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

A Cross-sectional Survey of Comprehension and Satisfaction of Spanish-Reading Adults Regarding RÁPIDO as a Stroke Awareness Acronym

ABSTRACT

BACKGROUND: Delay time to hospital arrival may be influenced by lack of recognition of stroke signs and the necessity to seek emergency medical, which in turn is influenced by language barriers to, a modifiable risk factor, stroke awareness education. The objective was to determine the comprehension and satisfaction of a Spanish stroke awareness acronym, RÁPIDO, among community-living, Hispanic and Latino, Spanish-reading adults. METHODS: A 33-item survey was completed by 166 adults. Data on sociodemographics, language preferences, stroke education, and comprehension and satisfaction with RÁPIDO were collected. Descriptive characteristics were calculated. Fisher exact tests were performed to determine whether reading language (group 1, only or predominantly reads in Spanish; group 2, reads in Spanish and English equally or reads predominately in English) influenced survey responses. Responses to open-ended questions were categorized. RESULTS: Sixty-nine percent of the participants were born outside of the United States, 82% currently resided in the United States, 34% read only or predominately in Spanish, and 7% had a stroke. Most participants thought RÁPIDO was informative, eye-catching, and easily remembered. Significant differences were found between reading language preference groups for correctly identifying RÁPIDO images for facial drooping (group 1, 80%; group 2, 95%; P ≤ .001) and dizziness/loss of balance (group 1, 54%; group 2, 73%; P = .027). Eighty percent or more of all participants were able to correctly interpret RÁPIDO images for facial drooping, blurry vision, impaired speech, and call emergency services. Adding "911" to the RÁPIDO image of the clock was a common suggestion. CONCLUSIONS: RÁPIDO was well received among the participants. Modifications to RÁPIDO images representing dizziness/loss of balance and arm weakness, and the addition of "911" may improve its usefulness. Obtaining more extensive feedback across the United States and testing the effect of RÁPIDO on increasing knowledge of stroke signs and retention of that knowledge are necessary next steps.

Privacy-Preserving Authentication Protocol for Wireless Body Area Networks in Healthcare Applications

Mobile healthcare service has become increasingly popular thanks to the significant advances in the wireless body area networks (WBANs). It helps medical professionals to collect patient’s healthcare data remotely and provides remote medical diagnosis. Since the health data are privacy-related, they should provide services with privacy-preserving, which should consider security and privacy at the same time. Recently, some lightweight patient healthcare authentication protocols were proposed for WBANs. However, we observed that they are vulnerable to tracing attacks because the patient uses the same identifier in each session, which could leak privacy-related information on the patient. To defeat the weakness, this paper proposes a privacy-preserving authentication protocol for WBANs in healthcare service. The proposed protocol is only based on one-way hash function and with exclusive-or operation, which are lightweight operations than asymmetric cryptosystem operations. We performed two rigorous formal security proofs based on BAN logic and ProVerif tool. Furthermore, comparison results with the relevant protocols show that the proposed protocol achieves more privacy and security features than the other protocols and has suitable efficiency in computational and communicational concerns.