User talk:Lh13lg/strokes sandbox

Congratulations group. Good luck with your project. --LynnMcCleary (talk) 13:40, 10 September 2014 (UTC)

Hey group, it's Lydia! Feel free to introduce yourselves on this talk page so that we can get started! Thanks. Lh13lg (talk) 23:43, 10 September 2014 (UTC)

Hi, it's Shawna! Thanks Lydia, for getting our sandbox set up! — Preceding unsigned comment added by Sg13vp (talk • contribs) 20:47, 11 September 2014 (UTC)

Lh13lg's initial thoughts about the article
Here are the opportunities for improvement of the Stroke article I have come up with so far:

Under Rehabilitation

 * I think there is potential for illustrations such as images, diagrams, statistics, etc.
 * In terms of treating someone who has had a stroke, how do you communicate with a patient who has speech production disorders such as dysarthria and apraxia of speech, and/or aphasia, cognitive-communication impairments and/or dysphagia? i.e. Ways of communicating with a patient who cannot communicate verbally and/or nonverbally
 * Adding examples of speech-language pathology for stroke patients.

Under Prognosis

 * How can communication help improve cognitive and psychological outcomes of a stroke such as emotional problems, post-stroke depression, emotional lability, and cognitive deficits?
 * Is assertive communication a helpful style to use when improving these outcomes?
 * What is a helpful approach when responding to and communicating with a patient experiencing emotional lability?
 * Adding an illustration for "hemispatial neglect".
 * How do you communicate with a patient who is experiencing anosognosia? i.e. the patient is unaware of their disabilities

Let me know what you guys think! Lh13lg (talk) 23:03, 14 September 2014 (UTC)

Sg13vp's initial thoughts
Those suggestions look great! I like how you included a lot of things that can be improved on the page in regards to communication. There are a few things that I noticed and feel as though should be addressed. I noticed throughout the article there were a few points where citation is needed. Specifically under the headings ‘Cerebral Hypoperfusion’, ‘Ischemic’, and ‘Hemorrhagic Stroke’ there are several areas under these headings where there are no citations. I also think that there is some more information required in a lot of the ‘Prevention’ areas such as the section on diet and diabetes mellitus. These paragraphs are inconsistent in content and I feel as though it can be improved. The article has a lot of great information and the pictures that are included in some areas of the article are detailed and relevant and provide a better understanding to the topic. It looks like a great article to work with! Sg13vp (talk) 20:47, 15 September 2014 (UTC)
 * Shawna, I think your suggestions will be very effective in bettering the article. I agree that there are already many great attributes to this article but in terms of communication we can definitely improve specific sections. I guess we will now wait to see what our other group members think. Excited to see what we decide on! Lh13lg (talk) 18:24, 18 September 2014 (UTC)
 * There is a tutorial on images on the student resources page (linked from the course Wikipedia page).--LynnMcCleary (talk) 03:00, 24 September 2014 (UTC)

SHBROCK's initial thoughts

 * 1) Well Written: very professional terminology, great use of grammar. Note the exceptional use of the Oxford Comma. The author of this fabulous piece of work must have worked efficiently, safely and time effectively to complete this excellent article.
 * 2) Verifiable: yes, every statement made on this article was supported by factual evidence in the reference section of the wiki page
 * 3) Broad in its Coverage: yes very thorough coverage on what strokes are and lots of background information
 * 4) Neutral: yes, no bias opinion or unnecessary points of view regarding strokes on this page.
 * 5) Stable: yes
 * 6) Illustrated Properly: multiple images helped convey the concept of strokes clearly and effectively. These pictures ranged from images of the brain to Hippocrates the ancient Greek. Many color images made the page aesthetically pleasing.

Well done group, you all had great ideas on this page and all comments were relevant.

SHBROCK (talk)
 * It seems like there's a slight difference of opinion about breadth (is there important content about communication missing) and whether or not there are adequate references/citations (see below). That's okay. You need to keep the good article criteria in mind as you go ahead with your edits. --LynnMcCleary (talk) 02:55, 24 September 2014 (UTC)

Coming to a consensus and setting editing goals
Alright guys, how about we start deciding what specific edits we want to make to enhance the article? Personally, I think we should focus more on communication in relation to strokes. I gave a few suggestions already if you guys would like to refute my suggestions, build on them or agree that those are areas that we could make edits to, that would be great! Shawna, I feel that the edits you are suggesting under the Prevention section could be a good focus as well. We could probably find some sources in order to make that section more consistent. Lh13lg (talk) 22:03, 21 September 2014 (UTC)
 * I think cleaning up the citations will be relatively easy to get done so I'd really like to work on that. I also really like the ideas of adding in some communication skills under the rehabilitation section. Maybe we can find some info on the different levels at which a stroke can affect communication (minor to severe communication issues after having a stroke). The article does not go into great detail of what the communication impairments could potentially be, we should expand there. I think we have some good idea rolling! Sg13vp (talk) 01:04, 23 September 2014 (UTC)
 * I agree! In summary, it sounds like we want to focus on adding some citations under the Prevention section and enhance the Rehabilitation section by researching in greater detail how strokes can affect communication and how communication might take place when impairments occur. Is that an accurate summary of our areas of focus? Lh13lg (talk) 22:12, 23 September 2014 (UTC)
 * Great summary! I also think, now that we have narrowed in on exactly what we want to work on, we should look at adding some images if we can find any that are beneficial and relevant. I know Lydia, you mentioned adding images earlier on and now that we know exactly which sections of the article we are planning on cleaning up, we can keep an eye out for some pictures that might be useful under these specific sections. I am excited to get started! Sg13vp (talk) 00:40, 24 September 2014 (UTC)
 * There is a lot of helpful information about strokes in our Psychology textbook in chapter 2. There is a good illustration of hemispatial neglect if you want to check it out. It is a drawing that a patient had done of a clock. Let me know if you think this could be an editing possibility! Lh13lg (talk) 01:47, 26 September 2014 (UTC)
 * That looks like a great image. If we can get that I think it would be a big asset to the article. Awesome find! I have been looking and reading through different journal articles online and I have been finding a lot of information regarding social frustrations stroke survivors experience when they are no longer able to communicate and how a patients loss of speech affects their self confidence. I can't seem to find a specific article solely dedicated to the affects a stroke will have on communication but there are smaller sections regarding the topic embedded within larger articles. There is a section I found in this article: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3869390/ It is small, but I think it has some good info. The section is about halfway down the page under the heading "Social Relationships" if you want to take a look. Let me know what you think, because I have found a few articles with a similar idea, and if you think it will be any value to our article. Thanks! Sg13vp (talk) 03:24, 29 September 2014 (UTC)

Some early feedback from Lynn
You'll notice I added some headings. I think that might help you organize your conversations. Threaded conversations about specific issues, will probably occur as you get going and that would also make it easier for you to follow along. Feel free to change my attempt to help you with organization. You have to do what works for you. --LynnMcCleary (talk) 02:53, 24 September 2014 (UTC)

I notice that your article is semi-protected from editing and that there are editors active on the article. That means you should be careful and sensitive when making editing suggestions (when you eventually get your research done. You would need a good rationale for wanting to include content about communication throughout the page (or for adding a section or sub-section about communication and strokes. I suggest that some of your research be about how communication is affected and ways that communication can be improved when interacting with someone whose stroke has affected communication. You do want to keep the whole article in mind, so that your editing doesn't disrupt coherence of what's already there. You may start off thinking that your research will fit in one section and then, when you've learned more, find that it fits in another section. --LynnMcCleary (talk) 02:53, 24 September 2014 (UTC)

I formatted your discussion about plans going ahead to be a threaded discussion. I hope this is okay with you. I just wanted to illustrate it for you. --LynnMcCleary (talk) 03:00, 24 September 2014 (UTC)


 * Thank you LynnMcCleary! That was all helpful feedback! This will get us on our way to coming to a consensus and setting goals. Lh13lg (talk) 17:05, 24 September 2014 (UTC)

Lh13lg's Credible Sources
Source 1:

Heilman, K. M. (2014). Disorders of Emotional Communication After Stroke. In The Behaviorial Consequences of Stroke (7). Retrieved from http://link.springer.com/chapter/10.1007/978-1-4614-7672-6_7

''The above citation provides in depth information on how emotional communication is affected after a stroke. There is not much in the stroke article about communication therefore this could be a good starting point to enhance the topic.''

Source 2:

Rodgers, H., Bond, S., & Curless, R. (2001). Inadequacies in the provision of information to stroke patients and their families. Age and Ageing, 30(2), 129-133. Retrieved from http://resolver.scholarsportal.info/resolve/00020729/v30i0002/129_iitpoitspatf

''The above citation would provide information to enhance the stroke page in relation to communication. This article stresses the importance of relaying information to stroke victims and their families to provide understanding.''

Source 3:

Miller, C. A. (2008). Communication Difficulties in Hospitalized Older Adults with Dementia: Try these techniques to make communicating with patients easier and more effective. American Journal of Nursing, 108(3), 58-66. doi:10.1097/01.NAJ.0000311828.13935.1e

''The above citation would provide information on how to assess language deficits and facilitate communication. This would enhance the stroke article in relation to communication.'' Lh13lg (talk) 22:22, 29 September 2014 (UTC)


 * Hi Lydia, I looked at your sources and I think we are pretty much on the same page which is great! I think the main ideas from your sources will definitely fit in perfectly within the wikipedia article. As I mentioned earlier I really like the image you found from our psychology textbook and I think it will be great on the page! I also really liked the source you retrieved from the nursing centre website, I think it was a great idea to incorporate communication with a person who has limited communication from a nurses perspective. If you have time, would you take a look at my sources and just let me know if you think they will be helpful to the article? Thanks!! Sg13vp (talk) 01:26, 30 September 2014 (UTC)


 * Unfortunately I talked to Dr. Lynn McCleary about using our psychology textbooks as a potential resource for that image but it seems as though it probably is not an option. I found a replacement source - an article which provides interesting insight on the carers of stroke victims who are experiencing aphasia. Let me know what you think! Lh13lg (talk) 18:30, 1 October 2014 (UTC)


 * That's disappointing! Although, I did read that it was extremely hard to be able to find an image that wikipedia will accept, so I'm not surprised. I really like the new article you found, when I was researching I seemed to come across several articles with this similar idea so I think the issue of lack of communication to patients and the patients families is something that is very common and also, is not addressed in the current wikipedia stroke page. Are you planning on including this information under the rehabilitation section to better explain how lack of communication can sometimes inhibit healing? I'd love to hear your ideas and where you'd like to go with this! Sg13vp (talk) 16:37, 2 October 2014 (UTC)
 * Just to clarify, it's not a Wikipedia rule that gets in the way of using the image, it's the copyright law, protecting the image as the property of the publisher. Wikipedia's rules are about respecting and not breaking copyright law. We'll learn a bit more about this later in the course.]]LynnMcCleary ([[User talk:LynnMcCleary|talk) 00:37, 7 October 2014 (UTC)
 * Lh13lg, the first source is a research article, making it a primary source, not a secondary source. Other group members, have you come across other good secondary sources, maybe in the bibliographies of your sources? If so, it would be great to share them with Lh13lg. A librarian could help with searching. LynnMcCleary (talk) 00:34, 7 October 2014 (UTC)
 * LynnMcCleary, thank you for pointing out my mistake! I will look for another secondary source immediately. This will be very helpful for the future when distinguishing between primary and secondary sources. Lh13lg (talk) 15:08, 8 October 2014 (UTC)

Sg13vp's Credible Sources
Source 1:

Hamilton, R., Chrysikou, E., & Coslett, B. (n.d.). Mechanisms of aphasia recovery after stroke and the role of noninvasive brain stimulation. Brain and Language, 40-50. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109088/

''The article above explains the advances being made in technology that will help rehabilitate patients with chronic stoke induced aphasia. I think that this would be great under the rehabilitation section explaining how technology is coming further along to help create treatment for those who are struggling with aphasia caused by stroke.'' Sg13vp (talk) 22:35, 20 October 2014 (UTC)

Source 2:

Addington-Hall, J., Lay, M., Altmann, D., & Mccarthy, M. (1995). Symptom control, communication with health professionals, and hospital care of stroke patients in the last year of life as reported by surviving family, friends, and officials. Stroke, 2242-2248. Retrieved from http://stroke.ahajournals.org/content/26/12/2242.full

''The above article explores the affects of lack of communication between caregivers, and physicians affect stroke patients and their families. It goes into detail about how many stroke patients do not receive the information they need in regards to stroke rehabilitation and often inhibits recovery.'' Sg13vp (talk) 22:35, 20 October 2014 (UTC)
 * Sg13vp, please see my Sakai email. This is a tricky source. It says it's secondary analysis. That sounds like it would be a secondary source - but when you get to the details you'll see that this is a research article. Secondary in this context means that the data are analyzed for a secondary purpose - they were collected for another study and then reanalyzed. The source below is used by another group member. I notice that your group has shied away from what I think of as "easier" sources like textbook chapters. I think there should be information in chapters on stroke in medical surgical nursing textbooks or gerontological nursing textbooks. This would be a lot easier to understand than some of the sources your group has. I also suggest clinical articles in journal such as Nursing 2014. For example, "An overview of communication movement and perception difficulties after stroke" in the journal Nursing Older People (2014) or the article "communication impairments in patients following stroke" by borthwick in 2012 Nursing Standard would be relevant and may be more accessible than some of the other articles your group has. I hope this is helpful. --LynnMcCleary (talk) 01:08, 21 October 2014 (UTC)

Source 3:

Mackenzie, C. (n.d.). Dysarthria in stroke: A narrative review of its description and the outcome of intervention. International Journal of Speech-Language Pathology, 125-136. Retrieved from http://informahealthcare.com/doi/pdf/10.3109/17549507.2011.524940

''The above source provides information on the affects that some stroke patients have with dysarthria. It explains the impact that dysarthria has on patients not only in regards to their speech limitations but also the impact it has on social relationships and self identity.'' Sg13vp (talk) 22:35, 20 October 2014 (UTC)


 * I think these sources look very valuable! It definitely does seem like we are on the same page. I'm glad we are thinking in the same direction. It looks like our focus is primarily on rehabilitation which I think is good because the original proposition was focusing on communication in the treatment of stroke victims. I am so pleased that we were able to find useful sources on communication in relation to post-stroke cases. I am excited to choose which content we will potentially contribute to the page! Lh13lg (talk) 15:17, 30 September 2014 (UTC)
 * Sg13vp, these sources are relevant and credible, but they are research articles. That means that they are primary sources, not secondary sources. Lh13lg, Mh13va, SHBROCK, and Lh13lg, maybe you have secondary sources to recommend? I think that neurology, neuro-nursing, medical-surgical, psychology, aging, and some communication textbooks might be good sources. You could check with a librarian for help with searching.LynnMcCleary (talk) 00:45, 7 October 2014 (UTC)
 * LynnMcClearly Thank you for the help, I will fix my sources to find credible secondary sources. Sg13vp (talk) 17:53, 7 October 2014 (UTC)
 * LynnMcClearly I have corrected my sources, I hope that these fit the criteria! Sg13vp (talk) 22:35, 20 October 2014 (UTC)

Corrected Source #4:

Ackley, B., Ladwig, G., & Kelley, H. (2010). Guide to Nursing Diagnoses. In Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed., p. 43). Maryland Heights, Mo.: Mosby.

''The above citation provides insight as to how those who have had a stroke will most likely be feeling. It more specifically identifies communication issues that may arise and how communication impairments can affect a stroke survivor and how it may impact their social relationships.''Sg13vp (talk) 01:08, 5 November 2014 (UTC)

SHBROCK's Credible Sources
Source #1: Ashkan Afshin, Renata Micha, Shahab Khatibzadeh, and Dariush Mozaffarian. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. The American Journal of Clinical Nutrition

This article explains the Importance of nuts and legumes (beans) in relation to their nutritional properties that may reduce cardiometabolic risk. SHBROCK (talk) 02:50, 5 November 2014 (UTC)SHBROCK

Source #2: James G. Crawford, PhD. Proposed Stroke and Heart Attack Mechanisms. Journal of Orthomolecular Medicine.

This article is an record of the potential causes for strokes and heart attacks. SHBROCK (talk) 02:51, 5 November 2014 (UTC)SHBROCK

Source #3: Cheryl Bushnell, MD, MHS, and Louise McCullough, MD, PhD. Stroke Prevention in Women: Synopsis of the 2014 American Heart Association/American Stroke Association Guideline. Annals of Internal Medicine Volume 160, Number 12

This article explains the guidelines for the first stroke prevention targeted at women.

SHBROCK (talk) 02:51, 5 November 2014 (UTC)SHBROCK

Professor advice re: summarizing and collaborating
Lh13lg, Sg13vp, SHBROCK, and Mh13va , you’ve got lots of information with these sources. I have some suggestions for you for your next steps – to help you keep your work manageable and within the scope of this assignment. Keep your expectations of yourselves reasonable and keep your focus. Thinking about the communication model we learned in the first week of class might be helpful.

See the course page for information about your tasks due October 22.

Your summaries should be between 250 and at most 400 words for each source. Try not to make them long. If there aren’t 250 words worth of information in your source, don't blather on to fill space – but I don’t think this will be the case for you. I am looking for summaries I can understand and that are logical and coherent. You'll need to really focus in on the heart of the relevant findings. You should be aiming to tell your group members what the key messages are in your sources and how you think the information fits or doesn't fit with the article (it's okay if you logically determine that it wouldn't add to the article). If there is repetition within your sources, you should note that. Hopefully there is. Each summary should have a citation that is acceptable for Wikipedia and that has the information needed for a reader to verify your interpretation by finding your source. Links that only work within the university aren’t user friendly for me or your group members. If there is information that you can’t paraphrase, indicate quotes with quotation marks and page numbers.

When you've got your summaries done, hopefully there will be some themes and repetition among your summaries. Your job then is to collaboratively decide on what deserves to be suggested as an edit for the article and craft summaries of what your group found that could be incorporated in the article. That might be citations for information that is already there or new information. Discuss why your new information is relevant to the article.

I can copy your article over to your sandbox so you can practice editing before you make any suggestions to the editors of the stroke article. If you want me to do that, let me know by email or by using my user name in a response to this post. As always, I'm available to guide you.

Don't forget to sign your posts. I look up your contributions by user name for grading. If you don't sign your posts, you won't get credit for them when I'm grading.LynnMcCleary (talk) 01:20, 10 October 2014 (UTC)

Lh13lg's Summaries
Summary 1:

This source is Heilman, K. M. (2014). Disorders of Emotional Communication After Stroke. In The Behaviorial Consequences of Stroke (7). Retrieved from http://link.springer.com/chapter/10.1007/978-1-4614-7672-6_7.

This chapter focuses on how stroke can cause changes in emotional behavior and reviews how emotional communication is affected following a stroke. Emotions that are considered to be primary including happiness, sadness, fear, anger, disgust, surprise, and neutrality are a main focus in this chapter. These primary emotions tend to be affected by the deficits in emotional communication that occur after a stroke. Emotions can be expressed in a variety of ways. Some of the means for communicating emotions are facial expressions or movements, body language or posture, and nonverbal speech. A type of nonverbal speech described in this chapter is called prosody. Prosody is defined by someone’s pitch, volume, speed, and rhythm when they speak. This nonverbal speech can change depending what someone is talking about, who they are talking to, how they are feeling, or the message they are trying to convey. These basic means of communicating and expressing emotions are impaired when someone has experienced a stroke. As a result of these impairments, problems with both receiving and sending messages can occur between people.

I think this information would fit in the article under the section of Prognosis. This section only briefly discusses how the emotional expression of stroke victims is affected. This source would add more depth to this topic. It would also contribute to the communication aspect of emotional expressions of stroke victims since currently there is nothing about how both the sending and receiving of messages is affected. Lh13lg (talk) 22:29, 15 October 2014 (UTC)

Summary 2:

This source is Rodgers, H., Bond, S., & Curless, R. (2001). Inadequacies in the provision of information to stroke patients and their families. Age and Ageing, 30(2), 129-133. Retrieved from http://journals2.scholarsportal.info.proxy.library.brocku.ca/pdf/00020729/v30i0002/129_iitpoitspatf.xml.

This article focuses on the need for information to be given to stroke victims and their families and how health care providers have often failed to do so previously. According to the article, patients who have suffered from a stroke would like to be informed of all areas of the care process and included in the decision-making process. Unfortunately the patients face difficulties getting this information. The result of this lack of communication often leaves patients with misconceptions, anxiety, and fear. These factors tend to lead to poor health and emotional problems in victims of stroke. It has been recommended by the UK National Clinical Guideline for Stroke that from the beginning the needs of the family to be given information, be involved in decisions and planning, and given support should be taken into consideration. Another recommendation made was to inform families of the nature and manifestations of stroke and the national and local services that are available. These recommendations could be helpful to stroke victims and those caring for them but it has been realized that as time goes on, additional and different information is required due to the changing state of the stroke victim. Studies of education programs for stroke patients and those caring for them and studies of the provision of information by a stroke specialist nurse or stroke family support organizer are outlined. The results of these studies show that the methods for providing information need to be improved because they are not effective.

The information about how anxiety, fear, and misconceptions, as a result of lack of information communicated to stroke patients, can lead to emotional problems and poor health could fit under the Prognosis section. This information is similar to the information in The Behavioral Consequences of Stroke. There seems to be a consistent theme of communication being affected as a result of stroke and the importance of recognizing this in order to improve communication between health care providers, patients, and those caring for them such as family. The information about the need for information to be provided to stroke victims and their families could fit under the Management section. This information would be appropriate in this section because in order for stroke victims and their families to manage their condition and improve they need to be properly informed initially and over time. Lh13lg (talk) 22:29, 15 October 2014 (UTC)

Summary 3:

This source is Miller, C. A. (2008). Communication Difficulties in Hospitalized Older Adults with Dementia: Try these techniques to make communicating with patients easier and more effective. American Journal of Nursing, 108(3), 58-66. doi:10.1097/01.NAJ.0000311828.13935.1e.

This article outlines different techniques for nurses to try in order to assess the communicative abilities of patients with dementia and in turn communicate with them more effectively. These techniques encompass assessing receptive and expressive abilities, the challenge with language and cultural differences, and effectively communicating results. Communication is impaired in people living with dementia since the process of perceiving, understanding, and responding to both verbal and non-verbal messages is affected hence the importance of finding ways to communicating with people who have dementia. Many case examples presented throughout the article show how these techniques can be applied in various settings and situations.

Although this article is about communicating with patients with dementia I think it could be useful to the stroke article because, in the case of dementia and in the case of stroke, communication is impaired. The concepts presented in this article are similar to the information in The Behavioral Consequences of Stroke since they both present the idea that communication is impaired and therefore the receptive and expressive abilities of a patient may be affected verbally and non-verbally. This information could fit into the Prognosis section since it deals with communication after a stroke has occurred. The information about effectively communicating results could be relevant to the Rehabilitation section because it talks about referring patients to speech therapy as well as considering the environment the patient is in and its effects on communication. Lh13lg (talk) 22:29, 15 October 2014 (UTC)

Sg13vp's Summaries
Summary #1: Hamilton, R., Chrysikou, E., & Coslett, B. (n.d.). Mechanisms of aphasia recovery after stroke and the role of noninvasive brain stimulation. Brain and Language, 40-50. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3109088/

This article goes in depth about how technology is advancing in the area of aphasia treatment after a stroke. I specifically want to highlight the area of the article where it explains the benefits of noninvasive brain stimulation techniques that have been proven to come with benefits in rehabilitating those who suffer from aphasia. The stroke article already briefly goes over some aspects of this source but I would like to add to the information already in the stroke article. It is called Transcranial Magnetic Stimulation, also referred to as TMS. I think that it would be beneficial and be a good addition to the stroke article because it gives those a chance to see where technology is going in regards to therapy for aphasia and speech difficulties following a stroke. TMS involves several pulses at a frequency already determined in order to depolarize neural membranes and create action potential. These impulses are executed in specific areas of the brain that can potentially improve linguistic function. Sg13vp (talk) 22:35, 20 October 2014 (UTC)

Summary #2: Addington-Hall, J., Lay, M., Altmann, D., & Mccarthy, M. (1995). Symptom control, communication with health professionals, and hospital care of stroke patients in the last year of life as reported by surviving family, friends, and officials. Stroke, 2242-2248. Retrieved from http://stroke.ahajournals.org/content/26/12/2242.full

I found an article similar to Lydia’s in regards to the lack of communication that takes place between health care providers and patients, and families. This article explains how stroke patients (specifically in the final year of life) did not receive optimal symptom control, the aid required in order to overcome psychological morbidity, or any options within their health care. The article also examines symptoms after a stroke such as pain, confusion, down mood, and urinary and fecal incontinence. The article explains how these symptoms tie into poor communication on how to deal with post stroke health issues. Also, it is imperative to communicate with stroke patients and not only ensure that their physical well being is taken care of but also their social and emotional needs. I think that this article would benefit the wikipedia stroke page and aid the effects communication has on stroke patients. Sg13vp (talk) 22:35, 20 October 2014 (UTC)

Summary #3: Mackenzie, C. (n.d.). Dysarthria in stroke: A narrative review of its description and the outcome of intervention. International Journal of Speech-Language Pathology, 125-136. Retrieved from http://informahealthcare.com/doi/pdf/10.3109/17549507.2011.524940

This article explains the impact that the limitations of communications has on a stroke survivors social life, self identity, and emotional well being. Dysarthria is a neuro-motor disorder which causes issues in speech. It does not necessarily limit someone from speaking but rather can affect accuracy, speed, tone, range, and strength. In the article is explains how the affects of lack communication can often affect stroke survivors more than a physical impairment. The article also covers the fact that even though dysarthria is very prevalent among those who have experienced a stroke, there is very little research and information available to provide and pinpoint treatments or rehabilitation. I think that this information would also fit well under the rehabilitation section to provide more in depth knowledge about the affects a stroke can often have. Sg13vp (talk) 22:35, 20 October 2014 (UTC)

Summary #4 Ackley, B., Ladwig, G., & Kelley, H. (2010). Guide to Nursing Diagnoses. In Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed., p. 43). Maryland Heights, Mo.: Mosby.

Our text book uses diagnosis techniques that attempt to understand how stroke survivors may be feeling after a stroke and provides a variety of answers and descriptions of how this could potentially impact their lives. I feel as though this will be beneficial information because it provides different perspective on the outcomes of a stroke and also may give a fresh view on communication impairments after experiencing a stroke. Sg13vp (talk) 01:08, 5 November 2014 (UTC)

SHBROCK's Summaries
Summary #1: Ashkan Afshin, Renata Micha, Shahab Khatibzadeh, and Dariush Mozaffarian. Consumption of nuts and legumes and risk of incident ischemic heart disease, stroke, and diabetes: a systematic review and meta-analysis. The American Journal of Clinical Nutrition

This article explains the Importance of nuts and legumes (beans) in relation to their nutritional properties that may reduce cardiometabolic risk. The contents of legumes and nuts are unsaturated fatty acids, dietary fibre, antioxidant vitamins/minerals (vitamin E, potassium) and plant protein. A study cited in this article addressed the correlation of legume and nut consumption with stroke occurrence. In the article is explains how the effects of insufficient nut consumption. They found that 2.5 million deaths globally can be attributable to low nut intake. Therefore neglecting the nutritional properties of nuts has contributed to the global cardiometabolic mortality. The article focuses almost exclusively on nuts, but also mentions legumes (beans) and their potential to improve health. Beans are known to be comprised of many bioactive components that have the potential to enhance cardiometabolic health. These constituents are fibre, phytochemicals and folate. Legumes improve cardiometabolic health by: lowering cholesterol, lower an individual’s glycemic responses (protect against diabetes). The article states that nuts and legumes are essential to a healthy cardio metabolically balanced diet. I think that this article’s information would fit well under the ‘prevention’ section to provide more in depth knowledge about the benefits of this often neglected food group to reduce the risk of stroke.

Summary #2: James G. Crawford, PhD. Proposed Stroke and Heart Attack Mechanisms. Journal of Orthomolecular Medicine.

This article is an record of the potential causes for strokes and heart attacks. These include: magnesium deficiency, inflammation, high blood sugar, sicky cells and dehydration. The main message of this article is to highlight the possible simultaneous occurrence of types C and D strokes, and to raise awareness of this fact. If an individual is to prevent embolic strokes, they must meet the needs of their body with both C (Framingham recommendations) and D (magnesium and hydration supplementation). The article states that if an individual has experienced a ‘type D embolic event’ (heart attack or stroke) and fails to hydrate their body properly, the consequences are severe. When an individual suffers a stroke they are at risk for a repeat stroke soon after the first attack if their hydration levels are insufficient. The author asserts that dehydration is not recognized as a major risk factor by many medical professionals. The use of common sense to keep the body from dehydration after an embolic event is recommended. I think that this article’s information would fit well under the ‘Causes’ section of the Stroke wikipedia page, as it includes multiple documented causes of strokes.

Summary #3: Cheryl Bushnell, MD, MHS, and Louise McCullough, MD, PhD. Stroke Prevention in Women: Synopsis of the 2014 American Heart Association/American Stroke Association Guideline. Annals of Internal Medicine Volume 160, Number 12

This article explains the guidelines for the first stroke prevention targeted at women. Some areas of risk include: pregnancy-associated disorders and oral contraception and hormone therapy. The pregnancy-associated disorders such as preeclampsia can potentially have permanent consequences to a woman’s health. The types of stroke which are suffered primarily by women are addressed in this article. These can include: atrial fibrillation, migraines, hypertension, cerebral vein thrombosis and others. In the article, the authors present the evidence of the risk factors in women. Prevention strategies and recommendations are also found in this article. These precautionary measures should be used for treating and identifying hypertensive disorders in the period of pregnancy, which has an increased risk for stroke. The article also covers the fact that in the United States, 6.8 million people have suffered a stroke. The majority of stroke victims are women, at 3.8 million. The guidelines stated in this article serve to prevent strokes by emphasizing the risks that are more prevalent among the female population. The author’s goal for this article was to inspire further research to ascertain optimal approaches to stroke prevention in both genders. I think that this information would also fit well under the ‘Prevention section’, subsection ‘Women’ on the wikipedia Stroke page. This will provide more in depth knowledge about the risks of embolic events in women.

SHBROCK (talk) 02:53, 5 November 2014 (UTC)SHBROCK

Collaboration
I think it would be good for us to collaborate and head toward the edits we will suggest. In my summaries I tried my best to keep the suggestions for adding information on communication as general as possible and related them to the “communication model” we learned in class at the beginning of the year. Personally, I think it would best for us to focus on how a victim’s communication is affected emotionally (as seen in my first summary) since the article does not go into very much depth about this. Do you agree and if so, do you think it would fit well under the Prognosis section? Another thing I think it would be good to focus on is the need for communication between health care providers and the victim and their families. We both seem to have found evidence that this has been an issue and needs to be stressed and improved in order to increase the well-being of stroke patients. I refer to this in my second summary. If you agree this would be a good suggested edit, do you think it would fit well under the Prognosis section? Let me know what you think and we will be well on our way to coming to conclusions! Thanks. Lh13lg (talk) 17:11, 27 October 2014 (UTC)


 * Hi Lydia, I think that is a great place to head with our edits! I agree with the fact that communication between health care providers and patients, should be included and be a big portion of what we include because it has come up several time while researching communication information about the stroke. I also think we should focus in on the difficulties a stroke survivors experiences in regards to identity and social difficulties caused by communication difficulties post stroke. I also really like the idea of including the communication model we learned in class! I think if we go ahead and begin to summarize in detail and pinpoint exactly where in the article our information would best fit I think we will be well on our way to finalizing our edits! Sg13vp (talk) 19:24, 28 October 2014 (UTC)


 * Hey Shawna, I noticed that we now have a copy of the stroke article in the user page section of our sandbox which is excellent! I am going to begin trying out edits. I bolded the suggested edit that I put into the prognosis section. I am not entirely sure if I cited the source correctly. LynnMcCleary Could you take a look at the edit I made in the Prognosis section and let me know what you think? Thanks.  Lh13lg (talk) 14:46, 30 October 2014 (UTC)
 * Lg13lg, sorry I didn't see this earlier. This is a good idea. I can easily see your edits - and the edits so far make a lot of sense to me. LynnMcCleary (talk)  — Preceding undated comment added 02:55, 5 November 2014 (UTC)

Hey everyone! I thought it was a great idea Lydia had so I also uploaded my edits to the user page in our sandbox in bold so it would be easy for LynnMcCleary to be able to pick out our edits with ease! Sg13vp (talk) 01:33, 5 November 2014 (UTC)

Sg13vp's Final Edit
This edit builds on previous information in the article explaining the emotional impacts loss of communication after a stroke can have on the stroke survivor. The edit describes some social impacts a stroke can have on a stroke survivor along with physical self perception. It would provide another look at how some have been and are affected by communication impairments after a stroke. This edit was included on the stroke page under the Prognosis section, bolded as the fourth paragraph down.

'''Disruption in self-identity, relationships with others, and emotional well-being are sometimes social consequences after stroke due to the lack of ability to communicate. Many patients who experience communication impairments after a stroke find it more difficult to cope with the social issues rather than physical impairments. Wider aspects of care must address the emotional impact speech impairment has on those who experience difficulties with speech after a stroke. Those who experience a stroke, have a risk of experiencing paralysis which could result in self disturbed body image which may also lead to other social issues.'''  Sg13vp (talk) 23:53, 5 November 2014 (UTC)

Lh13lg's Final Edit
Just to make it clear for those of you looking at the stroke page: I added my suggested edit to our sandbox user page but one of the editor's of the stroke page added part of my edit himself to the actual user page. The edit I added under the prognosis section in the sandbox is bolded but I will post it below just to ensure you recognize it.

'''As a result of these post-stroke emotional difficulties, emotional communication can be affected. Emotional communication is expressed through facial expressions, body language or posture, and nonverbal speech such as tone of voice, pitch, volume, and rhythm when speaking. After a stroke as occurred however, these basic means of communicating and expressing emotions may be impaired. These impairments are likely to result in problems with both the receiving and sending of messages between people.''' Lh13lg (talk) 18:42, 7 November 2014 (UTC)

Summary of editing suggestions and direction for student reviewers
The students in this group are going to make a short summary of their editing suggestions here. The rationale for their suggestions are also on the Stroke page talk page. Their editing suggestions are bolded on the sandbox, here.

The Stroke page asks that students post their suggested edits on the talk page first, for approval. This helps the page keep with Wikipedia standards. Two students posted their suggestions and one has had edits made as a result (see the discussion on the talk page). An editor on that page, Doc James, was very helpful to them.

you are assigned to give the students in this group feedback. That could be a bit challenging because they've been quite successful in identifying opportunities to enhance the article. None-the-less, there is always room for improvement. I encourage you to read through the research that the students did and read the stroke article and see if you think there are any other opportunities to enhance the content about communication on the stroke page [e.g., maybe they have additional research that might be important, maybe they have something that could be an added citation (assuming it fits with the criteria for credible sources for project medicine articles (read this link to figure that out), maybe there's something that was missed as an opportunity that you'd like to flag for future editors of the Stroke page (hopefully some of you will continue editing after the course finishes). You have a great opportunity here to stretch your critical thinking skills, learn more about Wikipedia, and learn more about how strokes affect communication. LynnMcCleary (talk) 00:27, 7 November 2014 (UTC)

Kathleen's Edits
Hi! I've been assigned to edit your group's contribution to the wikipedia page. As a whole, you guys did a great job. The edits you added to the prognosis section fit perfectly and highlight the struggles of communication post-stroke. I just have a couple suggestions.

Suggestion #1 I was looking at the Rehabilitation section of the article and in the fourth paragraph (right at the bottom) it mentions speech and language therapy. There isn’t a lot of information in this section but based your summaries I think you guys could add to it.

Lydia’s first summary mentions prosody. Although this isn’t listed as one of the speech disorders that could receive speech therapy I think you could put it in (from what I can see from Lydia’s description of prosody it is very similar to Shawna’s description of dysarthria which is listed so I think it would make sense to add it). Besides that, maybe you guys could discuss what communication barriers stroke victims face before the speech therapy (frustration, trouble with self identity etc.) and then the improvements that are seen after (I’m not sure if you resources include this but if they discuss therapy I’d think the outcomes would be there somewhere).

You could also go into a brief explanation of what some forms of speech therapy are. I know that Shawna mentioned aphasia in her first summary. This would give people some insight as to what these victims must overcome to regain their communication abilities.

Suggestion #2 This time I was looking at the Prognosis section of the article.

There is a piece about emotional lability of stroke survivors. This means that patients tend to flip around in their emotions. I noticed that Lydia’s first summary talked about how strokes can cause changes in emotional behavior. You (Lydia) provide a list of emotions and then say, “these primary emotions tend to be affected by the deficits in emotion communication …”. Are they affected in the way that the Wikipedia article describes emotional lability (crying when happy etc.)? If so, you could contribute a bit more information about those emotional changes.

Also, another thing that could be edited in that paragraph it the last sentence that says, “Some patients show the opposite of what they feel, for example crying when they are happy”. You guys could discuss how this incorrect expression of emotion is frustrating and how that acts as a barrier to their commutation. Shawna’s fourth summary is about the experiences of stroke survivors so you could find a story where one of them talked about going through this struggle.

Suggestion #3 My final suggestion is on the topic of the relationship between the client and the health care professional. Both Lydia and Shawna had a summary on how the poor communication between clients and HCP professionals can cause clients to be scared and stressed which ultimately hinders their recovery. This doesn’t really fit too too well anywhere but if you put it as a small sub heading underneath the rehabilitation section it could act as a warning to patients and a reminder to HCPs that a lack of communication is not beneficial to the healing process. I think that this would be a good place to incorporate it be rehabilitation is all about clients working with health care professionals to improve their health (which could in fact be hindered if proper communication doesn’t occur). Just a thought.

Wording and Sentence Structure Suggestions

1. Sg13vp’s Final Edit: Sentence structure in the first sentence

Original: Disruption in self-identity, relationships with others, and emotional well-being are sometimes social consequences after stroke due to the lack of ability to communicate.

Correction/Comment: I find that “sometimes” is a bit awkward. Maybe replace it with “some of the social consequences…” or “can lead to”. Also, is it a consequence? Are they being punished? Maybe a word like “social difficulties” or “social barriers” would be a better fit.

2. Sg13vp’s Final Edit: Wording in the second sentences.

Original: Many patients who experience communication impairments after a stroke find it more difficult to cope with the social issues rather than physical impairments.

Correction/Comment: Just some picky wording corrections: I find the word “issues” to be quite broad. Maybe use the word “implications" instead. So the sentence would be something like, “…more difficult to cope with the social implications than the physical ones”.

3. Sg13vp’s Final Edit: Wording in the third sentence

Original: Wider aspects of care must address the emotional impact speech…

Correction/Comment: The third sentence is started with the word “Wider”. I think that “broader” would flow a bit better.
 * One final thing, the word experience is used twice within the last sentence. Try to find a word to replace one of them to avoid repetition!**

Overall the edits were very neutral and appear to be correctly cited. Great job! Kf14af1 (talk) 22:33, 11 November 2014 (UTC) Kf14af1 (talk) 17:48, 12 November 2014 (UTC)


 * Thank you Kathleen for your extensive feedback! I agree that there is much that could be added to the article based on our early summaries of research; however, when it came down to making actual edit suggestions on the stroke talk page it seemed best, since I am not even close to being an expert on strokes as many of the editors are, to keep our suggestions at a basic level. I decided to focus on the communication model we learned early on in the semester to explain how communication may be affected post stroke. I hope this clarifies why we decided not to go into too much depth with our edits. Thank you for taking the time to make all of these considerations! Lh13lg (talk) 02:06, 15 November 2014 (UTC)


 * I would also like to thank you Kathleen Kf14af1 (talk) for such detailed edits. Your suggestions are very clear and extremely helpful to help us improve our existing edits. Sg13vp (talk) 01:37, 19 November 2014 (UTC)

Jack's Edits
Okay I have to tell you guys that I might be a bit too meticulous so I apologize in advance. Furthermore, I cannot even begin to fathom how hard it must be to have a very detailed article and improve on such since I personally had somewhat of a stub which was fairly easy to add new information and incorporate ideas. I do just want to say your group has done a great job provided the circumstances. There is always room for improvement and here are some of my suggestions on how to improve.

First, I noticed something was out of place in the sentence "After a stroke as[sic] occurred however, these basic means of communicating and expressing emotions may be impaired". Did you mean "has"? If yes, this would fall upon the Wikipedia's good article criteria specifically well-written. (sentence located in lh13lg's final edit)

Second, In the phrase, "Emotional communication is expressed through facial expressions, body language [sic]or posture..." I noticed you did not use an Oxford Comma in between the words language and or. An Oxford Comma is not exactly enforced but seeing as you have already made use of such in the phrase "voice, pitch, volume, and rhythm". I recommend adding one to the earlier statement remembering that an Oxford Comma is to be used when listing three or more items and should be placed before the conjunction which in this case is or. This also another one for the well-written criteria same as the next one. (phrase located in lh13lg's Final Edit)

Third, in the sentence "Those who experience a stroke, have a risk of experiencing paralysis which could result in [sic] self disturbed body image which may also lead to other social issues.", I think putting an "a" between the words "in" and "self" would allow it to flow more freely since it seemed a bit awkward in my opinion. (sentence located in Sg13vp's Final Edit)

Fourth, in the section "venous thrombosis", it did not talk about causes of the "increased venous pressure" and also in comparison to the other sections has very little information. Coincidentally, our PEKN course has been discussing the topic of venous pressure and the creation of a thrombus. I do strongly believe improvements could be made to this section making it a more comprehensive article which is another one of Wikipedia's good article criteria.

Fifth, your source "Dysarthria in stroke: A narrative review of its description and the outcome of intervention" does not indicate a publication year on your reference list which I believe is 2011. I suggest indicating the year to add on to your article's verifiability especially since Wikipedia could assume that it wasn't formally published which would make it an unreliable resource unfit for Wikipedia.

Sixth, I noticed that in your article the picture for embolic stroke is right next to the description of thrombotic stroke instead of the description of the embolic stroke. I believe it might confuse some people and it would make more sense to put that picture next to the embolic stroke description.

Lastly, in the diet section of your article, I noticed there was barely any information and it was not adequately explained either. It says "Nutrition, specifically the Mediterranean-style diet, has the potential for decreasing the risk of having a stroke by more than half." and does not elaborate as to what contributes to the decrease of risk. In our NUSC 1P12 class, we have talked about the determinants of health. Lalonde stated how one's lifestyle, a component of which is diet, can affect health significantly. I believe this section could be improved by either adding more information on what kinds of diet can help decrease the risk of stroke because I highly doubt only one specific diet decreases the risk or your group could also elaborate on how and what specific elements in one's diet could affect a person's risk for stroke.


 * I found your article to be very stable seeing as people use the talk page instead of just editing immediately without any prior warning.
 * I also noticed your views are neutral considering it is factual and based on findings from your sources and not your own personal subjective interpretations.
 * I found the number of words in your article is overwhelming compared to the number of pictures. I recommend adding a picture specifically in the prevention, management or even prognosis section due to the absence of any pictures whatsoever.

Overall: Your group has done a great job especially under these circumstances. I hold a great deal of respect for your group seeing as your article is very well made and trying to improve it is difficult to say the least.

Rs13cs (talk) 02:09, 12 November 2014 (UTC)


 * Thank you Jack for taking time to articulate the edits we made. You are correct that it was challenging to make edits to this article. I fixed my spelling error in my edit immediately after you pointed it out to me! Thank you, that is embarrassing. The reason I refrained from using an Oxford Comma between "language" and "or" is because they are two closely related items and it seemed best to keep them together. What do you think would be better? In relation to your suggestions about the topic of "venous thrombosis" and the diet section of the article: we decided as a group not to stray from the idea of how communication is affected after a stroke has occurred. Our reasoning for narrowing our focus to communication is because we are not experienced enough, as are the editors of the stroke article, to make more complex edit suggestions. Lynn suggested to us early on not to get too broad with our research and editing to avoid getting in over our heads. With that being said, you have made some great suggestions that I think would be excellent for future editors with expertise in the field should consider making! Lh13lg (talk) 02:21, 15 November 2014 (UTC)


 * People might not know how body language and posture relate to each other so I do think putting a comma would be better but do what you think is best because by no means am I an expert. Rs13cs (talk) 21:28, 17 November 2014 (UTC)


 * Thank you Jack for the help! I think the mild grammar changes you suggested really help with the flow of my sentences. I also wanted to thank you for pointing out that my source was missing the date. Sg13vp (talk) 01:37, 19 November 2014 (UTC)

Ashling's Suggestions
I think the edits done for this page were very effective. I have a few suggestions that can increase the quality of the information.

First of all, for the most part I believe the edits fit the Wikipedia's good article criteria. It is fairly well-written with one possible spelling mistake where T think the word has was supposed to be used instead of as. The edits were verifiable because it has citations and the information is broad. The point of view was neutral and the information was stable. There was no image added but that aspect is understandable based on the type of information added. It was mentioned that an image of hemispatial neglect could potentially be added. I do not know much about this topic and if it could benefit your edits but it definitely could benefit the entire Wikipedia page.

Secondly, I think there are a few suggestions that were mentioned in the summaries that I think are effective and can support your information. It was mentioned that there can be a lack of communication between the health care professional and the individual who had the stroke and their family. This information emphasizes the importance of communication post-stroke. This could potentially be put under the management section because it is important for the individual and their family to be informed so they can improve their conditions.

I think since we are mainly focusing on communication that it could be effective to include some of the verbal and nonverbal communication limitations after a stroke. You could divide the limitations by the severity of the stroke. This could also lead into problems they may develop in their social lives from their communication problems.

Lastly, under the rehabilitation section, if possible, it could be beneficial to include methods to improve their communication after a stroke if there is research available on that topic. I have not done research on this and do not know if there is anything on this topic but it can help improve upon how to increase their communication skills. Ad14xz (talk) 03:47, 12 November 2014 (UTC)


 * Thank you Ashley for pointing out my spelling error! Jack pointed this out as well and I fixed it! I will talk to my group about possibly adding some information on the importance of communication between health care professionals and stroke victims. Kathleen made a similar suggestion but instead of under the management section she suggested adding an additional sub-heading. What do you think would be better? Lh13lg (talk) 02:27, 15 November 2014 (UTC)


 * Thank you Ashling for pointing out some extra content that could be added to our article. I definitely think I am going to go back with your suggestions in mind and see what I can add. Your suggestions were very helpful! Sg13vp (talk) 01:37, 19 November 2014 (UTC)