amputation of the left leg or right arm causes significant shoulder rotations, amputation of the left leg causes increased thoracic loads. Amputation or additional equipment have no significant impact on head injuries.

Attitude of Student Professionals towards Persons with Disabilities

The research focused on students who are pursuing their final year in three different professional courses- Master of Social Work, Bachelor of Education, and Bachelor of Nursing at three different educational institutions in Puducherry. This study adopted a descriptive research design and used interaction with a disable person (IDP) scale to understand the attitude of student professionals toward persons with disabilities and also to find what influences the attitude of future professionals. The primary aim is to learn more about the way students of three different professions generally view persons with disabilities and feel about interacting with this population. The interaction and attitude will create an impact on their practice of the profession in the future. The findings indicate that the students of three different professions were having a negative attitude towards PWDs but no significant difference was found in gender, locality, and course of study. Results also enlighten the educators, health professionals and non-governmental organizations to plan programs that shall create changes in the attitude of students towards PWDs. This research concludes with reflections on the need to revive the social interaction of student professionals with persons with disabilities. Int. J. Soc. Sc. Manage. Vol. 8, Issue-1: 306-311

THE ANALYSIS OF HIDEN FACTORS OF ARCHITECTURAL BARRIERS IN SOSNOWIEC MUNICIPIAL OFFICE FROM DISABLE PERSON POINT OF VIEW AS IMPORTANT FACTOR OF SUSTAINABLE ARCHITECTURE

Sustainable architecture is important to minimize negative impact of building. In this paper we concentrate on the problem from people with disability point of view. For them one of must important factors of sustainable architecture in public space is the problem connected with architectural barriers. In presented paper we conducted an analysis of hidden factors of architectural barriers on example of municipal office in Sosnowiec in southern part of Poland. During the research we analyzed the needs of persons with disabilities (perceived quality) and their assessment in terms of the level of quality of services provided by the municipal offices. We analyzed twenty fourth variables connected with architectural barriers in the municipal office and its neighborhood. We analyzed following variables: office location (easy to reach), a sufficient number of parking spaces, Z3 - parking spaces for the disabled near the entrance of the office, a clear marking of parking spaces for the disabled, watch for unauthorized persons occupying seats for the disabled, facilities for disabled people in the office, elevators for disabled guests, toilets suitable for disabled guests, handrails of the stairs, a system of ramps and ramps for the disabled, the doors have a width that allows entry wheelchair, anti-slip floor, equal level thresholds and floors, pavement and curbs around the office adapted for the disabled, website provides information for people with disabilities, website readable for people with visual disabilities, officials are turning to people with hearing difficulties by means of a suitable device, officials are talking with a person of hearing in a separate room, the office's employee who knew sign language, officials can serve the customers with guide dog, the office is equipped with a special frame to allow signing a document, the visually handicapped person allows the presence of a trusted person who acquainted her with the content of signed documents, the city council does not contain architectural barriers hindering the movement of physically disabled person, an overall assessment of architectural barriers at the office. Next we conducted factor analysis to identify main hidden factors of architectural barriers.

THE PERCEPTION OF ARCHITECTURAL BARRIERS IN SOSNOWIEC MUNICIPIAL OFFICE FROM DISABLE PERSON POINT OF VIEW

The paper concentrate on problems connected with problems of peoples with disability. The main aims of the paper is to measure the level of quality of service in the case of architectural barriers in municipal offices by peoples in disability. We made following hypothesis: the types of disability significantly affects the perception of quality of services in municipal office regarding architectural barrier. The problem of satisfaction of people with disability in the case of architectural barriers in municipal office in Sosnowiec was analyzed from type of disability point of view. We distinguished five main types of disability in the paper: sensory impairment – a lack, damage or disorder of sensory analysers’ function (this category includes the blind, the visually impaired, the deaf, hard of hearing persons and people with visual and auditory perception disorders); intellectual impairment – mental retardation; social functioning impairment – disorders of neural and emotional balance; communication impairment – hindered verbal contact (speech impediments, autism, stammering); motor impairment – people with motor organ dysfunction. On the basis of that are discussed in this publication the research, we can conclude that the overall assessment of architectural barriers for people with disabilities is as in the case of the Municipal Office in Sosnowiec at an average level. The problems focus mainly on matters of specialized service selected groups of customers with disabilities who require further elaboration. Another type of problem is to issue a limited number of parking spaces for the disabled, but for objective reasons, it will be difficult to solve. Also we can say that the assessment of the architectural barriers by peoples with various types of disability vary significantly. The architectural barriers are the problem especially for people with motor disabilities – those persons are going to municipal office often and because of type of their disability barriers within the office and near the office is the big problem for them. The results are supporting the hypothesis that the type of disability affects perception of architectural barriers by peoples with disabilities.

Applying Auto-Regressive Model’s Yule-Walker Approach to Amyotrophic Lateral Sclerosis (ALS) patients’ Data

Background: The purpose of this study is to identifying time series analysis and mathematical model fitting on electroencephalography channels that are placed on Amyotrophic Lateral Sclerosis (ALS) patients with P300 based brain-computer interface (BCI). Methods: Amyotrophic Lateral Sclerosis (ALS) or motor neuron diseases are a rapidly progressing neurological disease that attacks and kills neurons responsible for controlling voluntary muscles. There is no cure and treatment effective to reverse, to halt the disease progression. A Brain- Computer Interface enables disable person to communicate & interact with each other and with the environment. To bypass the important motor difficulties present in ALS patient, BCI is useful. An input for BCI system is patient's brain signals and these signals are converted into external operations, for brain signals detection, Electroencephalography (EEG) is normally used. P300 based BCI is used to record the reading of EEG brain signals with the help of non-invasive placement of channels. In EEG, channel analysis Autoregressive (AR) model is a widely used. In the present study, Yule-Walker approach of AR model has been used for channel data fitting. Model fitting as a form of digitization is majorly required for good understanding of the dataset, and also for data prediction. Results: Fourth order of the mathematical curve for this dataset is selected. The reason is the high accuracy obtained in the 4th order of Autoregressive model (97.51±0.64). Conclusion: In proposed Auto Regressive (AR) model has been used for Amyotrophic Lateral Sclerosis (ALS) patient data analysis. The 4th order of Yule Walker auto-regressive model is giving best fitting on this problem.