Monthly Archives: November 2021

Fact or Fiction: Social Media Has a Negative Effect on Mental Health in Adolescents

If you are a parent, guardian, or grandparent of an adolescent, chances are you have wondered if the time they spend on social media is impacting their mental health. The topic of social media and mental health has been a concern that has only increased with the onset of the pandemic. According to Dr. Weigle in an interview aired by PBS NewsHour, isolation during the pandemic has resulted in decreased in-person connection, which therefore, escalated adolescents’ need to connect through social media (2021, 24:58). Dr. Weigle also points out, this increased use causes poor sleeping habits, resulting in negative impacts on the overall health of adolescents (PBS NewsHour, 2021, 19:55). Additionally, Dr. Weigle advises parents to be involved with their children, create “screen-free time” especially at dinner and around bedtime, and lead by example (PBS NewsHour, 2021, 20:19).

  You can find the full interview with Dr. Weigle here: https://youtu.be/W5yyy_TxC0M

What parents believe…

  A survey of over 2,900 parents conducted by Lurie Children’s Hospital focused on parents’ concerns with social media (WGN News, 2020, 1:02). First, the results indicated that “68% of parents … believe social media affects their teen’s ability to socialize normally” (WGN News, 2020, 1:44). Second, 56% of parents are concerned their teens are using social media to seek attention and approval from their peers (WGN News, 2020, 1:52). Third, 67 % of parents surveyed are worried that their teen is dependent on social media (WGN News, 2020, 1:58). Finally, parents were concerned with social media content stating it was “too sexual” (51%), led to cyberbullying (25%), and included hate speech (24%) (WGN News, 2020, 2:17).

  You can find the full report here: https://youtu.be/KKgz22Ag4ao

What teens are saying…

  While parents and experts are concerned with adolescences’ exposure to social media, many teens acknowledge feeling the pressure social media brings. In a recent report, teenager Macy Cabrera admits to feeling inadequate and judged by peers (FOX 61, 2021, 00:33). In addition, her friend Ella Adams explains how seeing pictures of others on social media makes teens compare themselves and lowers their self-esteem (FOX 61, 2021, 00:49). Another news report features Laynie Ferriman, a 17-year-old, discussing how social media causes a negative body image and lacks diversity (WCIA News, 2021, 00:50) She goes on to describe how she needs to occasionally disconnect from social media to help combat self-hate (WCIA News, 2021, 01:03). Lastly, CBS Mornings co-host, Nate Burleson, spoke to his 11-year-old daughter about how she feels social media impacts her life (CBS Mornings, 2021, 00:15). His daughter, Mia, confesses to using social media for over 8 hours a day and previously being addicted to TikTok (CBS Mornings, 2021, 01:46). Mia also discloses that even though she receives lots of positive reinforcement at home, she still compares herself to others she views on social media (CBS Mornings, 2021, 01:57).

  You can find all three teen videos here: FOX 61 https://youtu.be/DO35jiBGDC0

WCIA News – https://youtu.be/8X0Ixu51JI0  and CBS Mornings – https://youtu.be/xvmeizvQIL

What has research found…

In 2018, Berryman & Ferguson had their study published after evaluating questionnaires they provided to 465 teens that focused on the impact social media has on mental health. The surveys included the following: vaguebooking (posting attention seeking posts), hours spent on social media, social media importance, mental health symptoms, social support, parent-child relationship, social anxiety, histrionic symptoms, a need to belong, loneliness, compassion, and socially desirable responding (Berryman & Ferguson, 2018). According to the results, there was only a small connection between social media and these areas assessed (Berryman & Ferguson, 2018). Although, vaguebooking “slightly predicted both loneliness and suicidal thoughts” (Berryman & Ferguson, 2018). Furthermore, their study showed that social support is beneficial in reducing mental health problems (Berryman & Ferguson, 2018). In contrast, results indicated that strained parent-child relationships may have a strong impact on mental health in young adults (Berryman & Ferguson, 2018).  

You can find their full study here: https://doi.org/10.1007/s11126-017-9535-6

  Two additional studies published in 2020 had similar results, showing very little evidence that social media affects mental health. The first by Odgers & Jensen (2020) pointed out that prior studies mostly involved adults and not teenagers. They evaluated information from several previous reports, and they concluded there was no valid association between social media use and symptoms of depression (Odgers & Jensen, 2020). They added, it is very unlikely that social media may lead to mental health issues in teenagers (Odgers & Jensen, 2020).  Next, an 8-year study by Coyne et al. (2020) analyzed the hours spent on social media and how it relates to mental health disorders. The results indicated that the time spent on social media had no relationship to symptoms of depression or anxiety (Coyne et al., 2020).  They emphasized the importance of conducting further review of what teenagers are doing on social media rather than the amount of time they spend on their devices (Coyne et al., 2020).

  You can find their studies here: https://doi.org/10.1111/jcpp.13190 (Odgers and Jensen) and https://doi.org/10.1016/j.chb.2019.106160 (Coyne et al.)

In contrast, O’Reilly (2020) discovered when teenagers were asked directly, they recognized the connection between social media and strain on their self-worth, sleep habits, and the need to be included and liked. Moreover, the teens talked about the potential for bullying and mental health issues because of social media (O’Reilly, M., 2020). However, the results also indicated that teenagers found social media sometimes decreased stress by taking their mind off potential stressors (O’Reilly, M., 2020).

  You can find the study by O’Reilly here: https://doi.org/10.1080 /09638237.2020.1714007

What does this all mean…

  It is obvious that there are concerns about the influence social media has on the mental health of teenagers. Any Google search will result in numerous news reports, studies, and opinions on the subject. With such a variety of search results, how do parents and guardians know if their teenager is being negatively impacted? One important piece to note, the media and articles found offering a teenagers perspective indicate they are aware of the possible negative and positive impacts social media can have. This suggests that further research is warranted to assess the specific impacts social media has on their mental health. It also provides evidence that open communication with teenagers is crucial when evaluating any connection social media has on their mental health. Furthermore, a strong parent-child relationship could potentially decrease any negative influence associated with using social media. In the end, social media is here to stay and, therefore, this subject will continue to need evaluating.

 

References

Berryman, C., Ferguson, C. J., & Negy, C. (2018). Social Media Use and Mental Health among Young Adults. Psychiatric Quarterly, 89(2), 307–314. https://doi.org/10.1007/s11126-017-9535-6

CBS Mornings. (2021, October 14). Social media and its effects on youth development and mental health.  [Video]. YouTube. https://youtu.be/xvmeizvQILc

Coyne, S. M., Rogers, A. A., Zurcher, J. D., Stockdale, L., & Booth, M. (2020). Does time spent using social media impact mental health?: An eight year longitudinal study. Computers in Human Behavior, 104(1). https://doi.org/10.1016/j.chb.2019.106160

FOX 61. (2021, November 10). Digital distortion: Social media and its impact on teens’ mental health. [Video]. YouTube. https://youtu.be/DO35jiBGDC0

Odgers, C. L., & Jensen, M. R. (2020). Annual Research Review: Adolescent mental health in the digital age: facts, fears, and future directions. Journal of Child Psychology & Psychiatry, 61(3), 336–348.https://doi.org/10.1111/jcpp.13190

O’Reilly, M. (2020). Social media and adolescent mental health: the good, the bad and the ugly. Journal of Mental Health, 29(2), 200–206. https://doi.org/10.1080 /09638237.2020.1714007

PBS NewsHour. (2021, October 29). How social media platforms impact kid and teen mental health. [Video]. YouTube. https://youtu.be/W5yyy_TxC0M

WCIA News. (2021, October 5). Social media’s impact on teens. [Video]. YouTube. https://youtu.be/8X0Ixu51JI0

WGN News. (2020, September 21). Teens’ social media use is up during pandemic, and so is their parents’ concerns.[Video]. https://youtu.be/KKgz22Ag4ao

Autism in the Media: Is It an Accurate Representation of Those Who Live With It?

The media is known for it’s controversial takes on different populations, whether it be race, sexuality, or gender to name a few. Another group of people that are affected by the media are those with disabilities. Autism, or ASD, is a diagnosis that is widely known, and one that is becoming included in television and movies more frequently.

Examples of recent shows and movies with autistic characters include:

  • Atypical
  • Criminal Minds
  • The Good Doctor
  • Young Sheldon
  • Everything’s Gonna Be Okay
  • X+Y
  • Please Stand By
  • Rain Man

The video above describes multiple of the most well known characters with autism. However, many of these characters are based on the stereotypes associated with the diagnosis. While some representations may have realistic features, many others are not as accurate. Here, we will look at some of the biggest misconceptions.

Myth: Autism looks the same for everyone

Fact: Autism itself is defined as a developmental disorder of varying severity, meaning the way it is presented is unique to the individual.

When autistic characters are included in television shows and movies, they often look very similar to each other. The stereotypical autistic character in the media is depicted as being a white male, often with an academic appearance (Belcher, 2014). These characters are often uncaring of social norms and acceptance, while also being depicted as a savant in at least one area. Examples include Dr. Spencer Reid from Criminal Minds, Dr. Shaun Murphy from The Good Doctor, and Sam Gardner from Atypical.

In the video below, Ella, an advocate for special needs awareness that is autistic herself, describes how it feels to view these characters that are almost nothing like herself. While white, she is a female, and describes herself as someone with a desire to fit in while not possessing any amazing skills or being overly academic. Ella is almost the exact opposite of the stereotypical autistic character, and stated that she finds it hard to find characters that she can relate to.

However, Ella does mention two characters that she considers a good representation. These characters are Elsa from Atypical, who is described as a clearly autistic character, but is undiagnosed, and Jane from the movie Jane Wants A Boyfriend. Both are fun, female characters, and are seen trying to manage social relationships, self-esteem, and everyday life. They provide a more realistic representation of what living with autism looks like for some people, including Ella.

Myth: Everyone that is autistic is a savant.

Truth: Savant syndrome has only been reported in up to 37% of those with autism (Hughes, 2018).

In relation to autism, a savant is described by the Miriam-Webster dictionary as being “someone with a mental disability that exhibits exceptional skill or brilliance in some limited field”, for example, art, music, or mathematics. Characters Spencer Reid and Shaun Murphy are popular examples of savants. Both doctors, the men have high IQs and eidetic memories, which allows them to accurately analyze and memorize information. However, cases of savant syndrome are not nearly as common as it appears in the media.

In the video below, Loren Snow, an autistic public speaker and advocate, discusses how the media often portrays the “extremes” of autism. This includes depicting those with autism as having either a very low or high IQ, such as the doctors mentioned above, as well as either being extremely capable, or requiring assistance. Loren explains that media companies choose to do this, because these extremes are what interests the audience. However, in reality, people with autism can be anywhere within those extremes.

 

Myth: Autistic characters in the media are the most realistic representation of autism.

Truth: Documentaries are the most realistic form of autism in the media.

In more cases than not, autistic characters are shown as verbal and high functioning. However, while many autistic people do fall into those categories, many others do not and struggle in those areas. Media often uses these characters in dramatized storylines to make the plot more interesting, even if it makes it less accurate. For more accurate representations, biographical film such as Temple Grandin, who is an autistic advocate and public speaker, or documentaries such as Life, Animated  and The Reason I Jump. This is due to real people being filmed real life, rather than following a script. However, it is mentioned that this is still not 100% accurate. As said in one article on the subject,  “It is impossible for one piece of media to include portrayals of every single manifestation of ASD; however, it is not impossible to endeavor to show as many different types of characters as possible, especially in a realistic manner” (Prochnow, 2014). So while there is no perfect way to represent the entire population, there are ways to represent as many as possible in a accurate way.

Overall effect of autism in the media:

While the media does not portray those with autism in a negative way, it has been widely agreed on that the representation is not the best, and could definitely be improved upon. For a time, it was a concern that inaccurate representation of the diagnosis would increase the stigma surrounding autism, and lead to viewers thinking of it negatively. However, this theory was disproven following a study in which students were asked to watch the pilot of The Good Doctor. Following this, they were asked to look at a list of traits, and choose which they would

associate with autism. The majority of students that watched the pilot episode ended up associating more positive traits to the diagnosis, and even shared that they would be interested in learning more about autism in general (Stern, 2019).

It wasn’t too long ago that people with disabilities weren’t represented in the media at all. Now, while the representation itself can be improved, it is still considered progressive that more and more characters are being written to fit this population. It is the hope that, over time and with input from people living with autism, the media will be able to more accurately write these characters in ways that real individuals will be able to relate to.

References

Belcher, C. & Maich, K. (2014). Autism spectrum disorder in popular media: stories reflections of societal views. Brock Education: A Journal of Educational Research and Practice, 23(2), 97-115. https://eric.ed.gov/?id=EJ1057529

Hughes, J., Ward, J., Gruffydd, E., Baron-Cohen, S., Smith, P., Allison, C., & Simner, J. (2018). Savant syndrome has a distinct psychological profile in autism. Molecular Autism, 9(53), 1-18

Poe, P., & Moseley, M. (2016). “She’s a little different”: autism spectrum disorders in prime-time tv dramas. ETC: A Review of General Semantics, 73(4), 291-313. https://web-s-ebscohost-com.ezproxy.neit.edu/ehost/pdfviewer/pdfviewer?vid=16&sid=92b7c147-b10b-42a3-8a0b-ee97e6a7d737%40redis

Prochnow, A. (2014). An analysis of autism through media representation. Institute of General Semantics Inc., 71(2), 133-149. https://web-s-ebscohost-com.ezproxy.neit.edu/ehost/pdfviewer/pdfviewer?vid=8&sid=92b7c147-b10b-42a3-8a0b-ee97e6a7d737%40redis

Stern, S., & Barnes, J. (2019). Brief report: does watching the good doctor affect knowledge of and attitudes toward autism? Journal of Autism & Developmental Disorders, 49(6), 2581-2588. https://web-s-ebscohost-com.ezproxy.neit.edu/ehost/pdfviewer/pdfviewer?vid=18&sid=92b7c147-b10b-42a3-8a0b-ee97e6a7d737%40redis

The Benefits of Reiki Energy Healing

What is Reiki Energy Healing?

Reiki energy healing has been around for thousands of years as an alternative healing method. The current form of Reiki that is widely practiced was developed 98 years ago by a Japanese Buddhist by the name of Mikao Usui. Reiki is often called “palm healing” as the practioner’s palms scan the body over the 7 energy centers known as “Chakras”.

The Chakras start at the top of your head and flow to the base of your spine. Root chakra in red, Sacral chakra in orange, Solar Plexus Chakra in Yellow, Heart Chakra in green, Throat Chakra in Lavender, Third Eye Chakra in Navy Blue, & Crown Chakra in Purple. **Shown Below***

As an alternative therapy method, Reiki has been found to provide many health benefits. The benefits include reduce stress, inflammation, and fatigue. When one or more Chakras are blocked or unbalanced, physical symptoms manifest within the physical body. Signs and symptoms of blocked energy centers include: 

  • Feeling stuck or overwhelmed. 
  • Feeling stressed or overly anxious.
  • Feeling “not good enough” or behind in life. 
  • Pain/stiffness in the body 
  • Feeling ungrounded/unsettled
  • Pain and stiffness in your feet and legs
  • Feeling unsafe/insecure
  • Home life feels chaotic and unsettled

What are the Benefits of a Reiki Healing Session?

Reiki helps move negative or stuck energy within the physical body to alleviate any of the above symptoms listed. The movement of energy allows the person receiving reiki to release and feel a sense of healing and wellbeing. Reiki sessions help improve one’s sense of sense and promotes inner peace and belonging.

What’s a Reiki Session Like?

Having received Reiki therapy myself and going to a few different healers, I can say each of them from my personal experience involve crystals that align with the 7 chakras. Crystals are placed on the body and typically meditation music plays in the background (such as the video posted below) as you lie down with your palms open to receiving. The healer scans the body and identifies any blockages or stuck energy and either places their palms on the body or over the body to help move any energy. Typical reiki sessions last 15-20 minutes minimum as the healer uses energy from the universe to protect, align, and heal their patients. The benefits kick in immediately, as you will feel more relaxed, less stressed, and are able to unwind. You can find Reiki practioner’s online who also perform remote or in person sessions as holistic and alternative methods of therapy are on the rise.

References
Brathovde, A. (2017). Teaching Nurses Reiki Energy Therapy for Self-Care. International Journal for Human Caring, 21(1), 20–25. https://doi.org/10.20467/1091-5710-21.1.20
Freitag, V. L., de Andrade, A., Rossato Badke, M., Heck, R. M., & Marten Milbrath, V. (2018). Reiki therapy in Family Health Strategy: perceptions of nurses. Revista de Pesquisa: Cuidado e Fundamental, 10(1), 248–253. https://doi.org/10.9789/2175-5361.2018.v10i1.248-253

PISCHKE, K. (2018). Holistic Nursing: Integrating Reiki in the Oncology Setting. Beginnings, 38(3), 6–24.

The Truth About Carbohydrates

Are Carbs Really that Bad?

Carbs R Bad (Cherry Limited Edition) – Raskol ApparelBackground

Carbohydrates, the base to almost every food pyramid we grew up seeing has gotten a bad reputation when it comes to balanced nutrition. Foods such as macaroni, mashed potatoes, chips, cake, etc. are all loaded with carbs. That’s right your favorite comfort food is the boy of the diet world. Media outlets today are pushing a low carb diet culture and promoting diets such as Keto or Atkins that are built on a low to no carb guideline. Are these diets really the way to go or are carbs just really misunderstood?

A balanced diet is essential for  a healthy lifestyle and cutting out a whole food group is never really recommended. There are important vitamins and minerals that come from some starchy foods, but not all carbohydrates are created equal. Some media reports will try to sell you on fad diets to help lose weight or claim to promote a healthier lifestyle, but cutting carbs may not be sustainable long term or healthy if you are not replacing those essential vitamins and minerals.

Media Reports

Cooking Up a Storm with Al Roker | TODAY

In an article, provided by the Today show, they explore low carb diets and what you should know before trying one. Apparently cutting carbs has been around for over 150 years when it comes to dieting. The article also mentions diet programs Atkins, Keto, and Paleo and how they each promote various carb limitations for weight loss. Refined carbs do not offer a lot of nutritional value and should be limited, but other carbs have a lot of nutritional value that ends up being cut out when following these low carb diets. Recommended dietary guidelines for adults do not limit carbs and instead say you should be consuming 200-300g a day. The issue is the type of carbs you are eating. For example, a piece of toast or fruit and a few packets of sugar may have the same amount of carbs, but completely different nutritional values. The article as whole supports a low carb diet for maintaining weight loss and even provides a video with their host Al Roker, cooking a low carb meal. (Thurrcott, 2020) Research actually finds that low carb diets are not sustainable long term and may cause an increase in weight gain.

https://www.today.com/health/low-carb-diet-what-you-should-know-trying-one-today-t197225

Another media publication, Grist, also has an article supporting weight loss diets, they even quote the L.A. Times that states that there is scientific evidence that says carbs, not fat, are responsible for obesity, diabetes, and heart disease. They have chosen to pair the article with a chubby Santa eating a cookie just in time to remind people that holiday food is chock full of carbs. Once again there is support for the low carb diet, Atkins and a quote from the chairman of nutrition at the Harvard School for Public Health –

“If Americans could eliminate sugary beverages, potatoes, white bread, pasta, white rice and sugary snacks, we would wipe out almost all the problems we have with weight and diabetes and other metabolic diseases.” (Bruske, 2021)

Clearly a gross oversimplification of the obesity pandemic plaguing our country. The overall message that we should eat more fats is also shared by the video below from CBS news that is riddled with factoids and catchphrases about how bad carbs are and how they actually lower life expectancy. The problem with all these media sources is the lack of distinction between what kind of fats and carbs are being consumed. However they did not note what specific foods nutritionist were derived from. (CBS, 2017) There are different nutritional values to each food group, but if we only eat the processed refined stuff clearly there is no nutritional value in that.

https://grist.org/article/food-2010-12-20-scientists-say-carbs-not-fat-are-the-biggest-problem-with/

The Truth 

Scientific Reports

Yes, carbohydrates can be bad, but not all are bad. There are whole wheat grains and complex carbohydrates that have numerous nutritional benefits that are recommended for a balanced diet. Today’s dietician is a peer-reviewed, evidence based resource that provides scientific facts about nutrition. In their article on low- carb diets they explain how they can be extremely beneficial to those battling diabetes, but realistically low carb diets are not sustainable in the longterm. chandigarh, Good Carbs vs Bad Carbs | by Adhere To Fit | MediumAlthough, they stipulate that a low carb diet could be a good way to kick start weight loss, similarly to the media articles discussed above, there must be a plan of transition so as not to end up binge eating and gaining more weight. (Brown-Riggs, 2016) The Journal of Nutrition, Health, and Aging, another trusted source, provides a concise review on the merits and pitfalls of a low carb diet. Again, the main benefits are listed as short term weight loss and glycemic control, but they also point out major negatives. These include electrolyte loss, fatigue, and even mortality. The real message from this article is that the quality of the food you eat is more important than the quantity when it comes to healthy dieting. (Mooradian, 2020) Another scientific publication, Nutrition and Metabolism, provides some supporting data points for how carbohydrates can actually be beneficial. Out of 7000 participants they found a correlation between an increased carbohydrate diet and a lower risk of anxiety and depression. (Sangsefidi et al., 2021) So, not only can carbs provide important vitamins and minerals for your physical health, but can also be beneficial to your mental health.

The takeaway

So, the media reports did not get everything wrong. There are benefits to low carb diets, such as kick starting weight loss and glycemic control for those diagnosed with diabetes. Some carbs really are bad, and need to be consumed in moderation, but cutting out carbs completely really is not recommended from a nutritional stand point. The focus should be on the quality of food you are consuming. Even if you choose to follow Keto or Atkins who encouraged high fat diets, the type of fat you eat matters as well. You should eat good fats like avocados and olive oil not bacon and cheese. Same logic goes for carbohydrates, choose oatmeal and multigrain toast over white rice and white bread. When doing your own research make sure media publications are using information from leading experts in the field of nutrition. Remember when in doubt practice moderation because sometimes it is ok to indulge in a cookie.

References

Brown-Riggs, C. (2016) Low-carb diets and diabetes. Today’s Dietician, 18(8), 24-27

Bruske, E. (2021, April 7). Scientists say carbs — not fat — are the biggest problem with America’s diet. Grist.org. Retrieved November 19, 2021, from https://grist.org/article/food-2010-12-20-scientists-say-carbs-not-fat-are-the-biggest-problem-with/.

CBS News. (2017, August 30) New Study suggests its carbs, not fats, that are bad for your health. [Video] Youtube. https://www.youtube.com/watch?v=yhRb89_dIAg.

Mooradian, Arshag D. (2020) The Merits and the Pitfalls of Low Carbohydrate Diet: A Concise Review. Journal of Nutrition, Health, and Aging, 24(7), 805-808.

Sangsefidi, Z., Salehi-Abarghouei, A., Sangsefidi, Z., Mirzaei, M., & Hosseinzadeh, M. (2021) The relation between low carbohydrate diet score and psychological disorders among Iranian adults. Nutrition and Metabolism, 18(1), 1-9.

Thurrott, S. T. (2020, November 5). Low-carb diets: Why they’re so popular and what to know before trying one. TODAY.com. Retrieved November 19, 2021, from https://www.today.com/health/low-carb-diet-what-you-should-know-trying-one-today-t197225.

Meditation and Mindfulness for Healthcare Workers

Did you know that just sitting down, breathing with ease, highly positively impacts the brain?

 Meditation focuses mainly on the body and the mind working together to ease and relax the body in general. While working, some environments may be stressful, and they may cause anxiety due to the nature of work being done, errors may be made, fatigue builds up. All of these may be due to lack of enough sleep and other stress in the physical workplace.

Meditation is a way in which improve mental health and focus, and this is achieved by teaching the brain and creating a sense of concentration. Meditation leads to improvement of life and has a lot of benefits. Once one learns how to control the brain and concentrate, it helps reduce loneliness—also reducing the error rate, anxiety, stress, and handling the respective work in a much better way which is also effective.

Here are the ways to follow to begin meditation. To see what happens after you meditate, the best thing is to try it.  The steps are pretty straightforward, and one starts by relaxing the body, getting comfortable, and closing the eyes while breathing in a rhythmic way to achieve the required focus. With more practice, one gains enough experience to focus and starting enjoying the benefits of meditation. While starting, a few minutes between 5- 10 minutes is advised for the very first time. Afterward, one can try up to 20 minutes, and with time, one can try the time limit that suits them best.

It’s guaranteed that you will reap the benefits  (“Meditate Now – Go to the Source | Meditation.com”) of meditation with time and with more practice.

Works Cited

“Meditate Now – Go to the Source | Meditation.com.” Meditate Now, www.meditation.com/. Accessed 17 Nov. 2021.

“YouTube.” YouTube, 2019, www.youtube.com/watch?.

“Zen Habits.” Zenhabits.net, zenhabits.net/.

The Effect COVID-19 Has Had on Mental Health

How Has the COVID-19 Pandemic Been Affecting Mental Health?

It is well known that the COVID-19 pandemic has taken a toll on many lives both physically and mentally. Something that most people do not realize is how the pandemic has contributed to mental health problems. The pandemic has caused psychological stressors that have caused the rate of mental illness to go up and well-being to decrease in low, medium, and high income countries (Ivbijaro et al., 2020).

      This video presents a perfect representation of a couple of different ways the pandemic has affected mental health. One example that was brought up in the video was that those who were struggling prior to the pandemic are the ones who are struggling now. Parrish (2020), brings up the fact that many aspects of the COVID-19 pandemic will result in the exacerbation of mental illnesses such as obsessive compulsive disorder (OCD), anxiety, depression, substance use disorders, and many others. 

       The video brings up some great tips on how to reduce the feelings of loneliness, anxiety, and helplessness. By practicing different techniques like using Facetime or video calls to communicate with family members, practicing meditation, or outdoor/indoor exercise can help to overcome the negative impacts that the pandemic has had on mental health (Ivbijaro et al., 2020). 

       The video above depicts the toll that the COVID-19 pandemic has taken on the mental health of healthcare workers working the front lines. Hearing about the experiences from actual healthcare workers is a clear indicator of the accuracy of the information. AHC Media (2021), brings up the point that the COVID-19 pandemic and other crises’ can negatively affect the mental health of healthcare workers and one of these outcomes may be Post Traumatic Stress Disorder (PTSD). 

        A common misconception is that only the frontline healthcare workers are struggling greatly throughout the pandemic but healthcare workers in other settings are struggling in their own ways as well. A study that was preformed showed that healthcare workers working in the outpatient setting are worrying about things like the quality and access of care their patients are receiving (AHC Media, 2021). 

     The video above shows a personal experience of a woman who contracted COVID-19 and experienced what it was like to be hospitalized with others who had also contracted the virus. Many people like the woman in this video who has asthma or any other underlying medical condition, feared for the worst if they were to contract COVID-19. Some things that may exacerbate symptoms of long term physical health conditions could be stress and negative changes to diet or physical activity which are all things that many people were and are experiencing throughout the pandemic (Fisher et al., 2021). 

Conclusion

         By reading on the experiences of the people featured in the included videos, it is clear to see that COVID-19 has impacted people in many different ways. Regardless of the profession, someone somewhere has been affected by the pandemic in some way. Healthcare workers on the front lines and those in other work settings are experiencing negative effects on their mental health from the pandemic. It is important to participate in acts of self care and reach out for help when needed. 

                                                                         References

AHC Media. (2021). Reproductive Healthcare Workers Affected by Mental Health Stressors of      Pandemic: Severe psychological distress can occur. Contraceptive Technology Update,                42(5), 1-4. 

Fisher, A., Roberts, A., McKinlay, A.R., Fancourt, D., Burton, A. (2021).  The impact of the COVID-  19 pandemic on mental health and well-being of people living with a long-term physical                  health condition: a qualitative study. BMC Public Health, 21(1), 1-12.

Ivbijaro, G., Brooks, C., Kolkiewicz, L., Sunkel, C., Long, A. (2020). Psychological impact and        psychosocial consequences of the COVID 19 pandemic Resilience, mental well-being,                    and the coronavirus pandemic. Indian Journal of Psychiatry, 62, S395-S403.

Parrish, E. (2020). The next pandemic: COVID-19 mental health pandemic. Perspectives in            Psychiatric Care, 56(3), 485-485. 

The European Lung Foundation. (2021, April 20). Helen Parks: My COVID-19 story . YouTube. https://www.youtube.com/watch?v=AwASUzJDW0Q.

The Health Foundation. (2020, December 21). Surviving COVID: the impact of the pandemic on the mental health of NHS workers . YouTube. https://www.youtube.com/watch?v=Xokulltgi-I&t=1s. 

University of Arizona Health Sciences. (2020, June 18). Expert Insights: How is the COVID-19 pandemic affecting our mental health? . YouTube. https://www.youtube.com/watch?v=_x2U1_zX7Lw. 

World Health Organization. (2021). Coronavirus Disease (COVID-19). who.int/health-topics/coronavirus#tab=tab_1. 

 

 

Covid-19 and Pregnancy

What can get passed through from mother to baby during pregnancy ?

During the time of pregnancy not everything that enters the mothers body via ingestion or vaccination gets passed on to the fetus while still growing inside. The placenta is the gate keeper of what can and cannot come over from the mother to the baby. It will allow oxygen and the specific nutrients the baby needs to develop and grow over the 40 weeks but some antibodies do cross over. The antibodies will do not cross over though until closer to the end of pregnancy after the fetus is close to being fully developed and just gaining weight from now on.

Specific items that can cross no matter the week of gestation the mother is alcohol, nicotine, and some medications. That is why it is important to always ask your doctor if it is safe to take any over the counter medication before ingesting it.

Covid-19 Facts or Fiction 

By: NIAID

  • Will the vaccine cause new variants – No. The Covid-19 is a virus so no matter what there was already more than 1 variant of the virus living before the vaccine was developed
  • Is mRNA vaccine really a vaccine – Yes. The vaccine is unlike the flu or the measles vaccine where they administer a small piece of the infection so your body learns how to fight it off. A mRNA vaccine when injected teaches the cells how to build a protein that when noticing a Covid-19 protein, will attach and fight off the virus instead.
  • Do you get microchipped – No.
              • Do you become magnetic – No.
              • Will it effect my DNA – No. The vaccine does not enter the nucleus of the cell. It does cross over the outside wall but never enters the center of the cell at any time.

How does the vaccine effect woman who are pregnant ?

The vaccine effects pregnant woman just the same way it would someone who is just as healthy and not pregnant. It is recommended that woman who are pregnant get the vaccine, because they are more likely to catch the virus and have a harsher cycle of it than someone else. The vaccine just like with anyone else, reduces the chances of getting the virus, going to the hospital, spreading the virus or death. There has been no confirmed cases of infertility or issues related to pregnancy after becoming fully vaccinated. When other vaccines were developed like the yellow fever vaccine, when given to woman who were with child, it either did not end well for the mother, baby, or both. So The World Health Organization put a hold on the vaccine to pregnant woman because they saw it was doing more harm than good. Unlike, the Covid-19 vaccine where no complications like this has arises in regards to the vaccine which is why it is still available to woman that are carrying children. There is no current data saying that the vaccine is passed from mother through the placenta to the fetus.

As long as the mother checks in with her doctors and has no other major health conditions that could prevent her from receiving the vaccine, there is scientific reason to not get the vaccine.

 

Resources 

AHC MEDIA. (2021). Researchers Study COVID-19 Vaccine Outreach to Pregnant Women: CDC expert offers clarity. Contraceptive Technology Update, 42(8), 1–2.

Centers for Disease Control and Prevention. (2021, November 12). Key things to know about covid-19 vaccines. Centers for Disease Control and Prevention. Retrieved November 18, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/keythingstoknow.html?s_cid=10493%3Acdc+covid+vaccine%3Asem.ga%3Ap%3ARG%3AGM%3Agen%3APTN%3AFY21.

Centers for Disease Control and Prevention. (2021, November 12). Myths and facts about covid-19 vaccines. Centers for Disease Control and Prevention. Retrieved November 18, 2021, from https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html.

Freeborn, D., Trevino, H. M., & Adler, L. C. (Eds.). (n.d.). Blood circulation in the fetus and newborn. Blood Circulation in the Fetus and Newborn – Health Encyclopedia – University of Rochester Medical Center. Retrieved November 18, 2021, from https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P02362.

Jaffe, E., Goldfarb, I. T., & Lyerly, A. D. (2021). The Costs of Contradictory Messages About Live Vaccines in Pregnancy. American Journal of Public Health, 111(3), 498–503. https://doi.org/10.2105/AJPH.2020.306045

Uytenbogaardt, A. (2021). COVID-19 vaccines and pregnancy. British Journal of Midwifery, 29(3), 125. https://doi.org/10.12968/bjom.2021.29.3.125

What is the placenta? Pregnancy Birth and Baby. (2020, August). Retrieved November 18, 2021, from https://www.pregnancybirthbaby.org.au/what-is-the-placenta.

Can the Cold Weather Give You a Cold?

 

Can the cold weather give you a cold?

 

 

 

What is a cold?

It’s an everyday term, but what exactly is it?

A common cold is a contagious, viral respiratory illness. Symptoms are often mild, consisting of a runny nose, sore throat, clogged sinuses or sneezing.  A cold will often subside within two weeks. Over the counter medication is available, but generally not necessary. Typically, a cold will not result in a serious health problem. If the symptoms do become severe, that usually indicates other complications are involved beyond the scope of a common cold. 

There are over 200 viruses that can cause a cold, or cold like symptoms. The most common virus involved is rhinovirus (RV). RV and other “cold causing viruses” (now that’s a fun tongue twister to use at your next holiday party) can transmit via airborne droplets, touching a contaminated surface, or skin to skin contact with someone carrying the virus. 

 

 

How can you protect yourself from these viruses?

 

    • Frequent hang washing

    • Protect your living space- disinfect frequently touched surface
    • Avoid mingling with people who are sick (You may love your friends and family, but you won’t love their germs)
    • Incorporate vitamins into your diet, Zinc and Vitamin C are just two examples of beneficial supplements 

The best protection you can have against any virus is a healthy and operational immune system. Engaging in a healthy lifestyle will aid in your overall wellness.

 

So the cold can’t necessarily make you sick… but what about winter weather and wet hair?

It’s commonly thought that a mixture of wet hair and cold weather will guarantee a cold. However, there has been no proven correlation between the two. But do note that leaving the house with a water soaked head isn’t recommended for overall health, comfort and wellbeing. 

 

 

What does the cold weather do?

Although studies have found that there isn’t a direct relationship between the cold weather and a cold, there are elements about the cold that can make you more susceptible to viral infections. For example:

During the winter season people are more likely to be indoors and surrounded by other people. In this close proximity there is a higher likelihood of obtaining the virus from someone else. Due to the mildness of the viral strain, a person could be an unknowing carrier and infect an entire household.

There are also typical lifestyle shifts that can come with cold weather. People are less likely to  spend time outside, which diminishes their amount of natural exercise, fresh air intake and exposure to Vitamin D. 

Although these aren’t clinically measured relational values between the cold and a cold, they show how the cold may play a part in an immune systems vulnerability. 

It’s so true that it’s worth saying twice: the best defense against a cold is to build a healthy immune system that can sustain contact with the virus and remain strong. 

 

References

Common Cold. Centers for disease control and prevention. Retrieved November 11, 2021. https://www.cdc.gov/dotw/common-cold/

Common Cold. Mayo Clinic. Retrieved November 12, 2021 from  https://www.mayoclinic.org/diseases-conditions/common-cold/symptoms-causes/syc-20351605

Demystifying Medicine. [Youtube]. (2017, November, 21). Does the Cold Weather Really Cause the Common Cold? [Video]. https://www.youtube.com/watch?v=wjaZe3FR3ys&t=11s

Eccles R. (2005). Understanding the symptoms of the common cold and influenza. The Lancet. Infectious diseases, 5(11), 718–725. https://doi.org/10.1016/S1473-3099(05)70270-X

Medical Centric. [Youtube]. (2019, February 25). Common Cold, Causes, Signs and Symptoms, Diagnosis and Treatment. [Video]. https://www.youtube.com/watch?v=OzAe-J9tJXw

Simancas-Racines, D., Franco, J. V., Guerra, C. V., Felix, M. L., Hidalgo, R., & Martinez-Zapata, M. J. (2017). Vaccines for the common cold. The Cochrane database of systematic reviews, 5(5), CD002190. https://doi.org/10.1002/14651858.CD002190.pub5

Singh, M., & Das, R. R. (2015). Zinc for the common cold. The Cochrane database of systematic reviews, 2015(4), CD001364. https://doi.org/10.1002/14651858.CD001364.pub5

WUSA9. [Youtube]. (2021, November 8). Will Going Outside With Wet Hair Make you Sick? [Video]. https://www.youtube.com/watch?v=w30aw5OlRxQ

Postpartum Depression

What is it:

Postpartum Depression (PPD) is a common mental health diagnosis that affects 10%-15% of mothers.  Mothers of the NICU have a higher chance of this diagnosis at 40% (Tahirkheli, 2014).  With such a high probability rate it would seem to be common sense to screen at risk mothers, like those in the NICU, but unfortunately that is not the case. Multiple studies show that mothers of the NICU should have mandatory screened for PPD (Rogers, 2013).  Screening women will allow more chances to help these mothers that develop PPD. By helping these mothers there will likely be better outcomes for the mother’s mental health and the infant’s overall health (Wyatt, 2019).  Because of the lack of screening, mothers should be aware of the facts and fictions regarding Postpartum Depression.

Fiction:

  • You are alone
  • It is uncommon
  • It is easy to identify
  • Only weak women get Postpartum Depression
  • There are enough screenings measures in action to support those most at risk
  • You don’t have Postpartum Depression because you are not having harmful thoughts

Fact:

  • 10%-15% of mothers develop Postpartum Depression
  • 40% of mothers with a child in the NICU develop Postpartum Depression
  • Risk factors include: personal past history of anxiety or depression, family history, and lack of support
  • Early detection can improve outcome and quality of life from both mom and child
  • There is not enough screening in place, particularly in the NICU

What are some barriers?

  • Stigma
  • Lack of resources/funds/healthcare
  • Lack of knowledge
  • Feeling alone or embarrassed

Research vs Media

Luckily, Postpartum Depression is a medical diagnosis that is correctly portrayed in both current research and media that I came across.  Most inaccurate ideas and stereotypes of PPD is passed along from generational beliefs and old or dramatized movies.  As a mother with a history of PPD, I can say first hand that my symptoms were hard to detect because I didn’t have any lack of bonding or negative thoughts.  My symptoms were more like the ones explained in the first YouTube clip.  Being more educated on the topic and educating other women could literally safe a life.  Many times the internet can lead people to incorrect medical diagnosis but for me the internet saved me from myself.

If you feel as though you could be suffering from Postpartum Depression please seek help by contacting your doctor or a trusted friend or family member.

References

Rogers, C. E., Kidokoro, H., Wallendorf, M., & Inder, T. E. (2013). Identifying mothers of very preterm infants at-risk for postpartum depression and anxiety before discharge. Journal of Perinatology, 33(3), 171–176. https://doi.org/10.1038/jp.2012.75

Tahirkheli, N. N., Cherry, A. . ., Tackett, A. P., McCaffree, M. A., & Gillaspy, S. R. (2014).Postpartum depression on the neonatal intensive care unit: current perspectives. International Journal of Women’s Health, 6, 975–987. https://doi.org/10.2147/IJWH.S54666

Wyatt, T., Shreffler, K. M., & Ciciolla, L. (2019). Neonatal intensive care unit admission and maternal postpartum depression. Journal of Reproductive and Infant Psychology, 37(3), 267–276. https://doi.org/10.1080/02646838.2018.1548756

Occupational Therapy’s Role In Stroke Rehabilitation

The Impact of Strokes

The Impact of Strokes

 

Undergoing a stroke can be one of the most shocking and confusing things a loved one can go through.  With everything all happy and dandy one minute and then a person unexpectedly has a stroke, it can change the way a person feels and functions to complete daily life tasks.  An independent loved one now needs assistance to shower, to put a shirt on or even prepare a basic meal for themselves.  For a family or caregiver, the question turns to what now? 

 

Impairments that can arise from strokes include:

·      Muscular: Difficulty walking, paralysis with weak muscles, problems with coordination, or stiff muscles

·      Visual: Blurred vision, sudden visual loss, or visual neglect

·      Sensory: Loss of sensation or pins and needles

·      Speech related: Slurred speech, difficulty swallowing, muscle weakness and balance disorders.  

(CDC, 2020)

Rehab to the Rescue!

Each stroke is different and unique and can impact a person in many ways!  As a family or patient, you now must turn to rehabilitative services to assist in your recovery.  

 Stroke patients will begin comprehensive Physical and Occupational Therapies and dependent on the symptoms sometimes Speech Therapy.  

Physical Therapy vs. Occupational Therapy

 

Occupational Therapists (OT) and Physical Therapists (PT) are part of a patients stroke care team.  OT and PT will create a specific rehabilitation program that is tailored to helping you regain your function and becoming as independent as possible.  Both disciplines work together to achieve this common goal however they are different in some ways also.

 

Physical Therapy (PT)

A stroke can cause difficulty and problems with movement.  Loss of muscle function and muscle coordination is a common problem after a stroke, especially in one side of the body.  PTs are trained with an emphasis on movement and coordination.   

Some examples of what PT will address:

·      Strength and endurance

·      Range of motion

·      Ability to walk and gait abnormalities

·      Coordination and ability to sense one’s body ·      Motor planning and motor sequencing 

 

Occupational Therapy (OT)

OTs provide a holistic approach in helping patient’s reach the highest level of function and independence during stroke recovery.  The process focus’s incorporating the mind, body, spirit and emotion of the patient.  

Some examples of what OT will address:

·      Basic Activities of Daily Living such as feeding, bathing, toileting, grooming and more

·      Instrumental Activities of Daily Living such as cooking, driving, medication management and more

·      Rang of motion including improving muscle strength, tone and control and coordination for functional tasks

·      Cognition skills such as thinking, processing, and interpreting visual and spatial information

·      Movement and mobility when performing daily tasks 

The media clip below shares an example of the Occupational Therapist’s role in completing a functional task such as cleaning or grooming.  This media clip is a reliable source because the source is posted by AOTA which is the organization in charge of the practice of Occupational Therapy.  

(AOTA, Youtube)

Help me with dressing? Show me how that works!

The media clip attached shows an Occupational Therapist teaching dressing after a stroke.  

Some of the key takeaways include: 

The media clip accurately shares what treatment can involve in OT stroke rehab. You are being informed by an Occupational Therapist so you can rest assured this a professional and valuable clip of information.  This video directly correlates what the literature below discusses making this an informative source. 

(Youtube, 2018)

Sounds Great!! Does Occupational Therapy work?

 The short answer is…yes!!!

 Occupational Therapy has been shown and proven through evidence that it is an effective treatment with patients who have undergone a stroke!

With so many different possible things to address you may wonder what an OT would typically address first.  A study done in 2009, Classification of Occupational Therapy Intervention for Inpatient Stroke Rehabilitation, by Stacy Smallfield investigated the specific type of OT intervention used by OTs during inpatient stroke rehabilitation to determine the frequency of prefunctional versus functional activity usage.  The study analyzed patient services between 2003 – 2004 at an inpatient hospital located in the Midwest.  Each session data collected included type of intervention, intervention strategies, and adaptive equipment usage.  The study collected data for nearly two years.  

            The results of the study shared many noteworthy points. For example, musculoskeletal intervention strategies were used in more than half of the sessions (52.25%).  Most sessions, about 66%, consisted of activities that were pre-functional in nature compared with about 49% that focused on activities of daily living.  Activities of daily living include bathing, dressing, oral hygiene, functional mobility, and other basic self-care tasks. The authors concluded while the research was useful and important to highlighting the different interventions done in Occupational Therapy. 

(Smallfield, 2009)

More Evidence-Based Research

A study completed by Hoffman T, Bennett S, Kohn CL, McKenna KT explored the effectiveness of Occupational Therapy services to treat the cognitive impairment with stroke patients.  Cognitive impairment was a broad term utilized but the term covers visual and spatial deficits, memory, attention, and orientation.   

The study had two groups with one group focusing on compensatory approach’s while the other had a remedial approach training with paper and pencil tasks and even board games.  All participants had a stroke with some sort of cognitive impairment and received OT services for 34 minutes 3x a week.  The group was led by an Occupational Therapist. 

Outcomes were measured by participation in functional tasks. The Modified Barthel Index was used to determine the patient’s ability to function within their community.  Other outcomes included life roles, attention to task, and orientation during tasks.  In the total of the 33 patients’ judgement skills and ADLs were improved were observed to improve through utilizing the Barthel Standardized Assessment.  I would recommend this source to you or your loved one!

(Hoffman & McKenna)

Another study, Occupational Therapy for Stroke Patients, by Esther Steultjens discovers the effectiveness from the available literature to determine whether OT interventions improve outcomes for stroke patients.    

There was a total of seven intervention categories created and analyzed.  A total of 32 studies were included in the review with 18 being randomized control trials.  For the retraining of skills intervention, some evidence for growth in primary ADLs was discovered.  Inconsistent evidence was found that splints decrease muscle tone however, the review identified small but significant effect sizes for the effectiveness and efficacy of comprehensive OT on primary ADL, additional ADLs, and social participation.  This source is reliable because it is from the American Heart Association Journal which is a well-recognized resource and organization for all current evidence-based information about various healthcare topics. I would recommend this source to you!

(Steultjens, 2003)

 

 Lastly, in the article by, Almhdawi KA, Mathiowetz VG, White M, & delMas RC the article explores the use of occupation based or task-oriented treatment approach. The purpose of the study is to determine if occupational therapy is an effective treatment approach for those recovering from a stroke by assessing progress through standardized tests.

        This study uses a randomized control trial with 20 participants split into two groups that were all post-stroke. Group one participated in skilled interventions for six weeks for three hours a week. On the other hand, the other group had no skilled intervention.  The use of standardized tests such as the Functional Measures, Motor Activity Log, AROM and the Wolf Motor Function Tests were to determine outcomes. All of these assessments look at things such as level of assistance needed, motor skills, motor planning and range of motion, strength and other client factors.  Occupational therapy using occupation-based intervention showed a functional change in scores and the occupation-based approach was discovered to be an effective treatment method in those treatment from a stroke (Almhdaw, 2016).

The above video shares accurate information about OT interventions with strokes.  In the video, the therapist and patient are working on range of motion in attempt to regain loss function in daily tasks.  In comparison to the literature this media is an accurate representation and good visual resource for patients to see what is done in therapy.  The media clip directly and visually shares what is describe in the evidence-based article. This media clip is reliable to it being posted by a hospital, Helen Hayes Hospital.  (Youtube, 2016) This a great education resource to provide a glimpse into treatment.

How Do I Know What To Believe On The Internet?

Google, Yahoo, Wikapedia are available with the click of a button.  Twitter, Facebook and Instagram share what a friend of a friend knows and recommends for something yet in reality they are just reposting something they read! The internet and social media are a great thing, and it puts the world at our fingertips and puts ease to our lives. Unfortunately, anyone can post things on the internet or social media which have no professional backing or support. 

Some helpful tips and tricks to ask yourself include:

·      Does it seem accurate or biased allegations? 

·      Where is the information located? 

·      Is it a credible website or social media? 

·      Is the author credentialed? 

·      Is the information professionally or peer reviewed?

In healthcare and medicine, we have more knowledge of strokes that ever before which is wonderful but also leaves the door open for many interventions to be trialed.  The key is “to be trialed”… to be trialed with or by a professional such as an Occupational Therapist.   

In conclusion, when getting medical and health information online be sure to do research but not just any research, proper and correct research. It is recommended to use professional, reliable sources that are peer reviewed articles and journals that are experienced in the field working with the population and the factors that are associated with the diagnoses. Media clips are like a window, you can see a general idea, but the window can become foggy and this is where they can have misleading or biased information.  It is important to be aware of these factors when doing research on a health topic such as Stroke Rehabilitation through Occupational Therapy as they can cause barriers and misleading information if not aware of these factors.  Topics such as this are important to well-being and health and should be researched, discussed, and treated professionally and correctly with help from a professional.  


Sources:

Almhdawi KA, Mathiowetz VG, White M, & delMas RC. (2016). Efficacy of Occupational Therapy Task-oriented Approach in Upper Extremity Post-Stroke Rehabilitation. Occupational Therapy Internation, 23940,444-456. https://doi.org/10.1002/oti.1447

Hoffmann, T., Bennett, S., Koh, C.-L., McKenna, K. T., & Hoffmann, T. (n.d.). Occupational therapy for cognitive impairment in stroke patients. Cochrane Database of systematic reviews,9.

“Occupational Therapy How-to: Upper Body Dressing – Youtube.” Youtube, 18 Apr. 2018, https://www.youtube.com/watch?v=6B8mPwQjyZU. 

“Occupational Therapy Restores Arm Function.” YouTube, YouTube, 16 Mar. 2016, https://www.youtube.com/?app=desktop. 

Stacy Smallfield, Joy Karges; Classification of Occupational Therapy Intervention for Inpatient Stroke Rehabilitation. Am J Occup Ther July/August 2009, Vol. 63(4), 408–413. doi: https://doi.org/10.5014/ajot.63.4.408

Steultjens, Esther M.J., et al. “Occupational Therapy for Stroke Patients.” Stroke, vol. 34, no. 3, 7 Feb. 2003, pp. 676–687., https://doi.org/10.1161/01.str.0000057576.77308.30. 

“Stroke Signs and Symptoms.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 28 Aug. 2020, https://www.cdc.gov/stroke/signs_symptoms.htm. 

“What OT Can Do for You: Recovering after a Stroke – Youtube.” Youtube, 11 Oct. 2017, https://www.youtube.com/watch?v=mfpVMZDRg9A.