Abstract

In COVID-19, older adults have been disproportionately vulnerable to illness, death, and psychosocial repercussions. The proposed study aims to explore intersections between the COVID-19 pandemic and ageism among youth. Young adults recruited from the United States will read one of the three passages framing the pandemic in terms of its effects on the U.S. overall, the elderly of the U.S., or the young population of the U.S. and then complete critical measures of COVID-19 attitudes and behaviors. Participant ageist attitude will be included as a moderating variable and perception of the coronavirus as a personal threat will be included as a mediating variable. Conditional process models will be used to examine the direct and indirect effects of risk information on vaccine hesitancy and public health behaviors via the mechanisms of pandemic threat perception across levels of age bias. It is predicted that framing the pandemic in terms of its danger towards young adults will increase reported intentions to adhere to public health guidance via the mechanism of increased perceived threat, particularly for those high in ageism. Potential findings will have strong social, political, and cultural implications for establishing sustainable healthcare systems and intergenerational relationships.

Keywords: ageism, COVID-19, coronavirus, risk perception, public health, information framing

The COVID-19 pandemic has changed nearly all aspects of the daily lives of most individuals, yet those above 65 are disproportionately affected. Through August 2021, older adults have consistently been more prone to pandemic-related illness and death than younger people (Surveillances, V, 2020; Covid et al., 2020); they account for less than 20% of all COVID-19 cases but more than 70% of deaths worldwide (WHO, 2021). Older adults are vulnerable not only to negative physical effects of the coronavirus but also to long-term psychosocial repercussions due to social isolation. 

Along with the COVID-19 pandemic, there has been a parallel surge of ageism: from the media’s benevolent portrayal of the older population as a frail, vulnerable group, to hostile discrimination and abuse (Swift et al., 2021). The elderly face detrimental health impacts while having to cope with isolation, loneliness, anxiety, and depression (Banerjee et al., 2020; Bergman et al., 2020). The emergence of ageist attitudes and intergenerational divides have led to critical mental health ramifications on older adults. 

Additionally, non-compliance behaviors among adolescents exacerbate the negative impacts on public health. Adolescents are commonly identified with more non-compliance with preventive policies, especially with social distancing, than other age groups (Harris et al., 2021; Nivette et al., 2021; Roy-Chowdhury et al., 2020). Young adults are less likely to display severe COVID-19 symptoms and often consider themselves as immune and invulnerable to the virus (Ayalon et al., 2021; Surveillance, V, 2020). Therefore, as young adults frequently engage in social activities, those infected have high potential of transmitting the virus to others, which ultimately puts the elderly at risk (Andrews et al., 2020).  Recently, the Delta variant has become a pressing concern, as infection rate and hospitalization increase dramatically among the younger population (NBC, 2021). Internationally, health officials have been stressing the importance of adhering to health and safety guidelines. However, compliance to recommended health behaviors may be contingent on one’s attitude towards older adults. Accordingly, the current study sought to investigate the conditional indirect effects of reminders of coronavirus risk on adherence to pandemic-related public health behaviors (i.e., vaccine hesitancy, staying home, mask-wearing, physical distancing) as moderated by young adults’ ageism and mediated by perceptions of coronavirus risk.  

Participant Ageism

Prior research has demonstrated that ageist attitudes are often strong predictors of adolescent risk-taking behaviors. Young individuals with higher age bias also tend to report higher levels of risk behaviors (e.g., drug use, alcohol use, sexual behaviors) in daily life (Popham, et. al., 2011; Kennison, et. al., 2012). This is consistent with the terror management theory, which suggests that adolescents with strong ageism may attempt to dissociate themselves from their future older selves by seeking experiences that stimulate sensations of youth, strength, and invulnerability (Popham, et. al., 2011). Thus, the present study hypothesizes that youth with higher levels of ageism will also be more likely to engage in risky behaviors and subsequently report lower levels of engagement in COVID-19 protective behaviors. Although little research has been conducted on the specific effects of ageism on COVID-19-related health behaviors in youth, studies indicate that ageist attitudes may be a predictor of behavior change during the pandemic (Vale, 2020). 

Risk Information and Risk Perceptions

Risk information indirectly results in attitude and behavior modifications by increasing risk perception and altering emotional responses. Risk information, in the form of novel risk information or reminders of previously-known risks, is positively associated with levels of risk perceptions over time (Gerrard et al., 1999). Numerous studies have found that youth behaviors in risk-taking contexts, such as smoking and sexual behaviors, are responsive to risk information, especially when that information is personally relevant (Dupas, 2011; Gilbert et al., 2017). Moreover, authentic risk perceptions signal the need for preventive measures, and thus influence people’s decision-making and catalyze health behavior modifications in daily life and clinical settings (Edwards, et. al., 2001; Schmälzle, et. al., 2017). Amid past pandemics, such as the MERS outbreak in South Korea and the H1N1 influenza in Britain, increase in the public’s perceived susceptibility to the virus predicted increased preventive behaviors (Bish et al., 2010; Choi et al., 2018). In the COVID-19 pandemic, those perceiving greater risks also tend to report higher compliance with recommended health and safety precautions (de Bruin et al., 2020). Therefore, the present study intends to investigate the link between risk information, risk perceptions, and behaviors in the framework of the coronavirus pandemic.

Research Hypothesis: We hypothesize a conditional indirect effect of exposure to information about the increasing risk of the coronavirus for young adults on COVID-19 health attitudes and behaviors (i.e., vaccine hesitancy, staying home, mask-wearing, physical distancing) that will be moderated by participant ageism and mediated via the mechanism of increased perceptions of personal threat. We predict that exposure to information about the increasing risk of the coronavirus for young adults will cause participants to report increased coronavirus threat perception, which results in reduced vaccine hesitancy and increased health behaviors. 

Method

Participants

Participants will be recruited from undergraduate university subject pools from various universities in different areas of the United States. Participants will report their age, gender, race, and political orientation.

Measures

Ageism. Ageism will be measured on the 13-item Ambivalent Ageism Scale (AAS) validated (e.g., Cary et al., 2017) and used (e.g., Vale et al., 2020) by numerous peer-reviewed research studies. An example item is, “It is good to tell old people that they are too old to do certain things; otherwise they might get their feelings hurt when they eventually fail.” Participants will respond to each item on a 7-point Likert scale from 1 – “Strongly Disagree” to 7 – “Strongly Agree,” resulting in a range of possible values on the composite variable from 13 to 91. Higher value indicates greater level of ageism. See Appendix A.

Risk-information. Risk-information will be a manipulated (experimental) independent variable. Participants will be randomly assigned to three condition groups. In each condition, participants will be provided with information that emphasize the continued pandemic-related risks, its widespread impacts, and the importance of vaccination and safety measures. Participants in the threat to older population condition (Condition 2) will read a passage of information emphasizing the continued vulnerability and risks for the older population. Participants in the threat to younger population condition (Condition 3) will read a passage emphasizing the increased vulnerability and risks for the younger population. More details are reported below under “Procedure” and full text is available in Appendix B.

COVID-19 threat perceptions. COVID-19 threat perceptions will be assessed using the 7-item Fear of Coronavirus-19 Scale (FCV-19S) (Ahorsu et al., 2020). The reliability of the scale is validated in different populations (e.g., Perz et al., 2020). An example item is, “I am afraid of losing my life because of coronavirus-19.” Participants will respond to each item on a 5-point Likert scale from 1 – “Strongly Disagree” to 5 – “Strongly Agree,” resulting in a possible range of values from 7 to 35. Higher value indicates greater pandemic-related threat perceptions. See Appendix C.

COVID-19 health attitude and behaviors. Attitudes toward COVID-19 vaccinations will be assessed using three items, “All universities should mandate coronavirus vaccines for all students who are medically able to be vaccinated”, “Employers should mandate vaccinations for all workers who are medically able to be vaccinated, regardless of how otherwise young and healthy those workers are”, and “Everyone who is medically able to receive a vaccine should choose to be vaccinated.” Participants will respond to each item on a 7-point Likert scale from 1 – ”Strongly disagree” to 5 – “Strongly agree.” COVID-19 health compliance behaviors will be evaluated using a 3-items assessing how the framing manipulation has prospectively changed their likelihood to engage in certain behaviors, selected from public health recommendations by the World Health Organization (WHO, 2021), including: (i) stay at home, (ii) adhere to physical distancing (1.5-2m), and (iii) wear a face mask. Participants will indicate on a 7-point Likert scale, from 1 – “I will be much less likely to do this” to 7 – “I will be much more likely to do this,” resulting in a range of values from 3 to 21. 

Procedure

Participants will complete an informed consent document and are randomly assigned to read one of the three passages containing information on the number of cases, deaths, and hospitalization among (1) the U.S. population, (2) older adults, and (3) younger adults. All three passages will contain information regarding the rise in cases since the summer of 2021, the threat of the more contagious Delta variant, and the effectiveness of vaccination and preventive behaviors such as social-distancing and mask wearing. Then, participants will report to measures of COVID-19 threat perception, health attitudes, and health behaviors. Finally, participants will complete measures of demographic and personal characteristics (i.e., age, gender, and race) and read a debriefing statement regarding the purpose of the study.

Results

Conditional direct and indirect effects will be examined using PROCESS Model 8 (Hayes, 2013) with risk information as the primary independent variable (x); age-related bias as the moderator (w); perceived coronavirus threat as a mediator (m). Vaccine hesitancy was as the dependent variable (y1) in the first analysis and reported adherence to public health behaviors as the dependent variable (y2) in the second analysis. All indirect effects were computed for each of 10,000 bootstrapped samples and were considered significant if their 95% confidence intervals did not include zero (these bootstrapped effects do not produce exact p values). Non-dichotomous variables were mean centered. The conceptual models are illustrated in Figures 1 and 2. 

Discussion

The current study was designed to investigate whether ageism and framing the impact of the coronavirus pandemic in terms of the increased risk of young adults, rather than of the general population or the older population, would predict greater coronavirus threat perception, reduced vaccine hesitancy, and increased health behaviors. We expect that participants with high age bias will report less compliance behaviors and that participants receiving information regarding young adults will also report less compliance behaviors. Overall, we expect to be able to conclude that age bias and framing of risk information have a strong influence on public health outcomes, such as vaccine hesitancy and compliance to safety guidelines.

Implications

The results of this study (if consistent with the hypothesis) will have significant implications for public health and social policy. Ageism in young adults promotes reckless behaviors that jeopardize lives and entire healthcare systems. Reminders of pandemic-related risk that are age-specific and relevant effectively induce attitude modifications and reduce risk behaviors in youth. This accentuates the need for stronger social efforts, including mitigation and information campaigns targeted at young adults (Kolbe, et. al., 1993). In addition, fostering a culture that promotes the value of the lives of older people and reduces the youth obsession that feeds into anti-elderly bias is paramount, especially in a rapidly aging society (Ng & S. H., 1998; North, et. al., 2012; Meisner & B. A., 2021). 

Limitations

The study relies on participants’ self-reported response as a measurement of COVID-19 vaccine attitudes and health compliance behaviors. Therefore, the conclusions drawn from this study may be limited by the use of self-reported responses which might not accurately reflect actual behaviors, as participants may be unable or unwilling to report accurate estimates. Additionally, one’s vaccine hesitancy also varies across time, place, and vaccines, yet the assessment of vaccine hesitancy in this study lacks specific vaccine context, thus the results might not generalize to other countries or populations. 

Future Directions 

The proposed experiment assesses the effects of risk information on COVID-19 health attitudes and behaviors in the short term. Future research may examine whether the observed effects generalize across contexts and to what extent the effects are durable. As research demonstrates that manipulation of information in clinical settings affects patients’ decision-making and health outcomes (Edwards et al., 2001), future research could investigate the effects of framing pandemic-related risk information on public attitudes during the coronavirus pandemic. Future research may also explore the relationship between ageism, risk information, and response (i.e., attitudes and behaviors) in different age groups. 

References

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About the author

Vanessa Yu

Vanessa is an 11th grader at the United World College of South East Asia in Singapore. She is interested in social psychology, mathematics, and physics and also enjoys making and appreciating art.

The post Can Framing the Pandemic as Dangerous to the Young Reduce Non-Compliance Behaviors Among Young Adults in the COVID-19 Pandemic? An Examination of Age-Related Bias appeared first on Exploratio Journal.

“I think I have OCD because I want everything to be neat.”

Obsessive-Compulsive Disorder is one of the most well-known mental illnesses. However, it’s also one of the most misunderstood. Often when someone says, “I think I have OCD,” they’re referring to the fact that they always like to keep things organized. This, however, is not true. OCD symptoms consist of obsessing over the tiniest things. The obsession leads to constant anxiety and crushing stress. It’s not just someone wanting everything to be neat. People with OCD face repeated intrusive thoughts that mix with fear or danger. [1]

The fear that envelopes those with OCD can materialize as a need for symmetrical arrangement, although everyone’s symptoms differ based on their doubts in themselves and other internalized concerns. People who genuinely have OCD do not simply engage in excessively detailed practices because they feel like it. They constantly have these compulsions because of the anxiety that’s weighing on them; for example, the constant need to check on their family members or loved ones to make sure that they’re safe. [2]

According to www.helpguide.org, the cycle of OCD includes 1; an obsessive thought taking over someone’s mind. 2; the anxiety that comes along with not being able to control the thought. 3; compulsive behaviors such as repeatedly tapping or touching an object. 4; the temporary relief. Upon reaching the final step, the cycle starts again. These continued thoughts are what makes OCD such a severe illness and not something to joke about. [2] Patients who have it describe it as a ‘mental discomfort’ that leads to anxiety and fear. [5]

Simply because someone prefers everything to be neat does not mean that they have OCD. This common misconception can lead to others believing that this illness is not as severe and profound as it truly is. Bystanders will think that it is okay to use the term “OCD” lightly. 

When people see the symptoms and effects of OCD, they start to say things such as, “calm down, nothing bad will happen,” or, “the stove is off, don’t recheck it, it’s fine.” [3]However, for someone who truly suffers from OCD, these obsessions cannot just be cured by “calming down.” This is a severe chronic illness that deserves more attention. These obsessions and compulsions are almost outright impossible to control without medical help. [3] The thought itself is caused by a disturbance between the frontal cortex of one’s brain and the ventral striatum. Patients cannot just “calm down” when in the cycle of OCD because it is near impossible to control their anxiety. [4]

My research aims to identify the frequency of misinterpretation of OCD as well as the adverse effects that such misinterpretation may cause on those who have OCD. My study analyzes existing data on the prevalence of OCD, including self-developed surveys of individuals with and without OCD.

How OCD is Mischaracterized

Having OCD misinterpreted is extremely disrespectful to actual patients suffering from the disorder. Over 1 percent of Americans suffer from OCD. [6] Yet around 66% of Americans say that a dirty home makes them feel anxious.[7] These two types of anxiety are completely different. While OCD is a serious mental illness affecting 2.2 million Americans, feeling anxious about a dirty home is a common anxiety shared among over half of the population. There are so many people among these patients who hide their symptoms from embarrassment or fear. [8] Joking about OCD is extremely disrespectful and embarrassing to those who suffer from the illness. Saying “I’m so OCD” can blur the line between a devastating disorder and a regular need for neatness. People are stripping the illness of its severity, and this also applies to any illness. This can make it extremely hard for people to seek help. [9]

Making light of this extremely serious mental illness is not only insensitive, but extremely detrimental to a patient. Those with OCD might feel as though their very real symptoms and obsessions aren’t as important, leading them to avoid seeking help. Making a joke of OCD, or saying that one has it is making fun of an extremely tortuous routine that patients have to go through daily. Those who mischaracterize OCD are contributing to the stigma that has made many patients hide their illness for years and years. People are joking about patients who have to go through exhausting rituals as well as intrusive thoughts just to sound “quirky and different.” [8]

There are multiple scenarios where people mischaracterize OCD. The seven main ones include: Keeping a tidy living space, worrying about an upcoming event, wanting to arrive somewhere early, being a “perfectionist,” wanting to wash one’s hands, hanging onto things one doesn’t use anymore, and finally checking and then double-checking things. [10] Each of these examples are common anxieties among people who don’t have OCD. All of these things might annoy or bug someone, but it’s not to the extent of OCD, and it doesn’t have as negative of an impact on people, says a licensed psychologist Dr. Crystal I. Lee. [10]

A lot of things that annoy the usual person doesn’t affect them the same way as an obsession would affect a patient with OCD. OCD is much more extreme and it takes up so much more time in a patient’s life. The reason why OCD is so mischaracterized is because of the lack of education. Most people don’t easily come across information on certain illnesses because it doesn’t affect them, and they don’t search it up. OCD is also extremely misportrayed in the media. There’s a false representation of the mental illness. It’s usually represented mainly around a fear of germs and cleaning compulsions. When the majority of people look at the media and see this, it doesn’t give a clear picture of OCD. They feel like OCD is just what the media portrays it as. [11]

What It Truly Means to Have OCD

Charlotte, an anonymous contributor to the mental health awareness website www.mind.org, says OCD is like a constant fear of not being able to complete something the right way. She lives with obsessions taking over her thoughts daily. He also has rituals to get rid of those obsessions, which are called compulsions. She says that these compulsions are extremely horrific, especially because she has these thoughts on a daily basis. [12] Imagine having unwanted thoughts up to 20 times a day, and not being able to get rid of them. 

Mark Highet, a father and public servant from Queensland, Australia, says that even everyday actions like turning on a light switch can trigger his OCD. This can lead to anxiety, causing him to do rituals in order to forget about the obsessions. “For example, one day I was filling up my daughter’s water bottle,” he says, “and I had the thought that the water might be contaminated. I rationally knew it wasn’t, but I had this worry. So, I turned back to the sink, tipped it out and filled it again. I went to give it to her, but then I worried again, so I tipped it back out. I must have done it 40 times.” Mark goes on to say that it almost feels humiliating when someone from work sees him doing a ritual. He says that it feels like he’s so busy trying to live, that he’s forgetting to live. [13]

OCD isn’t just wanting everything to be neat. It’s about spending minutes to hours of one’s day trying to get rid of a thought that’s taking over one’s mind. For some, it might be “if I don’t do this, my family is going to get hurt.”[9] For others, it might be “If I turn something on, I might not be able to turn it off.” [13] These thoughts cause extreme and heavy anxiety among patients who have OCD. It can cause them to fear for their loved ones, because they think that they’ll end up hurting someone close to them. These thoughts aren’t just shallow little ‘what ifs.’ They are thoughts that can significantly impact a person’s life. It’s extremely complex, far past the point of wanting everything to be perfect. OCD can cause an overload of function systems in one’s brain. [14]

Having a constant obsession on one’s mind can lead to rituals. Rituals are an action that a patient performs when they try to forget about the obsession taking over their mind. For example, performing a repetitive activity, like locking, unlocking, and relocking a door. These rituals are usually performed physically to get rid of the muscle tension coming from obsessive thoughts. Rituals are usually described as mental and physical exercises that people with OCD perform to get rid of feelings such as disgust or anxiety. Rituals can also be performed to prevent a dangerous situation. People with OCD often can’t suppress their thoughts, which is why they cope through performing rituals. [15] Hattie Gladwell from metro.co.uk says that OCD takes up around 14 hours of her week every single week. [16] That’s over 8% of her entire week. These rituals aren’t actions that can be done only one or two times and solved. Patients spend hours and hours trying to get rid of their obsessions. 

Dangers of Mischaracterization

Charlotte at Mind.org also mentions, “anyone who says that having OCD is ‘helpful’ couldn’t be further from the truth. I may spend hours cleaning dishes and making sure my things are organised/symmetrical – but when will any of these compulsions benefit me? NEVER.” [12] Saying that OCD is beneficial to patients is disrespectful in and of itself because one is making a really serious mental illness seem like it’s benefiting a patient, even if in reality, it’s hurting them. 

Mark Highet has experienced jokes about OCD firsthand. He says, “At my work we have a regular meeting, where everyone goes around the table and updates on how they’re going. One day, one of my co-workers said, ‘Oh sorry, that’s so OCD of me,’ when she finished her bit. When I hear that, I think, ‘if only you knew.’ It’s a real, and really hard, condition.” Jokes like this can increase the stigma around OCD itself, which is harmful to people who are seeking help. It’s a real mental health issue, and no laughing matter. Michelle Blanchard says that “OCD is often appropriated as a casual term but trivialising it only adds to the stigma that often prevents people from seeking help.” [13]

Serena Ata from the website inkspire.org says that she wasn’t able to fully diagnose her OCD because of the stigma around the disorder. All of her symptoms were viewed as “normal” because people said that all her compulsions were things that she would grow out of. Serena says that making jokes about OCD is extremely damaging to patients who suffer from the  disorder. For her, she had to spend years scrolling through the internet to try and find an answer and a reason as to why she was spending hours of her week on rituals. “Unfortunately, many sufferers find themselves dependent on unreliable platforms for answers, often leading to a vicious cycle of misinformation, misunderstanding and misdirection.” [17]

It can take up to 17 years on average for people to receive an OCD diagnosis. [18] Only about 200,000 people with OCD seek therapy out of the 4.1 million people who need the treatment. [19] When patients view the media and see OCD being portrayed as a simple little quirk, they won’t seek out help, and they won’t try to get treatment. Patients would feel like their symptoms are normal, and they put it aside. Mischaracterizing OCD can lead to actual patients taking years and years to seek the treatment that they actually need. This can harm the patients themselves, because OCD symptoms can progressively get more intense. OCD symptoms get worse with age, so when patients don’t seek help at a young age, it would be harder for them to deal with it. [20]

Conclusion and Further Guidance

Mischaracterizing OCD can lead to patients not getting correct treatment, and patients feeling like their mental illness isn’t actually serious. It harms the OCD community by joking about a mental illness that’s extremely legitimate. Mischaracterizing OCD can also add to the stigma around the topic. When the media portrays OCD as something light and fun, it can lead to patients feeling like their symptoms aren’t important, even though they are. If any individuals have ever made a joke about OCD or have mischaracterized OCD, they should do their best to educate themselves on the topic. One should start to take this disorder more seriously from now on, and do one’s best to support patients with OCD as best as they can.

If someone knows a family member or friend who has OCD, the Victoria State Government Department of Health recommends that one should first make sure to educate themselves on their family member’s disorder. When people have connections with patients, it can ease the tension around their relationship. When they’re performing a ritual, one shouldn’t participate in the rituals themselves, because it could reinforce OCD behaviour and it could lead to symptoms potentially getting worse. [21] Though one shouldn’t assist them in the rituals themselves, they should remind them that it shouldn’t be something that they’re embarrassed about. They should make sure that they’re getting the right treatment like professional help. 

In the event that a patient starts to lose motivation in seeking help, close relatives and friends should continue supporting them. If they start to have less motivation to go get treatment, studies say that individuals should make sure that they remind patients about the progress that they’ve made through the whole process. Seeking help isn’t a sign of weakness, it’s a sign of strength. [21] It shows that they’re trying to treat their disorder. The general public can also help with maintaining a non-judgemental attitude, which can help as well, because patients know that their obsessions are irrational. Finally, the Victoria Department of Health recommends encouraging patients and rewarding them for the gains they’ve made. Most importantly, accept patients for who they are, and don’t ridicule them for their rituals. Supporting a patient with OCD is the best thing to do when they’re going through a difficult time. 

Works Cited:

[1] Benenden Health. (n.d.). OCD: Myths vs Reality. Benenden Health. Retrieved May 7, 2021, from https://www.benenden.co.uk/be-healthy/mind/ocd-myths/ 

[2] Smith, M., Robinson, L., & Segal, J. (2021, February). Obsessive-Compulsive Disorder (OCD). Help Guide. Retrieved May 7, 2021, from https://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm#:~:text=Common%20compulsive%20behaviors%20in%20OCD,senseless%20things %20to%20reduce%20anxiety. 

[3] Ryback, R. (2016, May 9). 4 Myths About OCD. Psychology Today. Retrieved May 7, 2021, from https://www.psychologytoday.com/us/blog/the-truisms-wellness/201605/4-myths-about-ocd 

[4] Pronghorn Psych. (n.d.). How Obsessive Compulsive Disorder Affects the Brain. Stone Ridge. Retrieved May 7, 2021, from https://pronghornpsych.com/how-ocd-affects-the-brain/#:~:text=Researchers%20know%20that%20obsessive%2Dcompulsive,known%20as%20 the%20ventral%20striatum 

[5] Mind. (2019, May). Obsessive-compulsive disorder (OCD). Mind. Retrieved May 7, 2021, from https://www.mind.org.uk/information-support/types-of-mental-health-problems/obsessive-compulsive-disorder-ocd/about-ocd/

[6] ADAA. (2021, October). Facts & Statistics. Anxiety and Depressions Association of America. Retrieved May 18, 2021, from https://adaa.org/understanding-anxiety/facts-statistics#:~:text=Crisis%20(Oct%202020)-,Obsessive%2DCompulsive%20Disorder%20(OCD) ,cases%20occurring%20by%20age%2014.

[7] Heinz, A. (2019, October 7). Survey: Americans More Annoyed With Clutter Than Dirt. Apartmentguide. Retrieved May 18, 2021, from https://www.apartmentguide.com/blog/americans-annoyed-with-clutter/

[8] George, N. (2014, September 3). When It’s Not Just OCD. Everyday Health. Retrieved May 10, 2021, from https://www.everydayhealth.com/news/when-its-not-just-ocd/?pos=2&xid=nl_EverydayHealthMentalHealthandMoodDisorders_20171015 

[9] Gallagher, W. (2017, October 23). You’re Actually Not “So OCD,” And Here’s Why You Shouldn’t Joke About It. Rolling Hills Hospital. Retrieved May 10, 2021, from https://rollinghillshospital.org/youre-actually-not-ocd-heres-shouldnt-joke/#:~:text=Unfortunately%2C%20for%20about%202.2%20million,OCD%20is%20no%20laughing %20matter.&text=You%20may%20not%20realize%20it,who%20deals%20with%20the%20disorder 

[10] Steber, C. (2018, January 30). 7 Symptoms That Are Wrongly Mistaken As OCD. Bustle. Retrieved May 19, 2021, from bustle.com/p/7-symptoms-that-are-wrongly-mistaken-as-ocd-8026866 

[11] D’Arcy-Sharpe, A.-M. (2020, January 6). Why Is OCD So Misunderstood And Misdiagnosed? IMPULSE. Retrieved May 19, 2021, from https://impulsetherapy.com/why-is-ocd-so-misunderstood-misdiagnosed/ 

[12] Charlotte. (2016, June 23). Living with OCD. Mind. Retrieved May 7, 2021, from https://www.mind.org.uk/information-support/your-stories/living-with-ocd/ 

[13] Queensland Health. (2018, October 10). What is it like to live with obsessive compulsive disorder? Queensland Government. Retrieved May 11, 2021, from https://www.health.qld.gov.au/news-events/news/living-with-obsessive-compulsive-disorder-OCD-symptoms-treatment-Queensland 

[14] International OCD Foundation. (2016, October). OCD – Misunderstood and Misdiagnosed | Orlando OCD Therapist Raises Awareness #OCDWEEK. Ground Work Counseling. Retrieved May 11, 2021, from https://www.groundworkcounseling.com/ocd/ocd-misunderstood-and-misdiagnosed-orlando-ocd-therapist-raises-awareness-ocdweek/#:~:text=A%20misdiagnosis%20of%20OCD%20has,management%2C%20 hospitalization%20and%20inaccurate%20reporting.

[15] Pulse. (n.d.). OCD Rituals: Symptoms and Treatment Options. Pulse. Retrieved May 11, 2021, from https://pulsetms.com/ocd/rituals/ 

[16] Gladwell, H. (2018, January 26). How much time OCD rituals take out of my day-to-day life. METRO. Retrieved May 19, 2021, from https://metro.co.uk/2018/01/26/how-much-time-ocd-rituals-take-out-of-my-day-to-day-life-7259595/ 

[17] Ata, S. (2020, November 2). “So OCD”: The Consequences of Delegitimizing a Disorder. INKSPIRE. Retrieved May 19, 2021, from https://inkspire.org/post/so-ocd-the-consequences-of-delegitimizing-a-disorder/-MHg9RS6V1RColwvc–S

[18] NOCD Staff. (2020, December 15). How Long Does OCD Treatment Take? NOCD. Retrieved May 19, 2021, from https://www.treatmyocd.com/blog/how-long-does-ocd-treatment-take

[19] Gershkovich, M., Middleton, R., Hezel, D. M., Grimaldi, S., Renna, M., Basaraba, C., Patel, S., & Simpson, H. B. (2020). Integrating Exposure and Response Prevention With a Mobile App to Treat Obsessive-Compulsive Disorder: Feasibility, Acceptability, and Preliminary Effects. ScienceDirect. Retrieved May 19, 2021, from https://www.sciencedirect.com/science/article/abs/pii/S0005789420300666

[20] Penn Psychiatry. (n.d.). OCD: SOME FACTS. Perelman School of Medicine. Retrieved May 19, 2021, from https://www.med.upenn.edu/ctsa/forms_ocdfacts.html#:~:text=Symptoms%20fluctuate%20in%20 severity%20from,symptoms%20were%20disrupting%20their%20lives.  

[21] Obsessive compulsive disorder – family and friends. (n.d.). BetterHealth. Retrieved May 27, 2021, from https://www.betterhealth.vic.gov.au/health/ConditionsAndTreatments/obsessive-compulsive-disorder-family-and-friends 

[22]Dogra, T. (2020, July 22). Obsessive-Compulsive Disorder (OCD): Symptoms, Treatment And Diagnosis. Onlymyhealth. Retrieved June 1, 2021, from https://www.onlymyhealth.com/obsessive-compulsive-disorder-ocd-symptoms-treatment-diagnosis-1595417322 

About the author

Sophia Zhang

Sophia is a student at the Shanghai American School – Puxi Campus.

The post Obsessing Over Obsessive Compulsive Disorder: The Damage Done by Mischaracterizing OCD appeared first on Exploratio Journal.

Abstract

Successful execution of every business startup / matured business enterprise depends entirely on management skills and expertise of the executive group of an organization. The business venture can, therefore, conceive modifications of how to move towards the modern intricate and changing situation for success in the market. Therefore, the executives of an organization try to revolutionize their methodology during pessimistic moments, to guarantee lasting and long-standing success of the business enterprise. They are required to continuously maintain and get hold of clients and vendors. By putting into practice these measures they can achieve a competitive advantage over other business enterprises.

This project report entitled “A study on financial performance of Infosys Technologies Ltd”. The main objective is to analyze the financial position of the company based on the relationship between the items of balance sheet, profit and loss account and cash flow statement to make investment decisions. All the financial data has been gathered from financial sites which form the secondary data. Various tools used to carry out the study are ratio analysis, comparative financial statements, histograms, graphs etc. 

The study concludes with a recommendation for investing in the company as a long-term investment, keeping in view the stable and gradual growth of the company since inception.

Introduction

Financial statement analysis is an essential step towards decision making as regards investing in a company stock, if analysis is not done one lands up in a game of chance.

Companies’ financial statements (Balance Sheet, Profit & Loss, Cash Flow statement, and the statement of owner’s equity) give us advice which as a combination provide a true financial picture of the company’s deep pockets.

Different analysis methods can be employed to evaluate the intrinsic value (true value) of the company stocks   based on the past, present, and predicted future financial performance of the company.

On completion of the analysis, the information can be utilized to decide as regards investing in the company with a positive speculation of the expected target returns.

Choice of Company/Sector

Infosys Technologies India was chosen among the peers of Infosys Technologies, in the Information and Technology sector in the Indian Stock Market.

Infosys Limited (Background)

Mr. N R Narayana Murthy and 6 software professionals established a software startup company in the year 1981 with an investment of only Rs10,000/- in Pune India.

Relocated its headquarters to Bengaluru in 1983 and subsequently opened its first office in BOSTON USA.

The company got ISO9001 certification in 1993.

Infosys went public by issuing an IPO at Rs 145/- per share.

Infosys team made arduous efforts and is now one of the leading IT services companies in India.

Now has several fortune 500 companies on its client list.

Infosys’ Mission Statement

“To achieve our objectives in an environment of fairness, honesty, and courtesy towards our clients, employees, vendors and society”

Infosys’ Vision Statement

“To be a globally respected corporation that provides best-of-breed business solutions, leveraging technology, delivered by best-in-class people.” 

Infosys Tagline

 “Powered by Intellect, Driven by Values”

Assessment Of Intrinsic Value of Share Price 

(To help Investment Decision making)

 Following data pertaining to the company was compiled:

Remarks

Distribution of the share holding pattern shows a good presence of institutional investors which indicates that promoters have no opportunity to change or make random decisions which can benefit the promoters without analyzing how it would affect the earnings and the shareholders.

Comparison with peer IT companies

Remarks

P/E Ratio 

A high P/E suggests that investors are expecting higher earnings growth in the future compared to companies with a lower P/E. 

The table shows the P/E ratio of Infosys is 35.78 standing near to TCS which has a P/E ratio of 36.72 and is sufficiently higher among its peers, as such it will not be wrong to expect a higher growth rate of Infosys technologies in the period ahead.

P/B Ratio

P/B ratio is a useful metric of the ratio of price of share to its book value. It provides comparison of the company’s market capitalization to its book value. The P/B ratio of Infosys as per the data is 9.02 second highest among its peers and a good indicator to BUY a share.

Dividend Yield

The dividend yield–displayed as a percentage–is the amount of money a company pays the shareholders for owning a share of its stock divided by its current stock price. The comparison shows the dividend yield of Infosys as 1.66%. This higher percentage of dividend indicates that Infosys is paying more to its shareholders as compared to its peers which is an indication that the company is at its maturity level and its growth is stable.

Peer group comparison for the past five years beginning from July 2017 to August 2021 shows that Infosys stock price has steadily grown in comparison to its peers which indicates the stability of the company.

Dividend Record 

Dividend per share (DPS) is an important financial ratio which indicates the financial health and long-term growth prospects of a company.

A steady and growing dividend payment by a company indicates the stability and growth of a company.

DPS is an important metric from investors point of view because the amount a firm pays out in dividends directly translates to income for the shareholder.

DPS is one of the most straightforward figures an investor can use to calculate his or her dividend payments from owning shares of a stock over time. A growing DPS versus time also implies that the company’s growth and earnings can be sustained.

As such the dividends record of Infosys gives a very positive signal to invest in the company, as depicted in the table below.

Balance Sheet / Income Statement Analysis

• A company’s balance sheet shows its assets and liabilities at glance.
• Analysts study the balance sheet to make decisions pertaining to an investment opportunity or evaluating a company.
• It is believed that the most important areas on a balance sheet are cash, accounts receivable, short-term investments, property, plant, and equipment, and other major liabilities.
• The top line and bottom line are two of the most important lines on the income statement for a company. Investors need to pay attention to any changes in these from quarter to quarter and year to year.
• The top line refers to a company’s revenues or gross sales. Therefore “top-line growth,” indicates an increase in gross sales or revenues.
• The bottom line is a company’s net income, or the “bottom” figure on a company’s income statement. Thus, the bottom line shows a company’s income after all expenses have been deducted. These expenses include interest charges paid on loans, general and administrative costs, and income taxes. This is also referring to as net earnings or net profits
• Other critical items include accounts receivable, short-term investments, property, plant, and equipment. and major liability items. The big three categories on any balance sheet are assets, liabilities, and equity.

BALANCE SHEET

Ratio Analysis

Liquidity ratios

These ratios indicate whether the company would be able to pay its short-term debts

when they are due. They give a picture whether the company has sufficient cash and cash equivalents to pay its short-term debts. The value of the ratio greater than ONE shows that the company is in good financial health.

The ratios help in determining the liquidity of a company:

Current ratio:

This tells us whether the company has sufficient funds to pay its liabilities over a period of 12 months.

Current ratio = Total Current assets / Total Current Liabilities

        = 60733 / 23865 

= 2.55

 The value of current ratio of 2.55 indicates that the current assets of Infosys are 2.55 times 

 its liabilities. This means that the company is in good financial state to pay back its liabilities.

Quick ratio/acid test ratio:

It measures the current short-term ability of the company to pay its liabilities.

It considers the very liquid assets (can be converted into cash immediately).

Quick Ratio = (Total Current Assets – Inventory) / Total Current Liabilities

= (60733 – 0) / 23865

= 2.55

Quick Ratio also measures the company’s liquidity position. A ratio 2.55 indicates that the company’s financial position is sound. This is also termed as Acid test Ratio.

Cash ratio

Cash ratio further improves the current ratio and quick ratio.

It considers only the most liquid short-term assets of the company.

It is the most rigid measure among the three liquidity ratios.

Cash Ratio       = Cash and Cash Equivalents / Current Liabilities

        = 24714 / 23865

        = 1.04

The cash ratio shows the immediate capacity of the company to pay off its current liabilities. A ratio of 1 means that the company has the same amount of cash and cash equivalents as it has current debt.

Profitability ratios

Gross profit margin/gross margin is a financial metric that shows how competent a company is at managing its operations. It is a ratio that indicates the performance of a company’s revenues based on the efficiency of its production process (COGS – Cost of Goods Sold). This ratio is valuable to the management of the company as well as the investors.

Gross Profit Margin = (Revenue – COGS) / Revenue 

      = (100472 – 70369) / 100472

      = 0.2996

      = 29.96 %

Gross Profit Margin indicates the efficiency of operation of the company, 29.96 % is sufficiently a good profit margin.

Net Profit Margin measures how much profit is generated as a percentage of revenue. It shows how much of each rupee collected in revenue is converted into profit.

Net Profit Margin = Net Profit / Revenue

  = 19423 / 100472

  = 0.1933

  = 19.33 %

Operating profit margin

This ratio specifies how much profit a firm makes after paying for variable costs of production such as wages, raw materials, etc. but before interest and tax

 Operating profit margin =EBIT/ Revenue

= 26628 / 100472

= 0.265

= 26.5 %

Graphical Representation of Financials from the Profit & Loss Statement

Profit and Loss

Cash Flow

Macro-economic Factors Affecting Stock Market and Investor Decisions

Introduction:

To assess the financial health of a company one needs to carry out fundamental analysis of the company. An insight to the trend of the stock (i.e., its price variations) is provided by technical analysis.

But an investor cannot ignore the macroeconomic factors which directly or indirectly affect the stock market and in turn the price of stocks.

Awareness of an investor in this respect can enable him to minimize (loss) or maximize(profit) 

The main macro factors which affect the stock market are: –

1. Economic Growth
2. Unemployment
3. Inflation
4. Interest Rates
5. Exchange Rate

ECONOMIC GROWTH

Economy’s health has a direct impact on the stock market, which implies if put mathematically the company’s and the stock market variation is in direct proportion. Thus, with economic growth the companies expand and increase their profits which in turn can increase the share prices vice versa.

A strong economy builds the confidence of an investor to invest in equity market, whereas if the economy is poor investors tend to protect their capital by hedging their investments.

UNEMPLOYMENT

When there is an increase in the rate of unemployment, the consumers will have the tendency to spend on only essential items. As a result, this will directly affect the earning capacity of the companies which in turn affect the stock market. 

INFLATION

Inflation means that there is a rise in the prices of goods and services which means that the consumers have less money to spend on non-essential items because inflation lowers the purchasing power of currency over time.

Inflation in turn affects the business and their profits as the input cost increases, which in case absorbed by the company reduces their profit.

INTEREST RATES

Increase in interest rates reduces the borrowing capacity of a company which will hinder the ability of the growth of business. Also rising interest rates affects the consumers as they must pay more interest on mortgage / personal loans which reduces their purchasing power.

EXCHANGE RATES

A reduced exchange rate results in cheaper exports which in turn increase the demand of exported goods. This raises the profit of companies involved in export business resulting in a rise in their stock prices which is favorable to investors.

On the other hand, if there is an increase in the exchange rate which means that the imports will be cheaper, this situation will benefit the companies using imported goods. Thus, reducing their input costs thereby raising their profits. Such companies will attract the investors to add them to their portfolio.

MACRO EFFECTS (of Past One Year) on Infosys.

COVID – 19 pandemics has its footprints all over Infosys’s annual report of fiscal 2020. 

Insecure and bumpy growth in the global economy has had an undesirable impact on the growth of the IT industry. Infosys believes its clients may reduce or postpone their technology spending significantly. This may in turn lower the demand for its services, negatively impacting its revenues and profitability. 

CORPORATE SOCIAL RESPONSIBILITIES

Infosys Limited as a corporate has taken up the responsibility for helping the society, along with the company’s aim to focus on the growth of the business as one entity

Infosys Limited has since its inception assumed its primary goal to implement its corporate social responsibilities along with its own sustained economic development as a business unit. It was established in 1996 with an aim not for profit only but with a dedicated thought of community development.

Infosys Foundation works towards removing malnutrition, improving healthcare infrastructure, supporting primary education, rehabilitating destitute individuals, and caring for animals, and preserving Indian art and culture. 

Infosys Foundation has associated with non-government organizations (NGOs) to make a difference among local communities with interaction with the people at ground level. The Company’s has always tried to contribute to the sustainable development of the society, environment, and to save our planet for future generations.

References

• https://www.smart-investing.in/main.php?Company=INFOSYS+LTD
• https://economictimes.indiatimes.com/infosys-ltd
• https://www.smart-investing.in/compareStocks.php?Company1=INFOSYS+LTD&Company2=WIPRO+LTD&Company3=TATA+CONSULTANCY+SERVICES+LTD
• https://www.smart-investing.in/compareStocks.php?Company1=INFOSYS+LTD
• https://in.finance.yahoo.com/quote/INFY.BO/financials?p=INFY.BO
• https://www.indiainfoline.com/company/infosys-ltd/peer-comparison/2806
• https://www.valuespreadsheet.com/blog/how-to-determine-a-realistic-growth-rate-for-a-company
• https://efinancemanagement.com/financial-analysis/methods-of-financial-statement-analysis
• https://efinancemanagement.com/financial-analysis/profitability-ratioshttps://www.smart-investing.in/main.php?Company=INFOSYS+LTD
• https://economictimes.indiatimes.com/infosys-ltd/shareholding/companyid-10960.cms
• https://www.sptulsian.com/f/p/current-assets
• https://corporatefinanceinstitute.com/resources/knowledge/finance/financial-ratios/
• Investments by Zvi Bodie, Markus, Alex Kane, Pitabas Mohanty

ACKNOWLEDGMENTS

I deeply thank my mentor Dr. Beryl Chang, Lecturer, Economics and Finance, New York University, for guiding me throughout my project on Investment Analysis in the months of July and August 2021. 

About the author

Simran Darak

Simran is an 11th grader who aspires to persue Economics as her major. Apart from academics she is also interested in painting and yoga.

The post Investment Analysis of Infosys Technologies appeared first on Exploratio Journal.

Abstract

Chinese herbal medicine (CHM) has been used in ancient China for over 2500 years, with its prevalence continuing to grow ever since. In recent years, traditional Chinese medicine (TCM) methods such as acupuncture, tai chi, and herbal medications have gained a global presence. However, its basis has not been proven scientifically, and anecdotes or observations of successful treatments have led to the foundations of CHM. Thus, believers of CHM and TCM practitioners have not encouraged the publication of many clinical studies on the efficacy and safety of herbal medications. Some experimental studies have led to promising results, but more research needs to take place to confirm such effects and any adverse effects medications may bring. The purpose of this paper is to examine the basis and research behind CHM as well as the risks of ingesting CHM.

Introduction

Rooted in Chinese culture, TCM has become a staple for the holistic treatment of illnesses. Although China’s healthcare system has embraced western medicine (WM) for the treatment of some illnesses in recent years, the prevalence of TCM is nonetheless prevalent across the nation’s citizens. According to the China Health Statistics Yearbook 2018, there were a total of 2,641 million visits to TCM practitioners, making up 32.3% of all clinical visits in 2017 (Liu et al.).

Many patients with chronic illnesses look to natural treatments such as TCM after WM has been unsuccessful. Moreover, when illnesses can only be treated with symptom relievers such as the common cold, TCM has been able to fill a gap by claiming to address the root cause (Marshall, 2020). With a growing number of patients utilizing TCM and success stories beginning to rise, it has begun to gain worldwide acceptance, with the World Health Organization adding a chapter regarding TCM in the International Classification of Diseases (Nature, 2019).
Essential components of TCM such as acupuncture and Tai Chi are deemed by the National Institutes of Health to be relatively safe due to their non-invasiveness (Hopp & Shurtleff, 2019).

Although these practices are often scrutinized due to their lack of scientific basis, there are generally fewer risks in participating in acupuncture or Tai Chi than ingesting CHM. However, the effects of acupuncture or Tai Chi are often credited to placebo effects due to their lack of scientific explanations. CHM seems to be the main concern, due to its lack of research into its adverse effects and long-term use by patients of all ages (Liang et al., 2018). The concern behind CHM is attributed to its extensive usage, especially in children and older adults, as well as the lack of randomized clinical trials required to validate claims of efficacy or safety.

Basis Behind Chinese Medicine

TCM is a medical system based on the Chinese belief of balance, where the equilibrium between Yin and Yang can ensure the health of a person (National Cancer Institute). Yin and Yang represent opposite elements that coexist to create a steady cycle between all entities. If an entity has an imbalance, it is deemed as unhealthy and may require a method of TCM to resolve the imbalance. Furthermore, the Chinese believe that among the balance exists ‘Qi,’ a vital source of energy that circulates the body. Based on this belief, traditional Chinese practices focus on the circulation of Qi and restoring the flow of Qi within the body by working to clear the path of the Meridians, channels that Qi flows through. This is a practice that has been passed down in Chinese society for thousands of years. The creation of Chinese herbal medicine is often attributed to Emperor Shen Nong, who sampled more than 100 herbs where he later introduced them to his subjects (Ergil et al., 2002). Illnesses and diseases are caused by disturbances in the balance of Yin and Yang and the flow of Qi within one’s body. Thus, TCM practitioners aim to reinstate the natural balance and flow in order to heal a patient. CHM supporters claim herbal remedies utilize a slow healing method that can eliminate the root of a problem and achieve a balance between one’s emotional, physical, and spiritual health.

In contrast to the western approach on fast responding medication that can suppress symptoms as well as a standard methodology to treat diseases and symptoms, CHM judges a patient as a whole and utilizes the syndrome differentiation theory. This theory analyzes the harmonic pattern inside a patient’s body based on the core beliefs of Qi to make a diagnosis of the illness (Jiang et al., 2012). As such, most CHM has not been clinically tested due to their belief that isolating a symptom and targeting it is an incorrect way of treating a patient which would only temporarily fix the problem.

Although the beliefs surrounding the Chinese medical system have been utilized for over 2500 years, it is important to note that all aforementioned beliefs are not defended by clinical research or trials and cannot be deemed reliable.

Dosage and Usage of TCM

In China, the Chinese Pharmacopoeia outlines stipulated dosages of CHM as a guideline for Chinese practitioners. However, a 2014 study found that practitioners often overlook the guidelines and prescribed quantities far greater than stipulated dosages. The study concluded that guidelines in the Chinese Pharmacopoeia are not comprehensive enough for clinical usage to match with stipulated dosages (Ni et al., 2014).

The majority of CHM is often primarily based on the experience of the TCM practitioner due to unspecified guidelines in the pharmacopoeia. Furthermore, there is no dosage guideline for pediatric patients, nor patients who are overweight (Marshall, 2020). This may lead to overdosing or underdosing of the medication. In contrast to WM which is set on a predetermined dosage, including medications used by children, there are no dosage guidelines for the pediatric use of CHM. Practitioners may use either their own clinical experience or the estimated body weight and age of the patient.

Among TCM practitioner visits, respiratory illnesses and symptoms were the most common reason for treatment. Respiratory symptoms are especially common in children. In a study based in Taiwan, 63.2% of children were found to have been treated with CHM at least once (Liang et al., 2018). However, due to the lack of dosage guidelines for pediatric patients, the usage of CHM may pose dangers.

Development and Research behind Medications

Chinese herbal medicine has been in clinical application for thousands of years and has also been under continuous and extensive research in hope of developing new formulas. As previously stated, the discovery of CHM is attributed to the Chinese belief in Qi as the vital life force, as well as the balance between Yin and Yang; however, while that may be true, Chinese herbal medicine is a collection of theories that have been altered based on years of experiments, observations, and anecdotes. According to Doctor Chen-Pien Li, herbal medicine was slowly developed by ancient scholars and governmental institutions, creating remedies and formulas that have since been passed down (Li, 1974). However, questions regarding its scientific basis and reliability have continued to grow with the development of modern science. In fact, many claim that certain CHM can be harmful to the human body.

However, it should be noted that some CHM has been the foundation of some WM. For instance, the calming effects of chamomile tea can be attributed to discoveries by Chinese herbal medicine in the Tang Dynasty. It was said to act as a healing coolant against the fire and heat within one’s body in the Ming Dynasty (Yang et al., 2014). Researchers are now conducting studies with regards to the concepts of TCM to see if tea plants can act as preventive medication. Furthermore, many current researchers aim to further develop CHM. Professor Si-Yuan Pan of the University of Beijing stated that researchers have been exploring ancient remedies and modernizing them. Studies now aim to modernize the method of consumption as well as some formulas (Pan et al., 2011). Researchers have been attempting to alter the method of consumption partly by extracting key ingredients from herbs and increasing the concentration, which then enables the possibility of forming it into granule pills.

Nevertheless, the modernization of formulas is essential. Some risks regarding the ingredients used in CHM have been identified by Chinese scholars, which are now under research and analysis. According to Dr. Gao RanRan of the Institute of Medicinal Plant Development, many scholars have been undergoing research involving the careful inspection of the quality and safety of the products (Gao et al., 2019). Therefore it is important to acknowledge that although TCM is one of the oldest forms of medical practice that still exists today, the medicine was slowly acquired through a collection of experiences. Since not all herbal medicines have been carefully and thoroughly inspected, patients should be cautious and always refer to a physician before ingesting CHM.

Adverse Effects of Chinese Herbal Medication

The lack of clinical trials and sufficient research into adverse effects in TCM has called its use in question. Natural remedies such as TCM often advertise as side-effect free and fail to record complications such medication can result in. Users of TCM may be unaware of adverse effects and may be unaware of complications from TCM. There are currently few regulations regarding herbal medications and the lack of strict oversight of TCM can lead to overlooked ill-effects (Chua et al., 2015). Thus, complications and contributions to illness or death from TCM are unable to be determined. Although few clinical studies have been conducted in China, other countries have begun to research adverse effects some herbs and traditional medication can result. For example, an Australian journal noted that because the contents and preparation methodology of herbal medications is not tightly controlled, products may contain illegal or harmful ingredients (Byard et al., 2017). Concentrations and ingredients may also be labeled incorrectly, which could lead to users ingesting the incorrect dosage.

According to the National Center for Complementary and Integrative Health, there have been documented cases of TCM containing traces of unapproved animal or plant products. Furthermore, some herbal medications contain drugs such as arsenic, lead, and pesticides. Combined, such ingredients can result in serious injury or death, especially in younger children (Hopp & Shurtleff, 2019).

Another possible complication is the possibility of drug interactions when treatment is utilized by both WM and TCM. When WM is used as a primary drug and TCM is added as a supplement, herbal medications may potentiate or antagonize the properties of WM, resulting in under absorption and possible ineffectiveness of WM. For example, one known interaction is between Danshen and Warfarin (used for blood-thinning properties). A case report found that the interaction between Danshen and Warfarin resulted in significant anticoagulation in patients (Chua et al., 2015). Danshen has also been reported to increase the concentration of warfarin by inhibiting hydroxylation. However, sufficient clinical research has not been conducted between the two medications, and patients are encouraged to avoid Danshen while taking Warfarin.

Conclusion

Although a handful of research studies have already been conducted on CHM and TCM, more clinical studies are needed in order to confirm the safety and efficacy of many herbs and treatments. While some research has shown that TCM does correlate to modern science, other studies have shown adverse effects instead. Therefore, it would be critical for the public to be educated on the risks and to be cautious of the consumption of CHM, especially for younger children and older adults.

Furthermore, the increased consumption of TCM worldwide should encourage further extensive research on treatments that address the complications and possible interferences of taking both TCM and WC. Steps should also be taken by both western and traditional Chinese physicians to inform the patients of the risks of a combination of WM and TCM.

Works Cited

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Chua, Y. T., Ang, X. L., Zhong, X. M., & Khoo, K. S. (2015, January). Interaction between warfarin and Chinese herbal medicines. Singapore medical journal. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4325561/.

Ergil, K. V., Kramer, E. J., & Ng, A. T. (2002, September). Chinese herbal medicines. The Western journal of medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1071750/.

Gao, R.-ran, Hu, Y.-ting, Dan, Y., Hao, L.-jun, Liu, X., & Song, J.-yuan. (2019, December 20). Chinese herbal medicine resources: Where we stand. Chinese Herbal Medicines. https://www.sciencedirect.com/science/article/pii/S1674638419301029#.

Hopp, C., & Shurtleff, D. (n.d.). Traditional chinese medicine: What you need to know. National Center for Complementary and Integrative Health. https://www.nccih.nih.gov/health/traditional-chinese-medicine-what-you-need-to-know.

Jiang, M., Lu, C., Zhang, C., Yang, J., Tan, Y., Lu, A., & Chan, K. (2012, January 31). Syndrome differentiation in modern research of traditional Chinese medicine. Journal of Ethnopharmacology. https://www.sciencedirect.com/science/article/pii/S0378874112000463.

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Liang, H.-F., Yang, Y.-H., Chen, P.-C., Kuo, H.-C., Chang, C.-H., Wang, Y.-H., & Wu, K.-M. (2018, June 22). Prescription patterns of traditional Chinese Medicine amongst Taiwanese children: A POPULATION-BASED cohort study. BMC complementary and alternative medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6013984/.

Marshall, A. C. (2020, March 2). Traditional Chinese medicine and CLINICAL Pharmacology. Drug Discovery and Evaluation: Methods in Clinical Pharmacology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7356495/.

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Pan, S.-Y., Chen, S.-B., Dong, H.-G., Yu, Z.-L., Dong, J.-C., Long, Z.-X., Fong, W.-F., Han, Y.-F., & Ko, K.-M. (2011, March 10). New perspectives on Chinese herbal medicine (zhong-yao) research and development. Evidence-Based Complementary and Alternative Medicine. https://www.hindawi.com/journals/ecam/2011/403709/.

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About the author

Nicole Zhou, Tsu-Yi Zoe Lee

Nicole and Zoe are aspiring physicians with interests in subjects regarding Biology, Chemistry, and Health Studies.

The post An evaluation of the methods and research surrounding the usage of Chinese Herbal Medicine appeared first on Exploratio Journal.

1. Introduction

During a time where social media use has become part of a daily routine, the latest and most viral trends can have further implications beyond interactions with friends and family. On social media sites such as Instagram, Twitter, and Reddit, users have the freedom to create their own content and post it for millions of people to see. Wanting to fit in with peers, many young users replicate the viral content they consume on social media without thoroughly researching it. Recently, social media’s widespread influence has even been used to advertise financial success and manipulate the stock market.

In 2021, the stock prices of video game company, GameStock, unexpectedly skyrocketed more than 1700%. This was due to a community of amateur investors on Reddit, posting on the message board r/WallStreetBets, who joined together to buy shorted stocks which drastically increased the stock price. Although experienced investors advised against purchasing GameStop shares, investors on Reddit rebelled. In addition to GameStop, Reddit investors also popularized investing in companies such as AMC and Robinhood, using catchy sentiments that appeal to the younger generation like “to the moon” to convince other Reddit users to invest. Like other social media trends, users on sites such as Reddit see the positive messages associated with investing in the stock market and feel inclined to partake in investing themselves in fear of missing the opportunity to become successful. Since those currently growing up using social media are accustomed to gaining their information from various social media platforms, events such as the GameStop short squeeze may become more common in the future.

As the global economy becomes more interconnected, recognizing these social media trends with regard to investing in not only the U.S. stock market but other countries’ stock markets as well is extremely important. Although considered a novelty in the U.S., South Korea’s growing music industry, “K-Pop,” has had surprising effects on the stock prices of large entertainment companies such as YG Entertainment, JYP Entertainment, and SM Entertainment. K-Pop stars, also known as “idols” are trained under a strict regime from young ages and making even the smallest infractions cause great controversy. Similarly, to the GameStop short squeeze and other phenomena, events in the K-Pop industry spread widely through social media and can significantly change stock prices. 

The rest of the paper is organized as follows:

Section 2 discusses the nature of social media and its relation to stock market investing. Section 3 delves into the creation of “meme stocks” and its rising popularity among investors while comparing this emerging phenomenon with the previous returns seen in the U.S. stock market. This section will also consider if this phenomenon is evidence of irrational stock market behavior, psychology behind investing, and future investors’ involvement in investing in the stock market. Section 4 builds upon social media’s growing influence on the stock market, focusing more specifically on how events in the Korean Pop industry affect the Korean stock market and making a comparison to the “Robinhood Phenomenon.” Section 5 contains concluding remarks followed by references.

2. Nature of Social Media with Reference to Stock Market Investing

2.1 Definition of Social Media

Social media is a web-based communication method that allows users to create content that others can view and interact with on the site. On these social media sites, users create profile pages, where they can personalize their account settings and share posts with their “followers,” or those who subscribe to their content. This content comes in the forms of pictures and videos that other users can interact with in the form of comments and “likes.” To “like” a post conveys that the user is interested in or enjoys certain content. In addition to “liking” posts, social media users can convey their interest in certain content by “following” other users. “Following” someone on social media signifies that the user would like to see another user’s posts in their feed, a section of the site that displays content and advertisements from various creators. Many people use social media to keep up with, or “follow,” their close friends and family but others may use it for advertising purposes or stay updated with news. Additionally, people can send each other direct messages and group messages as well as share the posts that they see on their feeds. Users can sign on to social media sites from almost any device that has access to the Internet, such as laptops and smartphones, making it easily accessible to billions of people. In addition to individuals, companies and brands also use these social media sites as a form of marketing. Using algorithms, social media companies cater paid advertisements from companies toward those who are more likely to purchase that company’s products. Social media sites also usually include a section where users can view new content from anyone, regardless of following status, that are generated by the sites’ algorithms. Some of the largest and most popular of these social media platforms are Facebook, Instagram, YouTube, TikTok, and Reddit, which have 2.85 billion, 1.07 billion, 1.86 billion, 689 million, and 52 million users respectively. The number of users on these sites has exponentially grown since their beginning and due to the upwards trend seen in the below graph, can be predicted to continue their growth and influence in the future (R12).

2.2 Nature of Viral Messaging

On social media, messages and posts can be shared instantly and because of this, can spread quickly to the millions of people that use it. For a post to go “viral,” that means it has gained a large amount of attention from social media users over a short period of time. One of the key components of virality is its spread specifically as a post is shared from person to person. As engagement with the post increases and it is shared more, more people will also begin to view it on their feeds as a result of the social media algorithm. Social media algorithms utilize factors such as location, interests, and previous content interacted with to show personalized and relevant content catered to each user. As these short-term trends spread, the young users on social media sites become more likely to participate as they see their peers partaking as well. Businesses particularly benefit from the virality of their posts because new viewers mean new customers and increased profits. Although there is not an exact formula to creating a viral post, those who partake in social media trends are often more likely to gain increased engagement on their post. 

2.3 Relation to Stock Market and Investing

Although social media’s virality is known for benefitting individual social media users, it has also had recent effects on the stock market and has the potential to have effects in the future as well. Social media users are largely influenced by herd mentality: the mindset that encourages following one’s peers rather than making decisions for themselves. This makes social media sites the perfect environment for propagating certain messages to a broad audience. Once a message or trend becomes popular on social media, it spreads quickly, and many social media users tend to follow these trends. Recently, a popular trend across various social media platforms such as Reddit and Twitter is investing in the stock market. Positive sentiments regarding certain stocks have caused stock prices to rapidly increase within a short period of time. As positive messages regarding these stocks spread, more social media users join in on the trend of buying a certain stock, therefore increasing its demand and the stock price (R3).

In early 2021, a new type of social media called BitClout emerged, one that combined celebrities’ influence with stock market investing. Using BitClout, people can bet on celebrities’ and creators’ reputations rather than stocks. Each creator is assigned their own unique cryptocurrency that they can then use to purchase other coins on the site. Just as people use money to invest in stocks they believe will perform well, users on BitClout can purchase creator coins of those they think will maintain a good reputation in the public’s eye (R21).

3. Traditional Stock Market Investing: Magnitude of Returns

3.1 Historical Returns in the U.S. Stock Markets

The S&P 500 Index has had an average annual return of around 10-11% since its beginning in 1957, which is around 6% when accounting for inflation. However, in more recent years, the average annual return has been closer to 8%. Compared to the S&P 500 Index, the Dow Jones Industrial Average’s average annual return is lower, closer to around 6% without accounting for inflation. Whereas the Dow Jones Industrial Average only comprises 30 companies, the S&P 500 consists of 500. Since the S&P 500 and DJIA consist of various stocks intended to reflect the entire stock market, their average annual return (measure of the money gained or lost from an investment) is representative of the returns of the whole stock market. It will be equivalent to the returns on holding a well-diversified portfolio over a longer period of time. (R10).

3.2 “Meme Stocks”: The Curious Case of GameStop and AMC (Robinhood Phenomenon)

As the coronavirus spread across the globe in early 2020, many businesses closed and unemployment levels increased, causing people to have less disposable income to invest in unnecessary expenses such as stock market investing. As a result, the stock market reached a low point which it began to recover from during April to November 2020. However, with travel restrictions in place, more people stayed home and spent less money on traveling and outdoor entertainment expenses such as going to the movies and eating out. Additionally, the government provided stimulus money to millions of American households. As a result, they had more time and money to explore new areas of interest, one of the most popular ones being investing in the stock market

More people interested in investing in stocks sparked more social media discussion surrounding the stock market. The most influential of these social media interactions was posts on the subreddit r/WallStreetBets. In the case of the 2021 GameStop short squeeze, positive sentiments regarding GameStop and the idea of raising the stock price “to the moon” garnered extreme social media attention. Wanting to participate in this meme-centric trend that also evoked a sense of nostalgia, many inexperienced young investors used the easily accessible trading platform, Robinhood, to invest in GameStop. Robinhood, a no-fee and easy-to-use trading platform, made stock trading accessible to a wider audience. Spite from the younger generation against the wealthy hedge funds was the main cause for beginning the “to the moon” campaign in the first place. As a result, Reddit users joined together to save the dying stock. 

The demand for physical video games has significantly decreased in recent years due to the emergence of online video game platforms such as Steam. With the pandemic at its peak, traveling outside to shop became unnecessary. Because of these factors, many institutional investors such as hedge funds took on short positions, meaning that they would profit if the stock price dropped. Former Chewy CEO, Ryan Cohen, joining GameStop’s board of investors is what initially sparked the interest in GME. Believing the company was undervalued and seeing the large number of short positions taken, r/WallStreetBets users spread messages that created an overwhelming demand for the GME stock, raising the stock price significantly and causing those who took on short positions to lose millions of dollars. Reddit investors used the same positive sentiments to apply this to other stocks such as AMC during this time. As a result of the high volatility in the market, Robinhood paused all purchases of the volatile meme stocks, making traders angry. They felt betrayed as if Robinhood was siding with the hedge funds, the main target. With all volatile stocks, the high gains are met with high losses, and GameStop’s stock price decreased steeply, causing uneducated young investors to incur heavy losses. (R1).

Late July 2021, Robinhood went public, pricing its IPO at $38. This reignited the diminishing passion for meme stocks across social media since Robinhood’s democratized trading platform served a pivotal part in trading these highly volatile stocks. Robinhood both facilitated these trades and restricted them, causing them to receive backlash from their users. When Robinhood announced on social media that they would go public, vengeful users on r/WallStreetBets hoped for the stock’s failure. Although it was originally uncertain if Robinhood would continue in the steps of its meme stock predecessors, the stock recently experienced the same short-term price surge that characterizes a successful meme stock. From August 3rd to August 4th alone, the stock rose around 50%. While that may not seem noteworthy compared to GME’s 1700% growth, it is well over the S&P 500’s and DJIA’s annual average of 10-11%. Shortly after its rapid growth, the stock price decreased by 28% to $50.97 but rose back up to $55.01 shortly and seems to be plateauing at around $50 (R20). 

This case is very similar to an earlier phenomenon that occurred during the 1600s, later known as “Tulip Mania.” Because of excessive speculation, the price of tulip bulbs increased to extreme values. Since tulips were new to western Europe, they garnered much attention and were considered a luxury good. Many people bought them simply as a symbol of high wealth. Tulips were in high demand but keeping them undamaged during transportation became a problem. Since these concerns were abundant, tulip cultivators created methods to grow the tulips locally. As a striped variation of the traditional solid-colored tulips developed due to viral infection, the demand for these rare tulips increased, leading to a high market price. In modern currency, rare tulips cost $750,000, whereas the more common variations traded for around $50,000 to $150,000. By late 1637, the market bubble burst. The prices of tulips rapidly decreased because there were no longer any buyers who were willing to pay the extremely high prices for tulips (R22). The Tulip Mania of the 1600s serves as a basis for future events of excessive speculation such as the Robinhood Phenomenon.

3.3 Psychology Behind Investing

3.3.1 Herding

Phenomena such as the Robinhood Phenomenon have psychological explanations, the most prevalent of which being herding. Herding behavior is when people tend to follow groups and popular trends rather than relying on individual knowledge or analysis. When people are under the influence of herd behavior, they tend to ignore logic and reason and simply follow the actions of the group. Large market crashes, driven by episodes of high buying and selling, are caused by herding behavior. As more people buy a certain stock, its scarcity and demand both increases, causing the price to increase.  Investors depending on the masses to buy and sell stocks causes markets to become extremely volatile, which may come with high returns but high losses as well. Additionally, people tend to advertise their successes over their failures. On social media, living a successful life is enviable, and others will take the same steps advertised to them, seeking to achieve the same success (R14). Just as people follow social media trends, they also follow stock market trends because humans are naturally susceptible to herd behavior. To avoid falling victim to herding and its downfalls, people can conduct their own analysis of stocks and companies rather than assuming that others have done appropriate research and following them.

3.3.2 Sunk Costs

A sunk cost is a past cost that does not have any potential to recover its losses in the future (R15). While sunk costs should not affect future decision-making, they often do. The sunk cost effect explains that people are more likely to continue an activity  after investing time or money into it. This is often justified by not wanting to be “wasteful” even if continuing the activity may not be the best decision. Many investors do not want to admit their poor investment choices and stay committed to an investment just to convince themselves that their initial investment was a good decision (R15). Inexperienced investors who bought GameStop or AMC stocks fell victim to the sunk costs trap. Although the stock prices rapidly increased over a short period of time, they also decreased rapidly, causing many investors to lose more than their initial investment. Rather than selling the stock after its decline in value, these inexperienced investors held onto it in hopes of seeing a recovery. They were reluctant to cut their losses and wanted to feel like their investment wasn’t all for nothing, which is a common feeling for those who have experienced the sunk costs trap. To avoid the sunk cost trap, investors should identify their sunk losses as soon as possible and reevaluate their investing strategies often. 

3.3.3 Irrational Exuberance

Popularized by Alan Greenspan in 1996, irrational exuberance explains that the high level of investor enthusiasm in a certain asset leads it to be priced higher than its justifiable value (R16). As video games have become more accessible through online platforms such as Steam, there has become less of a need for physical video game stores like GameStop. Because of the low demand for physical copies of video games, GameStop was not a very profitable company, making it a target for short sellers. The rise of no-fee trading platforms along with the popularization of the Reddit r/WallStreetBets have increased the number of people interested in investing in the stock market, especially since there are no upfront costs. Although experienced traders anticipated the stock’s price to fall, new traders from younger generations wanting to spite the older generation bought the shorted stocks, increasing the value. The movement that sparked excitement for the stock, enforced through appealing memes on Reddit, garnered enough support for GameStop. The reason this exuberance is known as irrational is because these gains will not last forever like investors may want it to. As investors become greedy for profits, they tend to overlook the actual worth of the asset (R17). The excitement in investing can contribute to market bubbles which will eventually burst, causing widespread selling and the stock’s price to drop. When encountering heavy exuberance, it is important to always be mindful of an asset’s value and that its price may not always continue to increase. 

3.4 Are the Young Getting the Wrong Message About the Nature of Stock Markets?

As technology progressed, reliance on using social media platforms to maintain connections has increased. Because information can be spread quickly and conveniently on social media, it is tempting to follow the sentiments regarding stocks instead of spending time analyzing charts and assessing risk. The Robinhood Phenomenon has especially heightened the expectations for returns in the stock market as a result of following a group because this was the first major market bubble burst for young investors. Many young investors are driven by greed and act as “noise traders,” making uninformed decisions regarding the buying and selling of stocks because they seek to make a large amount of money quickly, which has previously been reinforced by the rapid price increase of the GameStop stock where the value increased by over 1700% in just one week. However, the rapid decrease in prices that shortly followed the increase proved to many investors to not blindly follow other inexperienced investors and will cause them to be more cautious in the future (R13).

Noise traders contribute to the irrationality in the market because they trade without logic, causing the market to act abnormally. Compared to professional traders, noise traders make up the majority of users on trading platforms and can cause professional traders to lose money due to the high level of unpredictability they cause in the market (R6). In a world where commission-free trading accounts, like a Robinhood account, can be created in mere minutes with no skill required, investing has become extremely accessible to those from any background. 

4. K-Pop’s Influence on the Fluctuations in the Korean Stock Market

4.1 Korean Pop Music and the Culture Behind it

K-Pop (Korean Pop Music) is a genre of music originating in South Korea that has become a global phenomenon in recent years. K-Pop not only includes pop music, but it is also used as an umbrella term for other genres of songs sung in the Korean language such as rock, rap, and R&B. What makes K-Pop songs so popular among audiences from various countries is the memorable choreographies that highlight each song. Dance moves from PSY’s “Gangnam Style,” Blackpink’s “DDU-DU DDU-DU,” and Sunmi’s “Gashina” are widely known and have even become part of social media dance challenges such as the “Random Play Dance” where dancers try to recreate as many of these dances as possible in a short time frame. 

Those seeking to debut as a K-Pop artist, also known as a K-Pop “idol,” must audition for a South Korean entertainment company and if accepted, they must participate in rigorous daily training. From young ages, these trainees strengthen their singing, dancing, rapping and foreign language abilities and eventually debut either as a member of a group or as a solo artist. During this training period, which may last from as little as one day to over 15 years, trainees also attend school. It is also preferred for trainees to be young so that when they debut, they are more marketable to fellow young people, the target audience. In addition, K-Pop artists follow a strict no-dating rule, and they must always present themselves with a pure image to appeal to South Korean role model standards. This also allows fans to form a strong attachment to the artist (R11). 

In addition to developing their talents, trainees may also undergo physical changes, such as plastic surgery and dieting, to appeal to the Korean beauty standard of pale faces and low weights (R18) Out of the millions of K-Pop trainees, only 0.1% of them get to debut as an artist and achieve the glory of a K-Pop idol while the rest may work different jobs in the entertainment industry. To even be selected to become a trainee is a thorough process. Applicants must pass several rounds of auditions and camera testing before being offered a contract to train under specialists at an entertainment company. Although there are hundreds of K-Pop entertainment agencies that train idols, the most influential are JYP Entertainment, SM Entertainment, YG Entertainment, and HYBE Corporation. These companies are known as the most well-respected and influential due to the popularity of their artists, whose music videos garner hundreds of millions of views leading to high profits. 

4.2 Correlation Between Returns of Entertainment Companies and K-Pop Commentary

4.2.1 Tzuyu Taiwanese Flag Incident

In a 2015 online show, 16-year-old Taiwanese Twice member Tzuyu Chou was seen waving the Taiwanese flag. Although it may seem like an insignificant event, this incident caused major backlash from Chinese fans as tensions were high between China and Taiwan due to an imminent presidential election. During a time when other big entertainment agencies were expanding into the Chinese market, it was important for JYPE to have a positive reputation in China to remain competitive. In response to the uproar, Tzuyu issued an apology through JYP Entertainment, denouncing Taiwanese independence from China and agreeing to pause her promotions and activities in China (R9). This controversy was not only detrimental to Tzuyu’s image but also to her company’s stock price. The JYP Entertainment stock price dropped from 4,540 won ($3.96) to 4,140 won ($3.61), losing around 9% of its value and 13.6 million  won ($11,868) across all shares (R9).

 4.2.2 EXO’s Kris Wu Sues SM Entertainment

On May 15, 2014, EXO-M leader Kris Wu announced his leave from the group and filed a lawsuit against his company, SM Entertainment. He argued that his contract was unfair due to its uneven profit distribution, harmful working conditions, and excessive length. In 2016, he reached a settlement with the company so that he can freely pursue his music career in China and Canada. However, his contract with SM Entertainment is still valid until 2022, so if he wishes to promote in Korea or Japan he must do so under the company’s management. When this news was announced, SME’s stock price decreased 34% from 53,200 won ($46.43) to 35,000 won ($30.54) over the course of the month, causing the company to lose 356 billion won ($310 million).

4.2.3 B.I. LSD Scandal

In 2019, messages from 2016 between iKON rapper Hanbin Kim (B.I.) and his acquaintance were revealed in which the artist inquired about purchasing LSD. Because of the expectation for K-Pop idols to act perfectly, this report caused B.I.’s pure image in the industry to become corrupted. As a result, he was forced to issue an apology, leave the group, and get edited out of promotions and variety shows despite writing most of iKON’s music. This controversy, which evoked a sense of anger among fans, caused YGE’s stock price to drop 4.05% from 33,299 won ($29.06) to 31,950 won ($27.88) just  as it started to recover from the Burning Sun scandal earlier the previous year (R19).

4.2.4 Burning Sun Scandal

The Burning Sun incident, the most infamous scandal in K-Pop, shattered the innocent image of the industry as a whole. The scandal, named after the Burning Sun club in Gangnam, virtually ended the career of everyone involved. In early 2018, allegations of famous K-Pop stars drugging and raping women in the Burning Sun club and then sharing recordings of these incidents in a chatroom spread across the nation. Seungri, former member of BigBang under YG entertainment, was at the forefront of these crimes as he was a director of the Burning Sun club who engaged in illegal prostitution. Idols from many other popular groups such as F.T. Island, Highlight, and CNBLUE were also part of the chatroom where videos were exchanged. This prompted a protest on International Women’s Day to put an end to objectifying women. Furthermore, South Korean President Moon ordered investigations into the police force because of the accusations of covering up information related to not only the Burning Sun case but other crimes as well. Due to the Burning Sun controversy, fans sold their shares in YGE,  making the company lose around 105 billion won in shares and also lost 55 million won from previous investors (R5).

4.3 Comparison Between K-Pop Stock Market Events and the Robinhood Phenomenon

When observing the circumstances surrounding both the Robinhood Phenomenon and stock market events related to the K-Pop industry, parallels can be seen. The main connection between the two are the psychological effects of social media on their respective stock prices. These various events have the commonality of being a major discussion topic across multiple social media platforms, reaching millions of people. Its widespread influential rhetoric caused many social media users to expand their horizons to try stock market investing for the first time, seeing the successes advertised on social media. These inexperienced investors are extremely influenced by their emotions and connections to a specific stock, whether that be the nostalgia from GameStop or the activities of their favorite K-Pop groups. 

In both instances, there is also a general undertone of revenge. The GameStop short squeeze served as a movement for younger investors to make their voice heard among the older and wealthier generation. While experienced financial analysts bet against the stock price increasing, Reddit users pushed against them, raising the stock price and causing wealthy hedge funds to lose billions of dollars. With K-Pop scandals, overly attached fans sought revenge against the actions of certain artists and their companies. Since the fans are the backbone of the K-Pop artists, both in terms of merchandise sales and stock market shares, their opinions and support can shape the futures of entertainment companies’ finances. 

Additionally, these events show the power of the general public as opposed to wealthy investors who traditionally have the most influence on the prices of shares. Robinhood’s no-fee trading platform is widely known to have “democratized” trading, allowing those with little money and experience to participate in trading, an activity previously associated with only the wealthy. With Korean entertainment companies going public in the 2010s and 2020s, K-Pop fans were able to take their dedication to the next level and make their voices heard by previously untouchable CEOs through buying and selling shares. 

5. Concluding Remarks

By connecting major social media events with stock market volatility, we can conclude that there is a correlation between the two variables. The more a stock is mentioned on social media, the more noise traders will invest in it, causing high volatility in the market. In recent years, investing in the stock market has become more based on trader’s emotions rather than fundamental company analysis. K-Pop entertainment companies use their artists’ pure images to reflect back on company values, creating a direct connection between the two. Similarly, social media users create a positive association with a brand. This creates company loyalty which in turn leads to success in its stock market investments. When this image goes astray, losses are incurred. 

When deeply examining the causes of the Robinhood Phenomenon, led by Reddit users, and K-Pop entertainment stock fluctuations, driven by dedicated fans, it can be seen that the psychological impacts of using social media platforms play a significant role. To avoid these psychological traps, it is important to keep in mind that most social media investors are inexperienced and solely serve to propagate a message for a short period of time. Another key point to remember is to avoid extreme biases, especially since social media users tend to only advertise their successes and make it seem as though investing in a certain stock will only bring rapid success. 

Social media-related stock market events have opened doors for young investors to gain experience in the market. The major losses incurred from the GameStop and AMC short squeezes may have discouraged them from investing altogether, but their realization that investing in the stock market comes with as great of risks as returns should serve as a caution rather than an inhibitor. The pattern in findings from observing stock market behavior in relation to social media events will continue as technology progresses. As this progression occurs, future generations of investors will become even more connected to using social media to discuss their personal financial successes regarding stock market investing. Given the high volatility that this has caused, trading platforms may be more prepared to handle that type of situation in the future. In this shift to accessible trading accounts, more social media users may fall victim to the various psychological impacts of using both of these types of platforms, which can be easily avoided by being aware of them.

References

R1) Costola, Michele, et al. “On the ‘Mementum’ of Meme Stocks.” SSRN, 8 June 2021, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3861779. 

R2) Long, Cheng, et al. “’I Just like the Stock’ versus ‘Fear and Loathing on Main Street’ : The Role of Reddit Sentiment in the GameStop Short Squeeze.” SSRN, 30 Apr. 2021, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3822315. 

R3) Nguyen, Thien Hai, and Kiyoaki Shirai. “Topic Modeling Based Sentiment Analysis on Social Media for Stock Market Prediction.” ACL Anthology, July 2015, https://aclanthology.org/P15-1131/. 

R4) Hu, Danqi, et al. “The Rise of Reddit: How Social Media Affects Retail Investors and Short-Sellers’ Roles in Price Discovery.” SSRN, 2 Apr. 2021, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3807655. 

R5) “Stocks Held by K-Pop Agency Owners Plummet.” INQUIRER.net, 23 July 2019, https://business.inquirer.net/275197/stocks-held-by-k-pop-agency-owners-plummet. 

R6) Eaton, Gregory W., et al. “Zero-Commission Individual Investors, High Frequency Traders, and Stock Market Quality.” SSRN, 1 Feb. 2021, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3776874. 

R7) “Historical Returns on Stocks, Bonds and Bills: 1928-2020.” Welcome to Pages at the Stern School of Business, New York University, Jan. 2021, http://pages.stern.nyu.edu/~adamodar/New_Home_Page/datafile/histretSP.html. 

R8) Messerlin, Patrick A., and Wonkyu Shin. “The K-Pop Wave: An Economic Analysis.” SSRN, 17 July 2013, https://papers.ssrn.com/sol3/papers.cfm?abstract_id=2294712. 

R9) “JYP May Fall Further on Flag Incident.” Koreatimes, 17 Jan. 2016, https://www.koreatimes.co.kr/www/news/biz/2016/01/488_195614.html. 

R10) Maverick, J.B. “What Is the Average Annual Return for the S&P 500?” Investopedia, Investopedia, 27 July 2021, https://www.investopedia.com/ask/answers/042415/what-average-annual-return-sp-500.asp. 

R11) Arnaud, Jourdan. “A Brief History of K-Pop.” The Los Angeles Film School, Jourdan Arnaud Https://Www.lafilm.edu/Wp-Content/Uploads/2020/03/Lafilm-Logo-2.Png, 7 Apr. 2021, https://www.lafilm.edu/blog/a-brief-history-of-kpop/. 

R12) Dollarhide, Maya. “Social Media Definition.” Investopedia, Investopedia, 13 Sept. 2021, https://www.investopedia.com/terms/s/social-media.asp. 

R13) “How a New Wave of Retail Investors Is Redefining Stock Pricing.” Knowledge@Wharton, July 2021, https://knowledge.wharton.upenn.edu/article/new-wave-of-retail-investors-is-redefining-stock-pricing/?utm_source=kw_newsletter&utm_medium=email&utm_campaign=2021-07-13. 

R14) “Psychology and Investing.” Morningstar, 2004, http://news.morningstar.com/classroom2/course.asp?docId=145104&page=2&CN=sample. 

R15) Downey, Lucas. “Sunk Cost Trap Definition.” Investopedia, Investopedia, 13 Sept. 2021, https://www.investopedia.com/terms/s/sunk-cost-trap.asp. 

R16) Hayes, Adam. “Irrational Exuberance.” Investopedia, Investopedia, 4 Aug. 2021, https://www.investopedia.com/terms/i/irrationalexuberance.asp. 

R17) Amadeo, Kimberly. “Irrational Exuberance, Its Quotes, Dangers, and Examples.” The Balance, Jan. 2021, https://www.thebalance.com/irrational-exuberance-quotes-dangers-and-examples-3305937. 

R18) Adolph, Tamia. “The Destructive Side of Korean Beauty Standards.” The Tempest, 8 Oct. 2020, https://thetempest.co/2020/10/16/news/breakdown/korean-beauty-standards/. 

R19) King, Ashley. “YG Entertainment’s Stock Plunges Following IKon’s Drug-Fueled Scandal.” Digital Music News, 13 June 2019, https://www.digitalmusicnews.com/2019/06/12/yg-stock-falls-after-ikon-drug-scandal/. 

R20) Tepper, Taylor. “Should You Invest In The Robinhood IPO?” Forbes, Forbes Magazine, 25 Aug. 2021, https://www.forbes.com/advisor/investing/robinhood-ipo/. 

R21) Lester, Caroline. “The Dark, Democratizing Power of the Social-Media Stock Market.” The New Yorker, 9 June 2021, https://www.newyorker.com/tech/annals-of-technology/the-dark-democratizing-power-of-the-social-media-stock-market. 

R22) Hayes, Adam. “History of the Dutch Tulip Bulb Market’s Bubble.” Investopedia, Investopedia, 15 Sept. 2021, https://www.investopedia.com/terms/d/dutch_tulip_bulb_market_bubble.asp

About the author

Anusha Vangala

Anusha is a senior at Princeton High School with a passion for exploring the interconnectedness of the global economy, stock market investing In her free time, she enjoys leading her school’s fencing team, teaching Indian dance, and learning new languages.

The post Social Media and the Stock Market appeared first on Exploratio Journal.

Abstract

Million of Americans across the country currently live below the poverty line, and this issue has only been exacerbated by the ongoing pandemic. Studies have shown that poverty directly relates to health and wellbeing. This research paper describes the myriad ways lower-income communities struggle to gain access to nutritious foods, and how the stagnation of wages is a major factor of the ever rising poverty rate. I also conducted field-work at a local food shelter to experience first hand the problems of food insecurity and poverty that lie within the local community.

Vignette

Since middle-school, I have volunteered at a local food bank located within walking distance from my family’s Chinese takeout restaurant in Brunswick, Georgia. My experiences as a volunteer have deeply informed my interest in the topic of food scarcity. Moreover, it has provided me with first-hand insights into the challenges of hunger and poverty among low-income households within my community. The following vignette is based on my observations from two different morning shifts in early and mid-July 2021.

Field Notes

It is early July, and I worked my usual volunteer shift from 9 am until 12 pm. I arrived at Nest 5 minutes before opening (at 8:55 am), and I saw a group of 5 people, who were already waiting in line for the food bank to be open.

Today was a rather hot and humid day (around 90!), so I saw many people carry umbrellas to shield themselves from the sun as they waited in line to get registered for food. I also saw some using the registration papers to fan themselves to get a breeze and cool the sweat off their faces. Many of the people waiting in line bore noticeable signs of exhaustion. They closed their eyes and leaned on the graffitied walls when waiting in line.

I asked a few of them, “Hey, how are you doing?”

One person said, “I’m doing okay, just tired.”

Another person replied, “I’m just taking it a day at a time.”

Through my past conversations, I knew that most of the people receiving food live only a few blocks away from the Nest or near downtown. While two people had out-of-state drivers’ licenses like Florida and South Carolina, most people are local residents. The public housing apartments is located just one block away, which makes it convenient to walk over to the food pantry.

During those morning shifts, roughly 25 people received food, with roughly a dozen being women, about ten men, and a handful of elderly (over the age of 65). Of those twenty-something people who receive food, about three fourths typically have children (17 years old and younger) whom they are also getting food for. By looking at the driver’s licenses, almost all of the people lived either near downtown Brunswick or the nearby government housing.

During my shifts, I do a variety of tasks. One task is filling bags that contain Kraft mac-n-cheese, rice/pasta bought in bulk from America’s Second Harvest, donated cans of tomato sauce, Campbell’s chicken noodle soup, and Del Monte corn and green beans. Sometimes food bank volunteers would also add in random snacks that were donated, such as Kind bars, Doritos, and M&M candies. Another task is sorting the new donations–bread and various canned goods and vegetables–and stocking the shelves. I also distributed food. Doing the distribution meant I determined how many people were in the household and then handed out the correct number of bags. That day, I had toiletries in stock, so everybody received a bag containing toilet paper, toothpaste, toothbrushes, and soap. Sometimes when we received shipments of fresh produce, I asked if they wanted fresh produce and nearly everyone accepted this offer of produce (broccoli, squash, carrots, peppers, etc.).

Although we did not have any fresh produce on this day, we received a donation of personal/ family-sized salads, sliced fruits (pineapples, watermelons, and cantaloupes), and bread that were about 2 days away from the expiration date from the grocery store Harris Teeters.

I asked each person “We have salads and fruits today; would you care for some?”

Most replied, “Sure.” or “Yes please.”

I also stocked the shelves and sorted the new donations by expiration year. While distributing the food, I had to look at how many people were in the household and then give out the correct number of bags. There was a person that had 7 children, so I gave them a “Momentum Box,” which is donated by the local church that was made specifically for large families. The Momentum Box contains three family-sized cereal boxes (Honey Nut Cheerios) and canned food that equates to roughly six adult bags that we ordinarily give out. My responsibilities were to ensure that people who came into the food bank were being cared.

Brunswick, Food Scarcity and Poverty

I grew up in the small town of Brunswick, Georgia. Brunswick has a population of around 16,000 people, and poverty is not out of the norm. Poverty experiences are not unusual for people living in rural parts of the state, as Georgia’s poverty rate has exceeded the U.S. poverty rates every year since 1999. According to the Census Bureau, Brunswick is one of the poorest cities in Georgia, and poverty rates in Brunswick have exceeded Georgia’s poverty rate every year since 1999 as well. Brunswick’s median income for a household was $28,032 for 2019. Around 34.7% of the population was below the poverty line, which almost tripled the 13.7% national poverty rate.

These numbers are staggering when just an eight-mile-long car drive to St. Simons, the poverty rate dips 5.2%. According to the Census Bureau, the median household income of Brunswick is $24,417 whereas, in St. Simons, it is $78,782. Furthermore, in 2017, the average net worth of a household in Brunswick was $156,363 compared to $1,744,845 in St. Simons. These statistics go to show the drastic disparities of income and lifestyle choices in the short distance of 15 miles.

On a national level, the poverty rate in the United States has been trending upwards over the past decade, and this issue has been further deepened by the ongoing pandemic. Since the beginning of the pandemic, the U.S. economy lost 22 million jobs from February to April 2020 (U.S. Bureau of Labor Statistics). In January, some 24 million adults reported experiencing hunger (Congressional Research Service). With a disconcerting amount of job loss not seen since the Great Depression, poverty and poor health have taken a toll on many, especially those in lower-income communities.

Poverty has many adverse effects and is directly related to diet and health issues. Depending on one’s socioeconomic status, a person’s health can vastly differ based on their income. This is referred to as the “social gradient in health,” which is used to describe the phenomenon where people who are less advantaged in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged (Institute of Health Equity). What this means is that as income goes up, life expectancy and the ability to access higher-quality foods increase as well.

Ultimately, factors such as neighborhoods, costs, and behavior are all affected by poverty. As such, it is imperative to understand the underlying effects of how poverty is detrimental to health and overall well-being and find fruitful solutions to these issues. As Sandro Galea states, “Money purchases better food, better neighborhoods, political influence, and, crucially, peace of mind. If you need help raising your children, money lets you afford daycare. The Urban Institute found that the less money a person has, the less likely he/she is to have paid sick/ vacation leave and pension or retirement contributions; a neighborhood with sidewalks, parks, playgrounds, and a library of report good health.”

How does not having money undermine health? It makes us less likely to have a decent home in a safe neighborhood, to eat high-quality food, to receive a good education, or to live a long life. While it is true that all groups experience some hardship and stress, however, if you need a break from the psychological stress of work, for example, money lets you take a vacation or pay for quality therapy. This mosaic of advantages translates into better health.

Neighborhoods (the environment) in which a person’s life plays a large role in health and diet. In areas with lower incomes, some barriers prevent one from easily accessing healthy foods. According to data from the United States Department of Agriculture (USDA), roughly 23.5 million people live in food deserts. Food deserts are areas in which people have a hard time acquiring healthy and nutritious foods because they live in areas far away from grocery stores. Nearly half of the people in such circumstances are also low-income.

Over 2.3 million people (2.2% of all US households) live in low-income, rural areas that are over 10 miles from a grocery store (USDA). The most prominent reasons as to why food deserts occur include, but are not limited to, zoning restrictions, high- levels of crime in a certain neighborhood, and other factors like higher operating costs for grocers in low-income areas, which can make businesses hesitant to set up shop there.

Furthermore, another primary factor that contributes to the lack of access to food in rural areas is the lack of transportation. Unlike in urban cities where reliable public transportation is readily available, smaller cities are spread much more apart. In rural cities, the absence of basic public transportation services means that the only way to travel efficiently is by car, which is a problem since many people in food deserts do not have the economic ability to do so. Thus, people who live in food deserts suffer from limited accessibility of fresh and nutritious foods and impedes the ability to have a healthy diet.

Even in the chance that there are nearby small local grocery or convenience stores with fresh produce in stock, prices may be too expensive when compared to supermarket prices. As a result, people that are living in food deserts may turn to more accessible alternatives, such as fast-food restaurants, frozen meals, etc. which are unhealthy. Unfortunately, many struggle to eat anything at all.

The lack of access to healthful foods and easy access to fast foods is linked to poor diets that are high in sugar, sodium, and unhealthful fats. This can contribute to diet-related conditions such as high blood pressure, cardiovascular disease, and increase the chance of Type 2 diabetes (Smith 2009). Diet quality is strongly correlated to one’s socioeconomic status. For example, wealthier individuals can afford healthier and higher-quality foods, such as whole grains, fish, and lean proteins. Fresh fruits and vegetables are also more likely to be consumed by those with a higher socioeconomic status. On the contrary, as income levels drop, high-calorie and nutrient-poor foods become a staple in diets when trying to meet the daily minimum calorie intake. Cheaper foods such as canned goods are more likely to be energy-dense but also less healthy. The reason is that people with lower incomes prioritize getting the basic physiological needs, as depicted by Maslow’s Hierarchy of Needs. Canned foods, microwavable foods, and highly processed foods staples are readily available and cheap but are all loaded with fat and sodium that are way over the daily limits. This leads people with lower socioeconomic status have dietary profiles that often don’t meet the daily requirement, thus contributing to their poorer health. The graph below depicts the various effects poverty can cause.

Poverty → diet & food selection
Poverty → less money
Poverty → less resources (transportation/education/information/time/health
literacy)
Poverty → more stress

These low-cost food options are also lower in nutritional value. In contrast, nutrient-rich foods such as fruits and vegetables are often cost prohibitive for lower-income people. A significant body of evidence shows how healthy foods cost more than unhealthy foods. According to Donkin, “The price of vegetables, for example, costs nearly twice as much when measured as “price per 100 calories” than when it was measured as “price per edible gram” or “price average portion” (roughly $3.75/100 calories vs. $1.60 and $1.40, respectively).” These data go to show that healthier items such as fresh fruits and vegetables on average cost more than their less healthy counterparts. Shown below is a relationship of how cost and diet selection affect health.

Proximity/cost/availability→ diet & food selection
fast/cheap food → less nutrients
fast/cheap food → more fat/cholesterol

Furthermore, an important aspect that many seemingly overlook is the impact that poverty can have on mental health. One out of five people suffer from some mental disorders, and poverty in adulthood is connected to depression, anxiety, psychological distress, and even suicide (Simon 7). Lower income individuals often suffer more from the harshness of mental illness as opposed to someone with a higher income. The reason is that economic inequality is linked to disproportionate access to help. Lower-income families are often struggling to make ends meet and cannot afford to spend money to seek help or consult a therapist. This, unfortunately, results in people of lower socioeconomic status having a higher likelihood of developing mental health problems such as depression and anxiety. The financial burden is already overwhelming and constant worrying may lead to more problems. Also, the stigma around mental illness is not helping either, as many may feel ashamed to seek help. Another major factor on why poverty is increasing is because costs have gone up. It has become harder for Americans to obtain a comfortable standard of living because housing costs, food costs, and necessities have gone up in price, thus posing a threat to their financial security.

The federal minimum wage has not been increased in over eight years. If a person works minimum wage at $7.25 an hour, for 40 hours/week for 50 weeks/year, their annual salary is only $14,500. The national poverty threshold is at $13,064, and the U.S. government calculates the poverty line as an income three times the cost of a nutritionally adequate diet. What this goes to show is that a person working minimum wage, without considering other factors such as geographic location, is just barely scraping by. This is extremely concerning as the stagnation of wages in conjunction with the ever-rising cost of living will trap more Americans living in poverty

Unfortunately, poverty lines and other government poverty statistics do not accurately portray the real economic disparities Americans face today. This is because many of these government statistics fail to take shelter, transportation, medical care, and childcare costs into account. Poverty statistics oftentimes also fail to account for geographical differences, as living costs in California are drastically different than those in Mississippi. A recent poll conducted by the Center for American Progress poll found that “43% of people cannot afford to pay for necessities, 40% would struggle to find $400 in an emergency.” Millions of Americans are struggling just to get food on the table. What this data suggests is that there are far more people living the realities of poverty than what the poverty line suggests. An effective way to combat the rising costs of living and address the issues of poverty is to increase the minimum wage. According to Taylor, “The U.S. Department of Labor reviewed 64 studies on the effects of minimum wage increases and unemployment and found no correlation between the two. A groundbreaking study … for Research on Labor and Employment demonstrated that a $15 minimum wage would not create job loss but would lift more people out of poverty.” What this shows is that raising the minimum wage would not only help people with lower incomes achieve a better standard of living but reduce a major stressor that is detrimental to health and well-being.

In essence, poverty has many adverse effects and is directly related to diet and health issues. During my six years as a volunteer at the local food shelter, I saw first-hand the detriment of poverty and its effects on the local community. Despite the United States being one of the wealthiest countries in terms of resources and GDP, the significant income inequality gap has made the U.S. ranked fourth in highest poverty rate. As a result, because of a person’s socioeconomic status, a person’s health and wellness can vastly differ based on their income. The leading cause of death in the United States are chronic diseases such as diabetes, heart disease-all exacerbated by the ever-rising amount of people experiencing poverty and food choices of those in lower-income. With the ever-rising costs in housing, education, necessities, and the stagnation of wages, it has become harder to achieve a comfortable standard of living and escape the cycle of poverty.

References

Alain, A. (2019, May 27). Nearly 40% of Americans can’t cover a surprise $400 expense. CBS News. https://www.cbsnews.com/news/nearly-40-of-americans-cant-cover-a-surprise-400-expense/

Daniel Taylor, T. P. I. (2019, October 26). Opinion: I’m a Philadelphia pediatrician. Here’s the one thing that would help my patients most. WHYY. https://whyy.org/articles/im-a-philadelphiapediatrician-heres-the-one-thing-that-would-help-my-patients-most/

Darmon, Nicole, Adam Drewnowski. “Does Social Class Predict Diet Quality?” The American Journal of Clinical Nutrition, Vol. 87(5) May 2008: pp.1107–1117. https://doi.org/10.1093/ajcn/87.5.1107

Donkin, A. J. M. (2014, February 21). Social gradient. Wiley Online Library. https://onlinelibrary.wiley.com/doi/10.1002/9781118410868.wbehibs530

Galea, S. (2019). Well: What we need to talk about when we talk about health. Oxford University Press.

Rhone, A. (2021, May 24). Documentation. USDA ERS – Documentation. Retrieved September 19, 2021, from https://www.ers.usda.gov/data-products/food-access-research-atlas/documentation/

Simon, K. M., Manseau, M. W., & Beder, M. (2018, June 29). Addressing poverty and mental illness. Psychiatric Times. https://www.psychiatrictimes.com/view/addressing-poverty-andmental-illness

Smith, C., & Morton, L. W. (2009). “Rural food deserts: low-income perspectives on food access in Minnesota and Iowa.” Journal of nutrition education and behavior, 41(3), pp.176–187. https://doi.org/10.1016/j.jneb.2008.06.008

Vornic, A. (2020, July 13). As more go hungry and Malnutrition persists, achieving ZERO hunger by 2030 in doubt, UN Report warns. World Health Organization. https://www.who.int/news/item/13-07-2020-as-more-go-hungry-and-malnutrition-persists-achieving-zero-hungerby-2030-in-doubt-un-report-warns

About the author

Tyler Huang

Tyler Huang is a senior at Brunswick High School in Brunswick, Georgia. He is an active member of the local community and has deep passion for social activism, including building better access to healthy foods among low-income and marginalized communities.

The post Examining the Effects of Poverty on the Access to a Healthy Diet appeared first on Exploratio Journal.

Abstract

There are 100,000-200,000 anterior cruciate ligament (ACL) injuries in the United States each year. Physical therapy is a crucial process in the recovery from the ACL reconstruction surgery, involving physical exercises for patients to recover faster. Mentality of the patients plays an important role as well in this process. Besides conventional physical therapy exercises, there is a range of new technological approaches available to facilitate the recovery. The purpose of this paper is to review current options in physical therapy as well as technological advances. Novel technologies like wearable devices and virtual reality physical therapy are discussed.

Introduction

One wrong step. This is all it takes for the anterior cruciate ligament (ACL), one of the most common places of injury to the knee, to tear. There are commonly between 100,000-200,000 ACL ruptures in the United States every year (1). This ligament runs diagonally through the center of the knee, and provides support for the joints involved, shown in figure 1(2). This is commonly injured due to a pivot or improper jump landing, generally seen in
contact sports (3). “Many people hear a pop or feel a “popping” sensation in the knee when an ACL injury occurs. Your knee may swell, feel unstable and become too painful to bear weight (4).” Although this injury has different levels of severity and treatment required, surgery is usually a first step on the road map (5). Whether using an autograph, (graph taken from muscle or ligament in patients body) or a cadaver (donation from a deceased body), reconstruction surgery involves forming a new ACL through implemented stretched muscle, which is then secured into the body (6).

After one receives surgery, the extensive rehabilitation process begins, commonly known as the most important part of a recovery. Physical therapy is typically used to support the recovery, and help improve the patient’s outcome. Due to the wave of new technology over the last few decades, many new tools are available combining engineering and technology to injury recovery. In this review paper, we are discussing the commonly used physical therapy process after ACL surgery, as well as technology that is being designed to help facilitate it. This paper is inspired by the personal recovery of the author.

Conventional Physical Therapy

Physical therapy in an ACL tear is marked through a six month (average 22 weeks) therapy that is broken up into checkpoints about what a patient is able to perform (7). For the first phase of recovery, which usually consists of the first two weeks to a month, the main focus of the recovery process is to reduce the swelling and regain knee extension; painkillers, physical therapy and icing sessions become priority during the first month phase (7). The common exercises for this initial period after surgery focus on improving knee extension and reducing stiffness, with a focus on bending and straightening the knee (8). This generally includes straight leg raises, towels under the knee and ankle, and practice bending the knee to a 90 degree angle, as shown in Figure 2 (9). The patient will find these activities will become less difficult with more practice and time icing the knee to reduce swelling (9). From the interview between the author of this paper and Physical Therapist Victoria Wilson, the ability to fully extend the knee is one of the most important parts of recovery, since it allows for optimal hamstring and quadricep strength, and reduces risk of retear, which already has a high rate of 24% (10). Also, it is very important to work on full knee extension early on, because if not, scar tissue begins to build up, which will require additional surgery and physical therapy, as well as starting a more excruciating recovery process from scratch.

In addition to the physical recovery process, mentality plays a huge part in achieving full success. According to Wilson, many of her ACL patients don’t return to their contact sports due any fear of retear. According to Lorenz Buchler, from the department of Orthopaedic Surgery in the University of Bern, Switzerland, only about ⅓ of patients return to their sport after a year post surgery, and 50% in 2-7 years (11). This is due to all of the trauma that comes with an intense recovery process. In order to overcome that fear, the patients need to keep performing physical therapy, completing the exercises, and maintain a positive and patient mindset in that process. In the initial recovery process, the exercises completed allow for crucial knee extension and flexibility. A variety of exercises intended to strengthen the knee in this regard is described throughout the diagrams below (12). It is very important for the patient to complete these exercises on a regular basis, in order to prevent physical setbacks such as extra surgery and mental setbacks such as longer recovery time. As with any injury of this sort, physical therapy is the most crucial part.

New Technology Applications in ACL Recovery

In the modern world, there are many solutions involving technology to advance recovery from an advanced surgery such as ACL reconstruction (13). Wearable technology, virtual reality (VR), and telerehabilitation are all used in different ways to make the recovery process easier.

For example, wearable tech, such as watches and bracelets, are used to detect range of motion (14). This technology is used to collect data about movement patterns, and issues with the exercises to detect if there are any problems with the recovery (14). For example, technology such as DorsaVi provides medical professionals and athletes real time data about one’s injury recovery, which uses wireless sensors placed on the legs and lower back during times of exercises, that can measure the twists, turns, bends, speed and even the G-Force of the exercises (15). This is possible using tiny accelerometers, magnetometers and gyroscopes in the sensors that help collect the data from the body (15). This information can be used, alongside patient questionnaires, to give a more accurate representation on how a patient’s recovery is progressing.

In addition, a virtual system for physical therapy, including virtual reality, after knee injuries has been experimented with (16). One of the VR programs is called “VERA,” which is a platform that brings the guidance of a physical therapist into the home along with tools that help clinicians remotely monitor patient progress beyond the traditional in-clinic setting (17).Typically, the VR is used with a series of games that include different purposes, such as increasing muscle strength and improving bodily balance (10). For example, a body balance weight can be moved from one leg to the other, coordinating to something occurring on a VR screen. In a study by Wolters Kluwer Health, which contained 306 patients with the average age of 65, 88% of participants in virtual physical therapy completed their exercises, compared to only 65% during in person physical therapy (18). In addition, returning to normalcy rates remain similar between both options. However, the rates of reinjury increase for the virtual options (18).

Besides this example, other studies used telerehabilitation, in which rehabilitation service is provided through telecommunication (internet), to compare pain rates, return to normalcy, rates of reinjury, and motivation in order to measure success of rehabilitation (19). Tests have been done in the past to compare normal knee physical therapy to balneotherapy (aquatic therapy), demonstrating positive and negative effects (20). Similarly, according to a study by the Yale School of Medicine, physical therapy with use of telerehabilitation improves resource saving, access to care, and learning and engagement (19).

Virtual physical therapy and telerehabilitation would be an option that would greatly benefit those who have trouble leaving their home, whether due to global or personal circumstances, as returns to strength and ability to accomplish tasks on one’s own are major improvements. However, with virtual and telerehabilitation physical therapy, the inability to have a personal physical therapist might cause detriment to the patient, as there is less access to manual therapy and opportunities to ask questions (10).

Conclusion

Besides conventional physical therapy, new technologies are being adopted into the world of rehabilitation from ACL, as well as other knee injuries. Wearable devices offer improved statistics and data for doctors to see in real time as the patients complete the exercises. Virtual reality and telerehabilitation allow for patients to complete physical therapy through them internet and technology, enabling a more successful recovery process. However, challenges with the implementation of these technologies still exist, and there are still many benefits to the conventional practice.

References

1. Friedberg, R. P., Felds, K. B., & Grayzel, J. (2021). Anterior cruciate ligament injury. UpToDate. https://www.uptodate.com/contents/anterior-cruciate-ligament-injury#:~:text=EPIDEMIOLOGY%20%E2%80%94%20The%20ACL%20is%20the,2%2C7%2D9%5D
2. Fletcher, J., & Morrison, W. (n.d.). Ten common knee injuries and treatment. Medical News Today. https://www.medicalnewstoday.com/articles/319324#ten-common-knee-injuriesinitial research on knee injuries
3. Rothman Orthopaedic Institute. (n.d.). FAQs About Recovery From ACLSurgery. Roman Orthopedics.https://rothmanortho.com/stories/blog/faqs-about-recovery-from-acl-surgeryFAQs
4. Mayo Clinic. (n.d.). ACL injury [Factsheet]. Mayo Clinic. Retrieved August 7, 2021, from https://www.mayoclinic.org/diseases-conditions/acl-injury/symptoms-causes/syc-20350738
5. Heiden Orthopedics. (2020, February 24). What you should (and shouldn’t) do after ACL and MCL tears and surgery. Heiden Orthopedics. Retrieved August 7, 2021, from https://heidenortho.com/acl-mcl-tears-surgery/gave good dos and don’ts after surgery- maybe a posture checker for keeping the knee straight?
6. Emory Healthcare. (2019). Rehab Timeline Expectations [Fact sheet]. ACL rehabilitation program. Retrieved August 7, 2021, from https://www.emoryhealthcare.org/centers-programs/acl-program/recovery/rehabtimeline.html Good timeline of recovery
7. Dr. Alford. (n.d.). Dr. Alford’s postop instructions: ACL reconstruction [Pamphlet]. https://orthopedicsri.com/wp-content/uploads/2017/01/Alford-Postop-ACL-reconstruction.pdf Instructions for after surgery
8. Murray-Weir, M., Levinson, M., Graziano, S., Horovitz, L., Galway, W., Fives, G., & Urmey, W. (2001). Your pathway to recovery: surgery for ACL injuries [Pamphlet]. Hospital for Special Surgery 535 East 70th Street, New York, NY 10021. https://www.hss.edu/Cordasco/ACL-Pathway-to-Recovery.pdfInformation about pt
9. Caetano, D., Oliveira, C., Correia, C., Barbosa, P., Carvalho, P., & Montes, A. (n.d.). Physical Therapy in Sport. Science Direct, 129-137. https://doi.org/10.1016/j.ptsp.2021.01.015
10. Büchler, L., Regli, D., Evangelopoulos, D. S., Bieri, K., Ahmad, S. S., Krismer, A., Muller, T., & Kohl, S. (2016). The Knee. Science Directb, 549-553. http://dx.doi.org/10.1016/j.knee.2016.01.012
11. When an Injury Causes Knee Pain Knee Exercises. (2020, December 1). WebMD. Retrieved September 4, 2021, from https://www.webmd.com/pain-management/knee-pain/injury-knee-pain-16/slideshow-knee-exercised Used for pictures of physical therapy.
12. MRegen’s Breakthrough Technology for Rapid ACL Recovery. (2019, January 24). The Healthcare Technology Report. Retrieved September 4, 2021, from https://thehealthcaretechnologyreport.com/mregens-breakthrough technology-for-rapid-acl-recovery/ Tech that heals the acl faster
13. Newton, J. (2019, September 18). Is Wearable Tech the Future for Patient Recovery? The Yorkshire Knee Clinic. Retrieved September 4, 2021, from https://yorkshirekneeclinic.com/is-wearable-tech-the-future-for-patient-recovery/ First Source on wearable tech
14. Adams, K. (2018, June 22). New technology used by the NFL is changing the game for Kentucky athletes. Courier Journal. https://www.courier-journal.com/story/life/wellness/fitness/2018/06/22/wearable-sensor-technology-changing-game-kentucky-athletes/620380002/ Sensor tech helping recovery
15. Byra, J., & Czernicki, K. (2020). The Effectiveness of Virtual Reality Rehabilitation in Patients with Knee and
    Hip Osteoarthritis. Journal of Clinical Medicine, 9(8), 2639. doi:10.3390/jcm9082639 More about vr
16. Hofheinz, E. (2018, March 14). Virtual Exercise Avatar Latest Rehabilitation Innovation. Rhy Orthopedics. Retrieved September 4, 2021, from https://ryortho.com/breaking/virtual-exercise-avatar-latest-rehabilitation-innovation/ Vera
17. Caetano, D., Oliveira, C., Correia, C., Barbosa, P., Carvalho, P., & Montes, A. (n.d.). Physical Therapy in Sport.Science Direct, 129-137. https://doi.org/10.1016/j.ptsp.2021.01.015
18. Hughes, C. (2020, January 16). Virtual physical therapy after knee replacement brings similar outcomes, lower costs. Eurekalert! https://www.eurekalert.org/news-releases/834276
19. Gardner, E., & Dunphy, E. (2020). Telerehabilitation to Address the Rehabilitation Gap in Anterior Cruciate Ligament Care: Survey of Patients. JMIR, (e19296). https://doi.org/10.2196/19296 Telerehabilitation
20. Peultier-Celli, L., Mainard, D., Wein, F., Paris, N., Boisseau, P., Ferry, A., Gueguen, R., Chary-Valckenaere, I., Paysant, J., & Perrin, P. (2017). Comparison of an Innovative Rehabilitation, Combining Reduced Conventional Rehabilitation with Balneotherapy, and a Conventional Rehabilitation after Anterior Cruciate Ligament Reconstruction in Athletes. Frontiers in surgery, 4, 61. https://doi.org/10.3389/fsurg.2017.00061Balneotherapy

About the author

Daniel Gassenheimer

Daniel is currently a senior at Jericho High School. He is an aspiring engineer, and greatly enjoys building and design challenges. He is a cross country/ varsity track runner. Unfortunately, he torn his ACL playing football with his friends, thus his inspiration for deep research into the subject and the creation of this paper.

The post ACL Reconstruction Recovery: Current Practice and Technology of the Modern World appeared first on Exploratio Journal.

Abstract 

Parkinson’s Disease is a well-known and potentially life-crippling disease which puts thousands in hardship per year. This study aims to uncover the geographical/ethnic influence on this in relation to the Gut-brain axis which is the bidirectional pathway from the gut to the brain. Studies have been done on parts of this question, but never the whole issue. Typically, researchers focus on the Gut-Brain axis or ethnicity/geographical location in relation to Parkinson’s disease. But, rarely a combination of these.  This manuscript allows for the scientific community to understand specific triggers which may quicken or even cause the appearance of Parkinson’s Disease in patients worldwide. To understand the treatment, we must understand the causes. This study is a systematic review of several articles which answer parts of the whole question. Several keywords were searched and examined to create an organized, detailed review. Through this, we have found a correlation between the epidemiology of ethnic/geographic backgrounds and the Gut-brain axis in relation to Parkinson’s disease. This is vital for understanding due to the lack of knowledge in the field of how Parkinson’s is caused or progressed. 

Introduction

The brain is a complex organ that underlies all of our thoughts and behaviors. Unfortunately, there are a number of complex issues such as those that slowly destroy its tissues, i.e., neurodegenerative diseases, which interfere with its ability to function. Neurodegenerative diseases typically involve the progressive death or breaking down of a part of the brain, therefore, they are consequently one of the hardest to cure and treat. Due to this, many research efforts focus on ways to slow down these neurodegenerative diseases. Of all neurodegenerative diseases, Parkinson’s Disease (PD) is one of the most common. 

Parkinson’s Disease is a neurodegenerative disease that affects the movement of the patient as well as is known to cause apathy, depression, constipation, sleep issues, cognitive impairment, etc (Parkinson’s Disease, 2020). This disease targets the central nervous system (CNS), and specifically, the dopamine-producing (“dopaminergic”) neurons in an area of the brain called substantia nigra, a small nucleus in the brainstem (What is Parkinson’s?, 2021). The death of these dopamine-releasing neurons causes the symptoms of Parkinson’s such as tremors, stiffness, trouble walking, etc, due to its impact on the targets of these neurons, the Basal Ganglia. Typically in the earlier stages of Parkinson’s, a patient’s face may show little or no expressions, their arms may not swing when walking, their speech might become slurred, and several other movement issues will arise as time passes (Parkinson’s Disease, 2020). Although Parkinson’s is one of the most studied neurodegenerative diseases, the causes and ways to successfully treat the disease are still not known. Scientists have determined that there could be a genetic link to the development of the disease, and in fact, have isolated a specific gene that might increase one’s chances of developing PD.  With this, there are potentially many environmental triggers (i.e. toxins, climate, etc) that can act on this genetic combination, but again this is not well established. Furthermore, scientists have begun to study some of the physical characteristics of the neurodegeneration associated with the disease. Specifically, patients with PD have a substantial amount of Lewy bodies in the brain, and in these structures, scientists believe an important protein is located.  This natural and plentiful protein is called alpha-synuclein (a-synuclein), and is found in all Lewy bodies in a clumped form that cells are unable to break down (Parkinson’s Disease, 2020). Currently, this is a very popular topic among scientists researching PD. This disease is extremely difficult to live with and only gets worse as time passes, therefore, it is vital to understand the potential causes and potential risk factors. 

Although food may seem like an unlikely origin for a Neurodegenerative disease, the correlation between the stomach/intestines or the gut and the brain may be deeper than initially thought. There is a biological pathway referred to as the Gut-Brain Axis (GBA) which shows a possible relationship between gut health (microbiome, food intake, etc.) and brain health (diseases, cognition, etc.). The pathway is a bidirectional network that can communicate through neural, endocrine, immune, and humoral links. It is vital to explore these links due to the huge impact it may have in the future. One area that has received an increasing amount of attention in its relation to the human condition is the microbiome located within the human body. This microbiome is the presence of a community that consists of microorganisms in a specific habitat. This microbiome’s impacts are largely unexplored, but they are known to help with metabolism, immunity, etc. In a study done by Romano et al. they concluded that there were consistent differences between PD patients and control patient’s gut microbiome (Romano et al., 2021). Although there was slight variation between trials they accounted for the variability derived by the sampling cohorts to show there was consistency in the alteration of the microbiome between the trials. 

One such organism in this microbiome that has been demonstrated to exist in lower levels in PD patients compared to control patients is Lactobacilli. These bacteria are extremely vital to our gut health and have been observed in our gut from the first instances of gut microbiota composition studies. These organisms are commonly found in our digestive and urinary tracts. They reside here to assist with the breakdown of foods as well as the absorption of their nutrients. Additionally, they aid the immune system in fighting pathogens from harming the body (LACTOBACILLUS: Overview, Uses, side Effects, precautions, Interactions, dosing and reviews 2020). 

This organism is vital for our health and could be a factor in the risk of developing PD. Typically, one can eat foods containing this bacterium such as yogurt, but probiotics naturally found in food such as onions, garlic, and bananas can stimulate and foster the growth of this bacteria as well as other good bacteria (GMFH Editing Team, 2020). Typically, we see these foods eaten more in eastern countries than western countries which could be a possible link to the increased and decreased appearance of PD which will be discussed in the results this presents as a possible link to microbiome-associated PD occurrences. 

Thus, this paper will examine the evidence to explore a relationship between geographic patterns of PD prevalence and the associated microbiome patterns. The extensive research done thus far enables us to predict that areas with a higher incidence of Parkinson’s, such as the western world (ie: America, South America, etc), are associated with a microbiome content containing lower levels of Lactobacillales, along with others to be discussed below in further detail,  as well as lower gut microbiota diversity. These factors are discussed as possible predictive factors for an increased risk of developing Parkinson’s Disease.

Methods

As a systematic review, the methods were largely based on extensive literature search and assessment. Searches were completed primarily throughout the month of July, using search engines: ”Google Scholar”, “PubMed”, and “Britannica”. Key terms used included, but not always simultaneously, were: “Parkinson’s disease” [AND/OR] “gut” [AND/OR] “microbiome” [AND/OR] “microbiome diversity” [AND/OR] “Lactobacillus” [AND/OR] “Western gut microbiota” [AND/OR] “Eastern gut microbiota” [AND/OR] “Parkinson’s epidemiology” [AND/OR] “Gut-brain axis”. Articles were then screened to determine if they contained relevant information for this study. If found to be relevant or useful, articles were contained within topic folders for deeper analysis.  

Inclusion factors: We included studies that compared the composition of the gut microbiota between PD patients and control populations. We also included studies that examined the epidemiology of PD worldwide as well as within specific countries or continents. Slight variations in methodology were accounted for in this study. Additionally, all included studies were published within the last 20 years (2001-2021). Along with this, all studies using data must have a 95% confidence interval. 

Results

Worldwide prevalence of Parkinson’s Disease

The mechanisms underlying Parkinson’s Disease are not yet fully understood, however, there seems to be a correlation between PD and geographical location. The pattern of this epidemiology suggests that there are likely several environmental factors that influence the occurrence of this disease. In a study done by Abbas and others (2017), a door-to-door study was conducted which took data from populations worldwide, many of the eastern countries had significantly less crude prevalence rates (per 100,000) than many of the western countries. For example, Bambuí, Brazil (2006) had a crude prevalence rate of about 3,330 per 100,000 people (>64 years) compared to Beijing, Xian, Shanghai, China (2005) with a prevalence rate of about 1,700 (>65 years). This study concluded that PD incidence is also lower in Asian countries compared to Western ones; although it should be noted that data was limited for Asian studies. Other studies on different ethnic populations have reported a lower PD occurrence in Eastern (Asia/Africa) than Western countries (Caucasians, Hispanics, Latinos) (Abbas et al., 2017). While this could suggest a genetic influence on the risk of developing PD, the higher rate of occurrence of PD among ethnic groups in America (African Americans and Japanese Americans) compared to similar populations in their native country, suggest an environmental role in PD. This draws concern as to what differs between these countries and several things may come to mind. Such differences could include culture, race, food, climate, flora, and fauna, etc. Specifically, with regards to food, there could be differences in the availability of processed vs natural foods. Brazil is in a state of deep industrialization meaning there is a boom in processed, and inexpensive food. Although China is in the same state, the culture tends to be more conservative with tradition and food. Therefore, China is more likely to eat traditional natural foods than Brazil (Kearney, 2010).

Additionally, the prevalence rates of ethnicities (Asians) within America versus their homeland counterparts are drastically different. There is a higher prevalence rate in America as well as several other developed countries when comparing the same ethnicities. This rules out genetics in this specific comparison which leaves the culture and lifestyle of each to be compared. The major difference between each country is the food habits in which American ethnic populations are more likely to be more westernized (including foods) than their motherland. (Figure 1)

Are there differences in the gut microbiome composition of diversity worldwide?

In an attempt to determine whether a geographical and gut-microbiome relationship impacts PD likelihood, it’s important to examine whether the gut-microbiome composition varies predictably across the globe. Even among a diverse country that shares similar features nationwide, yet has a relatively high diversity of ethnicities such as the United States of America, there seems to be a difference in the epidemiology among ethnicities. Although there are several control variables with a nationwide population, there are likely external factors that affect the rate of infection among specific ethnicities. In a study done by Willis et al., (2010) the team came to a conclusion that among Americans there is a higher rate of PD among Caucasians than the Asian or African demographic (Wright, Willis et al., 2010). Although genetics may seem to be a significant reason for this, experts claim only around 15% of Parkinson’s development is reliant on genetics (Johns Hopkins Editing, 2014). The other 85% may be related to factors of the environment, including food intake. Thus, the food that those in eastern countries eat is different from those found in western cuisine which could be a major factor in the difference in ethnicities within the same country. There seems to also be a tie between the geographic locations/diets of remote Indian villages and their Gut-bacteria profile (GBP). This exemplifies that there is observed data that the gut is being affected by the foods eaten as well as the location of tribes (Dehingia et al., 2015). Through this, we are able to suggest that diet will alter the gut, and consequently the brain. 

Is there a correlation between PD and the Gut-brain axis?

As introduced above, the gut-brain axis includes the populations of organisms present in our gut, the gut microbiome, and its influence on the functioning of our nervous system. We were interested in determining whether there were components of this axis that were specific to those patients with PD. In a study done by Quigley (2017), germ-free mice (or those that lacked a microbiome) demonstrated decreased expression of the important neurotrophic factor, brain-derived neurotrophic factor (BDNF) in several brain areas including the cortex, hippocampus, and amygdala. Additionally, others have demonstrated impaired neurogenesis in the hippocampus and altered neural morphology in the amygdala in germ-free animals (Quigley, 2017). Through this study and several others, we can begin to see the link between the microbiome of the gut and the health and cognition of the brain. Thus, gut bacteria with immune activation go through a defective gut barrier, which eventually leads to a systemic inflammatory response which, consequently, impairs the blood-brain barrier and promotes neuroinflammation, and finally leads to neural injury and degeneration. This gives evidence for the influence of the gut-brain axis on all neural disorders. 

Despite the many factors associated with  PD, including aging and genetics, there is also a likely influence on the microbiota. In a study done by Romano et. al. (2021), they have found significant alterations between the microbiome of PD patients and control groups (Romano et al., 2021). This is depicted in Tables 1 and 2. 

Lactobacilli are commonly found in yogurt which is a daily meal for south Asians. Typically they eat a small serving of homemade yogurt with each meal. Additionally, several eastern countries (African countries, Asian countries, etc.) use probiotic ingredients such as onions and garlic much more frequently than western countries. This may additionally explain the lower correlation of PD in Eastern countries than Western countries (Abbas et al., 2017). Although some articles disagree on certain levels of these bacteria, the majority agree with what is stated in this review. Additionally, it may vary due to location and diet.

Bacilli are a wide range of bacteria that are very helpful for improving digestion, immune modulation, and growth performance. They are very helpful for the overall health of our body. These bacteria can be found in numerous foods including vegetables and raw foods (Bernardeau et al., 2017). They can also be benefitted from the consumption of probiotics, similar to other bacteria. (Table 2)

Phascolarctobacterium is also another bacteria commonly found in the gut which has variations between PD patients and the control group. This bacteria has been known to help metabolic reactions and processes. It has also been found in higher amounts with a higher fiber intake (Cross et al., 2017). It has also been found to increase substantially in the gut from the use of Berberine and Metformin (Wu et al., 2017), which may be an area of future interest. 

Akkermansia has been found to decrease the risk of heart disease, cholesterol issues, and fat storage. It has also been found to decrease inflammation, prevent weight gain, and improve immunity. This specific bacteria is obtained from fatty fish and Polyphenols. This has also been seen at increased levels in PD patients. 

Ruminococcus torques has also been noticed to be increased in PD patients. This specific bacteria has been known to decrease the gut barrier integrity and is pro-inflammatory (Deaver et al., 2018). It also is known to help break down cellulose and resistant starches (Tomova et al., 2019). This bacteria is benefited by long-term fruit and vegetable consumption. 

In addition to individual strains, gut microbiota diversity may be another factor influencing the risk for PD. In many PD patients, the diversity within the gut is lower than that of a control patient. In a study done by Li et al. titled “Gut Microbiota Differs Between Parkinson’s Disease Patients and Healthy Controls in Northeast China”, the authors took a group from Northeast China and derived a study from them using PD cases and control groups. From this study, they determined that there was a significant difference between the PD group and the control group in regards to their diversity (Li et al., 2019). The PD group had decreased species richness, β-diversity, phylogenetic diversity, and altered amount of taxa when compared to a control. Using data collected from the same article which provides which specific bacteria are altered between a PD patient and a control group in which this data can be interpreted. Additionally, it seems that due to the increased levels of other bacteria among the PD patients’ gut microbiome there may be a decrease in the diversity of PD patients. Since there are increased bacteria of several taxa and only a few decreased taxa the diversity is likely to decrease. The carrying capacity of bacteria in the gut does not get impacted whether or not one has PD, therefore when several taxa increase there is less space for less frequent taxa to thrive since they are being outcompeted due to the increased abundance of other taxa in PD patients. 

Geographical and ethnic influence on gut microbiota and its impacts on PD prevalence

As a summary of what we present above, there seems to be a correlation between geographical location and PD prevalence. Although ethnic genetics may be one factor in its occurrence,  a majority of the cause seems to be environmentally based.  One such environmental factor includes the foods consumed and the resulting microbiome. Thus, the geographical location may influence one’s GBA which may lead to a risk of developing PD. 

Discussion: 

Given the above data from the existing literature, we suggest a relationship between areas with a higher incidence of Parkinson’s, such as the western world (ie: America, South America, etc), and microbiome content. Specifically, the gut microbiomes of those with PD tend to contain lower levels of Lactobacillales, as well as a lower gut diversity. Beyond this, the results presented show patterns that are open to educated scientific interpretation and will be discussed further. 

This novel study covers a large-scale review of Parkinson’s epidemiology in relation to ethnicity/geographical location with the gut-brain axis. From the results discussed above, it has been seen through several studies that there are ranging levels of prevalence rates of PD in different countries (Figure 1). Although a portion of this could be due to genetics, it is too large of a difference showing there are external factors influencing this. Specifically, these results demonstrate differences in the PD prevalence of the Eastern vs Western countries. As seen in Figure 1, the redder and orange coloring indicated areas in the western countries, although there is also orange found in some Eastern countries. This seems to correlate with rapidly industrializing cities. From this figure, we are able to suggest a cultural factor (food habits, traditions, etc.) that may enable the differences between the two hemispheres. Thus, this could be due to a difference in food consumption. 

One type of food item consumed is one containing probiotics. Probiotics are always a welcomed food item into the body. Examples of this may be yogurt, buttermilk, kefir, tempeh, kimchi, miso, sauerkraut, etc (How to get more probiotics 2020). These food items are largely eaten in eastern countries which also have a lower PD prevalence rate. One may argue that there are high levels of PD in some parts of the eastern countries as seen through Figure 1. This is due to the fact that the red/orange points in the east are rapidly industrializing and in these rapidly industrializing cities processed foods are typically more common than traditional foods in traditional regions (Kearney, 2010). This is because it is more efficient and inexpensive than traditional cooking methods, and is supported by the Epidemiological transition model (ETM) typically the fifth stage (which includes developed countries such as the USA, Germany, Canada, etc.) are normally facing infectious diseases being replaced as the major cause of natural death by degenerative diseases (such as Parkinson’s). Using this model we can see that there has been repeated data collected which shows that degenerative diseases have been seen continuously to be prevalent in developed countries (McKeown, 2009). For this reason, it makes sense that rapidly developing cities would be redder than more traditional cities. An example of this in Figure 1 is within India; we see Bombay as highlighted in orange while Kalkutta (a more slowly developing city) is yellow. 

We additionally believe there is a correlation between the prevalence of PD and processed foods, a trademark of western culture, through the results above. As mentioned above, traditional cities do not have as many processed foods while industrializing cities (which are redder in Figure 1) tend to have much more processed foods. Additionally, there have been studies done such as Leo et. al (2019) which demonstrates an impact on brain health in a highly-processed diet. They show that ultra-processed diets may lead to low-grade systemic inflammatory and oxidative changes. These factors are very incubative of neurodegenerative diseases such as Parkinson’s and Alzheimer’s. We believe our results collected along with the other studies done may strengthen this developing theory.

Food consumption directly impacts the content of the gut microbiome. We show a strong link between the gut-brain axis and the prevalence of PD. The health and diversity of the microbiome of the gut is likely a possible factor in the development of PD. There are specific genus/orders/families/species which are more probable to influence this specific neurodegenerative disease. We have also strengthened the line of reasoning between the variations of the gut microbiome worldwide and the variations of the gut microbiome between control and PD patients (Table 1 & 2).

This paper combines and builds upon existing research. This data is vital to understanding degenerative diseases due to the possibility of understanding which external factors influence them. Understanding a possible link between the factors presented here may help us begin to isolate which specific food causes the biggest impact and avoid them. 

The generalizability of the results is limited by the lack of data collection of the epidemiology of PD and other factors worldwide. This includes data from those less developed countries and communities. The lack of this research makes it difficult to gauge what specific cultural differences make the largest impact. It also constricts the number of interpretations one can make about countries due to a large lack of resources. Specifically, there was a lack of data from several countries in Africa which made it difficult to discuss these regions in the results and discussion. Secondly, our understanding of the gut microbiota is still growing and evolving, so it is likely that we will learn more about the impact of specific strains in the future.  Finally, future work may focus on the specific qualities of processed foods that may impact gut health in relation to the GBA. This could be hugely helpful in the overall goal of combatting PD as it can help to uncover the impact of these sources of food in developed and developing countries. 

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About the author

Samay Inampudi

Samay is a Senior at Oswego East High School who loves socializing and the sciences. He loves life and lab sciences due to their complexity and precision. He participates in Science Olympiad, Ecology Club, and Model UN. Aside from his academic interests, he loves to spend time with his friends and plays tennis.

The post You are what you eat: Exploring the relationship between Neurodegenerative Diseases and the Microbiome. A systematic review. appeared first on Exploratio Journal.

1. Introduction

For over a year now, COVID-19 has wrought unexpected and far-reaching adverse effects on the health, safety, economic and social well-being of societies across the world. Of particular concern is the impact of this pandemic on the quantity as well as the quality of learning of school-age children. Considering the adage, that children are the future of the nation, this negative impact of COVID-19 on school learning is a matter of grave concern both in the short term and the long-term.

This paper will explore these short as well as long-term effects on school learning in China.

Firstly, because during the epidemic, students could not go to school, they had to take online classes at home. This robbed them of face-to-face learning as well as the experience of in- person socializing with their peers. We would like to explore the short-term as well as the long-terms effects of this adverse change. The major short-term impact of the pandemic on schooling was the modality of instruction – classroom teaching and learning suddenly had to go ‘online’. What are the problems in online-teaching and learning?

Online classes face many problems, not all regions and families have the conditions to access the Internet. Some families do not even have mobile phones. If you have a mobile phone, you do not necessarily have a network or Wi-Fi. Therefore, online classes, virtually also to many poor families caused a burden. Of course, this is a hardware problem when these problems are solved. And new problems arise, because the teaching level of different regions is different, and there are differences in children’s performance. The national unified online course, teaching materials cannot seamlessly connect most of the students’ learning. Perhaps in the special period, the education department has done some special work, and it is the best way to solve the problem of children’s learning in front of the epidemic.

Besides the issues of inequitable or spotty availability of the internet and the related equipment, there is the critical question of professional training of the teachers. This pandemic took everybody by surprise. The teachers as well as the school administrators were expected to ‘learn overnight’ how to use the new technology as well method of teaching. That is not so straight forward since it needs professional development, training, and time to learn.

Secondly, at the family level, the parents are naturally very concerned about the students’ performance in the college entrance examination. In China, like in many other countries, high school entrance examination and college entrance examination are very important for students with very significant impact on the rest of their career and life opportunities. Therefore, these are the most concerned issues of parents and all walks of life. The impact of the epidemic will certainly affect candidates to delay the examination.

Thirdly, in many children’s minds, their idols are no longer stars. And more are great people like Zhong Nanshan, Li Lanjuan, Yuan Longping and so on. There is no doubt that the seeds have been planted in the hearts of children. I hope that when I grow up, I will become a person like them and make my own contribution to the society and the country. This outbreak. No doubt for the children, let them grow up more clearly aware of their coming to this society. What to do. What kind of people they should be has a huge impact on their values and world outlook?

2. COVID-19: A brief History of the Pandemic

In this section, I will briefly describe the history of the outbreak of the COVID-19 pandemic.

Caught off guard in the late Fall of 2019, the novel coronavirus pneumonia from Wuhan has been a shocking surprise for China. There are different opinions about the source. Some say it came from the seafood market in South China, while others say it came from the expatriates of last year’s Wuhan military games.

On the morning of December 31, 2019, the expert group of the National Health Commission arrived in Wuhan to carry out relevant testing and verification work. The investigation found that most of the pneumonia cases were the operators of South China Seafood City.

On January 1, 2020, the South China seafood wholesale market was closed, and the public places in Wuhan, especially the farmers’ markets, were locked down in the interest of public health and efforts to control the spread of this deadly virus. In addition, the disease prevention knowledge was widely publicized to enhance public self-protection awareness. People were urged to cooperate with the national and provincial pathogenic research especially with the National Health Commission to timely report the epidemic information to the World Health Organization.

It was clear that this lockdown had a significant effect on people’s daily life. People cannot go to the public since gathering together will make it easier to be infected. School cannot set very large events like concert, sports meeting. Everyone had to wear masks anywhere and anytime which make communication very difficult.

What happened to the transportation, the economy, the unemployment and how families were affected and in return how that affected the children.

1. Transportation: Do not take public transportation when you have respiratory symptoms such as fever. Take less public transportation to avoid infection.
2. The economy: Many shops closed: they could not have many profits because of the reduction on customers.
3. Families: people had more time to stay with their family members because they seldom go outside due to the pandemic. we have a deeper understanding of family affection. In the past, we always felt that the holidays, especially the Spring Festival holidays, were too short, and the family members gathered less and left more. We felt that it was not easy to get together. This epidemic situation made us spend a super long “holiday”. We all stayed at home, and the whole family ate, lived, slept, and slept together for such a long time as never before. Our understanding is more comprehensive and further. Family is deeper.

The change of thought is a deeper understanding of life. The outbreak of the epidemic caught many people by surprise. Due to improper prevention and control or inadequate understanding, many people were infected with the virus and lost their lives. The healthiest of us, while feeling lucky, are deeply saddened by the fragility of life and the inconstancy of life. It used to be said that the moon has its ups and downs, and people have their ups and downs. It is the true facts that touch the deepest part of the mind.

3. Impact on Education at the School Level: Short Term Effects

3.1 The nature of the short-term effects in China itself

The major short-term effect was the very suddenness of the crisis. It was extremely disruptive of the life as people knew it. The range of effects included closing of businesses, lay- offs, closing of schools, shortages of food and essential supplies and generalized increase in uncertainty. The situation was particularly serious for parents with young children since after school closure, their schooling was interrupted and at the same time the parents were obligated to take care of them.

Thus, the major short-term or immediate effects could be job-related for the adults which meant financial uncertainty and budgetary crisis. Secondly, disruption of family life especially jeopardized the education of the school-aged children. Thirdly, the women in the society had to share a disproportionate burden of this crisis. Besides facing the heath crisis that everybody else faced, they disproportionately lost jobs, and, at home, they were expected to take care of the household duties such as cooking, cleaning and, on top of that, make sure of home-schooling of their children.

The picture shows that during the epidemic, which city helped which particular area.

The modernization of national governance system and governance capacity will be further accelerated, and the level will be further improved, especially the ability of defense against major biological risks will get new breakthroughs. The outbreak of the epidemic has conducted a practical test on China’s governance system and governance capability, which not only shows the effectiveness and achievements of the governance system and governance capability, but also exposes its shortcomings and defects. It provides living data and information for accelerating the improvement and improvement of the governance system and governance capability in the future, and provides a reference for the development of digital, artificial intelligence, robot, blockchain and other modern industries The application and role of science and technology in crisis management and risk prevention and control provide a realistic basis, and provide a rare opportunity for China to turn crisis into opportunity and save danger. This is another wake-up call for China’s biological risk crisis after SARS, prompting China to speed up the modernization of its governance system and governance capacity.

There will be new changes in people’s values. The most glorious and critical moment of human nature. The novel coronavirus pneumonia animal disease animal novel coronavirus pneumonia has been confirmed. For a long time, people have pursued the idea of “everything is human food”. The virus infecting wild animals has caused SARS, Ebola, new crown pneumonia and other viruses to spread to humans. After this outbreak, there will be great improvements in legislation and people’s habits, animal ethics and values. We should deal with the relationship between man and nature with a more rational attitude, respect, and revere nature, and treat wildlife well. The actual combat of the epidemic prevention and control not only highlights the glory of human honesty, kindness, integrity, justice, love, and courage, but also has a new sublimation in dealing with the relationship between people. People sincerely respect the ordinary medical staff, soldiers, farmers, workers, and those who are not afraid of sacrifice and sacrifice for everyone What ordinary fighters, volunteers and donors have done shows the importance of harmonious relationship between people, which makes people turn their attention from power, wealth and fame to respect and revere life.

Thus, it is very clear that the COVID -19 crisis had severe and unanticipated immediate effects which left the society in a virtual shock.

The novel Coronavirus (COVID-19) had spread across 215 countries and territories in all 5 continents by May 12, 2020. On January 30, 2020, the unrelenting spread of COVID-19 prompted the World Health Organization to declare it a public health emergency, and on March 12, 2020 COVID-19 was declared a pandemic. This pandemic has caused great social and economic disruptions, leading to a decline in consumption, investment, services, and industrial production activities around the world. In particular, the insurance market in mainland China has been severely affected. The year-on-year (YOY) growth rate of gross premium in the first quarter of 2019 was 15.8%, while the rate was 6.27% in the first quarter of 2020, indicating a decrease of 9.53 percentage points in growth rate. In addition, the monthly YOY growth rates of premium in the first three months of 2020 were −12.53%, −21.35%, and 1.93%, respectively, showing a sharp decline compared to the rates of 23.97%, 10.19%, and 6.76%, respectively, in the same periods of the previous year.

While research on COVID-19 and equity markets globally is evolving (Ali, Alam, and Rizvi 2020; Haroon and Rizvi 2020), a literature has developed that examines the impact of pandemics on various energy issues (Apergis and Apergis 2020; Fu and Shen 2020; Gil-Alana and Monge 2020; Liu, Wang, and Lee 2020; Narayan 2020; Qin, Zhang, and Su 2020). In addition, there are also studies on socioeconomic factors (Fang, Long, and Yang 2020; Qiu, Xi, and Wei 2020), pandemic mitigation (Chudik, Pesaran, and Alessandro 2020), and households’ spending and consumption (Baker et al. 2020; Eichenbaum, Sergio, and Mathias 2020). However, there is no empirical study on the impact of the pandemic on the insurance market. The fundamental function of insurance is to protect people from risks. Encountering the catastrophic hazard of COVID-19 has highlighted the importance of a well-functioning insurance market. Thus, it is of great practical and policy value to study how the pandemic affects the insurance market.

In this empirical study, we employ monthly provincial-level panel data and fixed-effects models to study the impact of COVID-19 on China’s insurance market. We find that COVID-19 had a significant adverse impact on the insurance market in the short term due to the limitation of insurance marketing channels and the suppression of household insurance demand. The development of social security and digital insurance could help alleviate the negative impact of COVID-19 on the insurance market. This study provides insights into the impacts of COVID-19 on the Chinese insurance market.

3.2 Impact on Health

Risk of Severe Illness from COVID-19. People with moderate to severe asthma may be at higher risk of getting very sick from COVID- 19. COVID-19 can affect your nose, throat, lungs (respiratory tract); cause an asthma attack; and possibly lead to pneumonia and acute respiratory disease.

During the epidemic period, travel was restricted to varying degrees, and we spent several times more time at home than before. In the serious lack of exercise, subtle changes in our body function, which is the most affected metabolic function.

Our body will take in a large amount of toxins through diet, breathing, percutaneous absorption and other reasons every day. In addition, the waste generated by our own metabolism will deposit in the body, which will increase the burden of various organs of the body, and increase the risk of thrombosis, arteriosclerosis, hypertension and other cardiovascular and cerebrovascular diseases.

When the metabolism function of human body is normal, these substances will be gradually discharged from the body. But the pressure of modern life, including lifestyle and other factors, most people’s metabolic function is disorder, resulting in toxins cannot be discharged from the body. Especially during the epidemic period, many people appeared dizziness, insomnia, forgetfulness, abdominal distension, diarrhea, constipation, palpitation, shortness of breath, arrhythmia, and other “poisoning” phenomenon. This is a serious sub-health symptom, if left alone, will gradually develop into cardiovascular, cerebrovascular, tumor and other serious diseases.

Of course, these symptoms can be gradually improved by changing daily habits. However, due to the pressure of work and life, coupled with environmental pollution and food hygiene, it is almost impossible for modern people to really restore their body to a real healthy state. Currently, we need to take some measures for health intervention.

3.3 Financial Impacts

Here, quotes the extent of the unemployment due to the epidemic and extent of the closing of the businesses and loss to the economy and the impact on employment both men and women. See if you can clearly show that women suffered higher unemployment. The financial impact comes primarily from (a) being out of work and/or getting infected of ill because of the virus.

In Keynesian economics, “uncertainty” refers to the risk that cannot be insured. The recognition of uncertain risk cannot be judged by the actual loss caused by the event. Compared with many other epidemics, the mortality rate of the new coronavirus epidemic is not necessarily very high, but the main reason why people panic is the uncertainty of the mode of transmission and the method of prevention and control of this epidemic. It is this uncertainty of the new coronavirus epidemic that leads to people’s sense of insecurity, so that people take more cautious preventive actions than other epidemics, and reduce a large number of tourism, entertainment and other activities, and correspondingly reduce a large number of consumer activities，so at this stage, in order to avoid the occurrence of small probability events, people tend to “make a mountain out of a molehill” or even “make something out of nothing”, and take a wide range of preventive measures. This will inevitably increase the cost of economic activities.

The impact of the new coronavirus epidemic on the economy is a typical external impact, which is not from the internal economy, but from external factors. This external factor has two characteristics, one is sudden, the other is caught off guard. External shocks will certainly and are interfering with China’s economic growth, and even blocking some industries (such as tourism and entertainment), but in the long run, they will not block China’s economic growth and seriously unbalance China’s economy. Therefore, the nature of the new coronavirus epidemic crisis is not an economic crisis, but a social crisis and psychological crisis caused by the social public health crisis; the industry decline reflected by the crisis will not be normal, but a temporary phenomenon of rapid economic growth. We should have a clear understanding of this. The internal cause is the basis, and the external cause is the condition. Objectively speaking, China is a big country with a huge market, and domestic demand is becoming the leading force of the economy. External changes will have a considerable impact on China’s economy, but not enough to form a dominant impact. No matter how strong the external shock is, the key lies in the anti- shock ability of various industries, the anti-shock strategies of various departments and the willpower of Chinese people to cope with the external test.

3.4 Impact on Learning

Different families have different access to the Internet, so students may meet problems when having online classes.

For students who want to go abroad for further study, they probably meet lots of trouble. Those who are in China cannot go home to reunite with their families, while those who are abroad cannot go back to China to reunite with their families.

Since the epidemic erupted during the Chinese Spring Festival, most Chinese students were not able to get together with their family members and relatives.

In terms of study, there will certainly be some delay. I do not know about it in foreign countries. In China, most universities only start classes in September. In the first half of the year, online courses are the main course. How much can I learn? How much can you learn?

As I know, lots of graduators who wanted to enter American universities can only stay at home, having online courses, because when China over comes the epidemic, other countries like Japan, USA, UK also erupted the COVID-19 disaster.

Students who only had online courses could not experience the campus life abroad or at home. And because of the different time zones, students taking foreign courses had to sleep in the morning and study in mid-night. Their time had been inversed.

Schools across the nation are closing to stop the spread of COVID-19 and in the scramble to provide at-home learning, a major problem has risen to the forefront: millions of American students don’t have reliable access to the internet.

According to recent federal data, approximately 14 percent of U.S. families with school-age children lack high-speed internet. Most of those families are low-income or live-in rural areas. While there are plenty of best practice guides available for online learning, strategies for bridging the digital divide are scarce.

The COVID-19 crisis has forced education systems worldwide to find alternatives to face-to-face instruction. As a result, online teaching and learning have been used by teachers and students on an unprecedented scale. Since lockdowns – either massive or localized – may be needed again in the future to respond to new waves of the infection until a vaccine becomes available, it is of utmost importance for governments to identify which policies can maximize the effectiveness of online learning. This policy brief examines the role of students’ attitudes towards learning in maximizing the potential of online schooling when regular face-to-face instruction cannot take place. Since parents and teachers play a fundamental role in supporting students to develop these crucial attitudes, particularly in the current situation, targeted policy interventions should be designed with the aim of reducing the burden on parents and help teachers and schools make the most of digital learning.

Impacts of COVID-19 pandemic on international higher education and student mobility Research findings of this study on Mainland China and Hong Kong university students’ attitudes toward studying abroad have approved the negative impact brought by the COVID-19 pandemic on international higher education and student mobility. The barriers for students to pursue their further degrees overseas include travel bans, visa restrictions, and campus lockdowns in destination countries, as well as students’ and their families’ worries on health and safety.

Some practical reasons like the delays of English tests also prevent students from completing the application in time (Mercado, 2020). The impacts of the pandemic on international higher education are manifested in various aspects. As to student mobility, the decrease of international students due to the pandemic will bring a significant impact to overseas higher education institutions, especially for those that financially depend on the tuitions of international students (Marginson, 2020a; Tesar, 2020). For example, the UK universities would face an approximately £2.5 billion loss in tuition income in the new academic year (University and College Union, 2020). Meanwhile, with the international students becoming scarce resources, the competitions for them will increase in international higher education. Moreover, the rate of recovery from the pandemic and post-pandemic governance will become a significant factor for destination countries to attract international students (Goris, 2020; Marginson, 2020a). This study argues that the domestic job market will become competitive because college graduates will stay for jobs instead of studying abroad. The predicted global economic recession will exacerbate this effect after the pandemic (Mercado, 2020).

3.5 Psychological Impacts

The novel coronavirus pneumonia epidemic is a crisis for the public. Crisis events have three characteristics: sudden and unpredictable, bring tension and pressure to people, the usual initial method cannot solve people’s psychological crisis, is the normal response to crisis events, and people will have corresponding stress reaction, which will last about 6-8 weeks. Stress psychological reaction can be divided into emotional reaction, self-psychological defense reaction and behavioral reaction. The most common emotional reactions are anxiety, anger, guilt, fear, depression, helplessness and so on. When dealing with stress, individuals have an adaptive tendency in their internal psychological activities, that is, self-psychological defense reaction, to extricate themselves consciously or unconsciously from troubles and relieve their inner uneasiness, to restore emotional balance and stability.

Oxford Department of Psychiatry, also found that people with a pre-existing psychiatric disorder were 65% more likely to be diagnosed with COVID-19 than those without. The researchers say this finding was unexpected and needs further investigation. In the meantime, they say, having a psychiatric disorder should be added to the list of risk factors for COVID-19.

Sufferers of “long COVID” – who are still experiencing symptoms months after testing positive – also appear to experience mental health issues, which can be triggered by a range of factors including post-traumatic stress disorder (PTSD), lethargy, fatigue and olfactory disorders such as a loss of their sense of smell.

Even for those who have not tested positive, lockdown measures have increased feelings of loneliness, isolation, restlessness and anxiety, as millions of people have been quickly forced to adapt to new realities and make drastic lifestyle changes. According to the Royal College of Psychiatrists, which represents 18,000 psychiatrists in the UK, more people are seeking crisis mental health services as a result of COVID-19.

Pandemics have had a detrimental impact on the mental health of affected populations throughout history. For example, The Lancet reported that outbreaks of the Ebola virus caused “widespread panic and anxiety, depression resulting from the sudden deaths of friends, relatives, and colleagues, and stigmatization and social exclusion of survivors.” And the Spanish Flu pandemic of 1918-1919 had a long-standing impact on the mental health of survivors as a result of the massive and sudden loss of life which plunged many into a chronic state of helplessness and anxiety.

Even though the link between pandemics and mental health is well-documented and researched, there is still more research needed to fully understand the causes and solutions. Scientists are still examining how COVID-19 affects the brain and the central nervous system to determine how much that plays a role in receiving a diagnosis vs the trauma of suffering with symptoms, and in some cases narrowly avoiding death.

3.6 Are there any positive impact as well?

Only 15% more – not much Appreciation and desire for a simpler uncomplicated life

Rapid medical advance and technology advancement. Young children may learn new skills by having to use online learning tools.

1. Protection of wild animals and punishment of crimes of eating wild animals. This will undoubtedly be beneficial to the harmony between man and nature in the future.
2. Exposed some social problems, need to establish, and improve a set of disaster prevention and control system.
3. The epidemic situation in China has been basically controlled and the national confidence has been improved.
4. China takes the lead in controlling the epidemic in the world, aiding foreign countries, deepening international cooperation and enhancing international status.

4. Impact on education at the school level: long-term effects.

4.1 What is the nature of the possible long-term effects

Besides the short-term effects noted above, it is easy to imagine the lingering or the long-term effects of COVID_19 pandemic. This section is going to note several of these long-term effects.

4.2 Long Term Impact on Employment Prospects Employment issues

Employment issues

In China, campus recruitment is major means for students to find employment. Campus recruitment is divided into autumn recruitment and spring recruitment. The autumn recruitment is generally aimed at students who have no plans to go for higher degrees, and want to work directly after graduation. Spring recruitment is aimed at those students who are otherwise accomplished, but performed poorly in postgraduate entrance examinations and hence need to find employment. For prospective graduates in 2020, the adverse impact of the epidemic on employment prospects is a matter of great concern. For students who participated in the autumn recruitment, whether they can graduate as scheduled becomes an important factor in deciding whether they can successfully enter the job market. Meanwhile, domestic and large enterprises have been adversely affected by the epidemic and whether demand for students as employees will accordingly shrink is causing great uncertainty.

For students waiting for the spring recruitment, this period is also very difficult. The spring recruitment was canceled due to Covid-19. Whether it will be reorganized after the full reopening of schools depends on too many unknown factors. Most of the students waiting for the spring recruitment either participate in the postgraduate entrance examination or take the public examination. Nevertheless, due to the epidemic, the timing for these tests has also become uncertain. It is feared that China may experience the largest spurt in rates of graduate unemployment in the last twenty years.

Employment

In China, campus recruitment is the main means of College Students’ employment. Campus recruitment is divided into autumn recruitment and spring recruitment. The target of autumn recruitment is generally the students who want to work directly after graduation without further education plan. Spring recruitment is targeted at students who have other achievements but do not perform well in the postgraduate entrance examination, so they need employment. For the fresh graduates in 2020, the adverse impact of the epidemic on employment prospects is a very noteworthy issue. For the students who participate in the autumn recruitment, whether they can graduate on time becomes an important factor to decide whether they can enter the job market smoothly. At the same time, large domestic enterprises have also been adversely affected by the epidemic. Whether the demand of students as employees will shrink correspondingly also brings great uncertainty.

It’s also a tough time for students waiting to be recruited in the spring. Spring recruitment was cancelled because of covid-19. Whether the school will be reorganized after the full reopening depends on too many unknown factors. Most of the students waiting for spring enrollment either take the postgraduate entrance examination or take the public examination. However, due to the epidemic, the timing of these tests has also become uncertain. There are concerns that China may experience the biggest surge in graduate unemployment in nearly 20 years.

4.3 Long term Impact on Learning Opportunities/education

Impact on studying abroad

According to news from the Ministry of Education, there are about 1.6 million overseas Chinese students, and currently there are still about 1.4 million abroad 5. It had seemed earlier that the interest in studying abroad among Chinese students was on the rise with 413,900 Chinese studying abroad in 2013 and 662,100 in 2018 6. The countries to which students go for higher education has diversified over the last few years. 7. The impact of the epidemic on the overseas study programs remains uncertain because much will depend on the decisions of universities in other countries to invest in higher education as well as their policies on migration. The global outbreak of the epidemic may lead to the postponement of enrollment of foreign students in many universities posing a dilemma for those students who have already been admitted. Government-sponsored overseas education is also greatly affected, including joint training of students and visiting scholars. Since the trajectory of the coronavirus remains uncertain many programs of training that were premised on global partnerships might need to be suspended.

In summary, the delay of graduation and rise of unemployment is inevitable. Overseas students who have already found a job, similar to domestic students, also face the risk of delayed entry into the work force or the cancellation of their positions. The long-term effects of such delays and uncertainties on the students who were accustomed to thinking that higher education will give them a secure future will need to be carefully studied in the coming years and plans for mitigation of these hardships will be an important project for the government and the universities alike.

The impact on postgraduate education inland

Despite the increasing interest in studying abroad, the poor management of the Covid-19 pandemic in many countries has made some families look at the prospect of overseas studies for their children more critically now. Accompanied by the pressures for adequate jobs mentioned above, the prospective graduates might prefer to take postgraduate admission examination, increasing pressure on domestic graduate admissions. The number of participants in the postgraduate entrance has exceeded 3.41 million in 2020 8. The epidemic will undoubtedly make the situation worse next year.

Apart from the students, the Ministry of Education and the colleges are under great pressure as they plan for the organization of examinations for the postgraduates, the written tests that have to be administered to such large numbers of students, and little experience with online testing methods. The biggest challenge is going to be how to alleviate the unemployment problem for the educated youth and restore faith in the Chinese economy.

As we all know, students have diversified to receive higher education. They will go to various countries for further study. The impact of COVID-19 on overseas study projects is still uncertain because each country’s policies are different. The global explosion of the new crown may cause many universities to delay their applications, and the students who have already been admitted are in a dilemma because they can only take online courses after paying the same tuition fees. As the trajectory of coronavirus transmission is still uncertain, some global activities may be forced to suspend.

Graduation will be delayed and unemployment will rise because of the epidemic. It can be said that graduates at home and abroad are facing the same problem. The long-term impact of these delays and uncertainties on students who are used to thinking that higher education will bring them a safe future needs to be carefully studied in the next few years. The plan to alleviate these difficulties will be an important project of the government and universities.

Despite people’s enthusiasm for studying abroad, the poor management of covid-19 in many countries makes some families prefer boring exam-oriented education to international education. If it goes on like this, it may be worse.

In addition to students, the Ministry of education and universities are also facing great pressure when planning to organize postgraduate examinations. However, there is little experience in online examination methods for large-scale examinations in China. The TOEFL or AP test for international students can be implemented online. It is clear that the university entrance exams in China will never be online, because many would cheat if in that case. The biggest challenge will be how to alleviate the unemployment problem of educated youth and restore confidence in China’s economy.

5. Concluding Remarks and Future Research

In this paper, I have examined and analyzed the nature of the impact of COVID-19 on school learning in China, a topic not only of great interest to me personally, but also of great significance for the world at large especially China.

The sudden outbreak of COVID-19 has brought many disadvantages to countries around the world including China. Focusing on China, its health, well-being, economy, transportation, and schooling along with many other sectors have been adversely affected in the first year and a half since this outbreak. The focus of this paper is the impact on school learning both in the short as well as the long run.

After an introduction in the first section, I present the history of the pandemic to provide the proper perspective to the issue at hand. The following two sections constitute the heart of this research study where I explore the short and the long-term impacts of COVID-19 on school learning China.

In terms of the short term, this paper finds that major impacts have been on the health, psychology, economics, and education part. People’s health conditions are weakened by this pandemic period, and they became afraid of this. The rate of unemployment rose for may shops closed because of the epidemic. Education was quite terrible because students could not go to school as usual. They stayed at home for months until the situation got better. While having online classes, they met a lot of problems.

On the other hand, in terms of the long-term, this paper finds that major impacts have been in terms of good effects on China, like, cities in China tried to work together to overcome this difficulty. Chinese medical power became stronger because many people were waiting to be cured, etc.

Future research.

Of course, it also promotes the rapid development of science and technology in human society. In the short term, the situation of students in class has changed greatly, from face-to-face teaching to online teaching. Although this is the best way during the epidemic period, it still has disadvantages. Moreover, COVID-19 has also aroused many students’ thinking. They organize related speeches, research, and other activities. In the long run, the employment of students is facing great difficulties. The life trajectory of many graduates may be changed because of this epidemic. The postponement of recruitment and examination, the postponement of graduation, and the change of teaching methods are unprecedented. Many families are also hesitant about whether they should study abroad or stay at home.

To study these topics, I investigated a lot of materials, read a lot of literature, and found many useful articles to help my research. Some lovely pictures and scientific charts have also become a great help. However, there are still some deficiencies in the study, such as the limited information, I did not conduct a questionnaire survey of the surrounding population, nor did I conduct further data analysis on the charts.

In future studies, I may not be confined to domestic surveys. I will look at the whole world and study the different effects of COVID-19 on different countries and different policies.

References

1. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/asthma.html
2. https://www.kqed.org/mindshift/55608/14-tips-for-helping-students-with-limited-internet- have-distance-learning
3. http://www.oecd.org/coronavirus/policy-responses/strengthening-online-learning-when- schools-are-closed-the-role-of-families-and-teachers-in-supporting-students-during-the- covid-19-crisis-c4ecba6c/
4. https://www.researchcghe.org/perch/resources/publications/wp54to-publish.pdf
5. https://americanethnologist.org/features/collections/covid-19-and-student-focused- concerns-threats-and-possibilities/analysis-on-the-influence-of-epidemic-on-education-in- china
6. https://www.tandfonline.com/doi/full/10.1080/1540496X.2020.1791074?scroll=top&need Access=true&
7. https://www.gavi.org/vaccineswork/anxiety-depression-and-insomnia-impact-covid-19- mental-health?gclid=EAIaIQobChMI-Jitqu2H8AIV4DytBh3FNwJ2EAAYASAAEgIUoPD_BwE

About the author

Helen Zhang

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]]> https://exploratiojournal.com/sars-data-analysis/?utm_source=rss&utm_medium=rss&utm_campaign=sars-data-analysis Mon, 30 Aug 2021 03:57:20 +0000 https://www.exploratiojournal.com/?p=1134 Seoyeon Cho

The post SARS Data Analysis appeared first on Exploratio Journal.

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Author: Seoyeon Cho
February 9, 2021

1. Introduction

Since the beginning of 2020, the economies and social activities of global markets ground to a halt due to the rapid spread of the novel contagious disease caused by Coronavirus from Wuhan, China. Scientists named this virus as ”SARS CoV 2” and the disease it causes as ”Coronavirus Disease 2019” (COVID-19). SARS, also known as Severe Acute Respiratory Syndrome, is a disease that can be easily spread through surfaces and saliva. It was first identified in February 2003, and has reemerged since then. The World Health Organization (WHO) first declared the new outbreak as a public health emergency of international concern in January, 2020 but soon declared the crisis a pandemic as the virus spread exponentially in March, 2020. COVID 19 has now spread to more than 200 countries in the world and has caused 1.9 million deaths.

2: R script

This is an R chunk with no plots:

>sarsdataset <- read_csv("sars_2003_complete_dataset_clean.csv", + col_types = cols(Date = col_date(format = "%Y-%m-%d")))

>#View(sarsdataset)

>names(sarsdataset

[1]	"Date"	"Country"
[3]	"Cumulative number of case(s)" "Number of deaths"	
library(readr)
[5] "Number recovered"

names(sarsdataset)[3]<-"CumNumber"

names(sarsdataset)[4]<-"Deaths"

names(sarsdataset)[5]<-"Recovered"

#install.packages("tidyverse")

library(tidyverse)

#install.packages("ggplot2")

library(ggplot2)

str(sarsdataset)
tibble [2,538		5] (S3: spec_tbl_df/tbl_df/tbl/data.frame)
$ Date	:	Date[1:2538], format: "2003-03-17" "2003-03-17" ...
$ Country	:	chr [1:2538] "Germany" "Canada" "Singapore" "Hong Kong SAR, China" ...
$ CumNumber:		num [1:2538] 1 8 20 95 2 1 40 2 8 0 ...
$ Deaths	:	num [1:2538] 0 2 0 1 0 0 1 0 2 0 ...
$ Recovered:		num [1:2538] 0 0 0 0 0 0 0 0 0 0 ...
- attr(*, "spec")=

.. cols(

..   Date = col_date(format = "%Y-%m-%d"),

..   Country = col_character(),

..Cumulative number of case(s)  = col_double(),

..Number of deaths  = col_double(),

..Number recovered  = col_double()

.. )

>sarsdataset$Country <- as.factor(sarsdataset$Country)

# Explore data for individual country

>

>list_Country<-levels(sarsdataset$Country)

>sarsdataset$Country <- as.factor(sarsdataset$Country)

>rev(sort(table(sarsdataset$Country)))[1:5]
Thailand	Singapore Hong Kong SAR, China	
96	96	96
Germany	China	
96	96	
>Country0<-list_Country[11]
>countryindexes<-c(6,11,27)
>countryindexes<-c(1:length(list_Country))
>list_Country[countryindexes]
[1]	"Australia"	"Belgium"	"Brazil"
[4]	"Bulgaria"	"Canada"	"China"
[7]	"Colombia"	"Finland"	"France"
[10]	"Germany"	"Hong Kong SAR, China" "India"	
[13]	"Indonesia"	"Italy"	"Japan"
[16]	"Kuwait"	"Macao SAR, China"	"Malaysia"
[19]	"Mongolia"	"New Zealand"	"Philippines"
[22]	"Poland"	"Republic of Ireland"	"Republic of Korea"
[25]	"Romania"	"Russian Federation"	"Singapore"
[28]	"Slovenia"	"South Africa"	"Spain"
[31]	"Sweden"	"Switzerland"	"Taiwan, China"
[34]	"Thailand"	"United Kingdom"	"United States"
[37]	"Viet Nam"		

With Sweave files, there is only one figure per chunk

countryindexes<- c(6)

for (j in countryindexes){

+   Country0<- list_Country[j]

+ sarsdataset0<- sarsdataset[ sarsdataset$Country== Country0,] + #print(sarsdataset0)

+ #ggplot(data=sarsdataset0, aes(x=Date, y=CumNumber)+ geom_line()

+

+ par(mfcol=c(2,2))

+ plot(sarsdataset0$Date, sarsdataset0$CumNumber, type="l",

main=Country0,

xlab="Date",

ylab="Cumulative Number of Cases")


plot(sarsdataset0$Date, sarsdataset0$Deaths, type="l",

main=Country0,

xlab="Date",

ylab="Deaths")

+

plot(sarsdataset0$Date, sarsdataset0$Recovered, type="l",

main=Country0,

xlab="Date",

ylab="Recovered")

+

plot(sarsdataset0$Date, sarsdataset0$Deaths/sarsdataset0$CumNumber,type="l",

main=Country0,

xlab="Date",
ylab="Death Rate")

}

3. From Google Docs

Background information

The purpose of this research paper is to critically understand the past situation of the SARS outbreak in 2003 with the objective of projecting the near future conditions of the COVID 19 crisis. This effort com-pares and contrasts quantitative information available from the two crises. It now has been almost a year since the outbreak started with significant impacts on human beings all over the world but to date, there have been no significant improvements or comprehensive solutions in countries of the world. The critical, analytical understanding of the SARS outbreak presented in this paper, improves the potential to better predict possible outcomes of the COVID 19.

4. Research Topic

4.1 Issues

Contrasting each country and analyze the SARS impact * examining the progression of disease in each country Interesting points that may arise: * Death rates may be higher in lower income countries * World Health Organization classifies countries by geography and by income level; perhaps there are patterns in expo-sure levels and death rates * When comparing progression of disease by country, accounting for different population sizes of the countries (focus on percentage increases/changes) and possibly residential density of countries. * Degree of government control on quarantines and isolation of active cases.

4.2 Connection between the covid and SARS

• Countries that experienced SARS were possibly better prepared to deal with COVID-19 (e.g., testing protocols and other .)

SARS – data, analysis (organized discussion with logical flow) (list the actual number on the data)

5. Plots from GGPlot

6. Analysis

The similarities between the countries that had most death rates.

This graph indicates the death rates of different countries along the time due to the impact of SARS outbreak back in 2003. One can easily notice the highest deaths has been recorded by China, second by Hong Kong, third by Taiwan, and fourth by Canada.

One can also notice that these four countries can be grouped into two parts , where one has recorded relatively significant number of deaths and another with less significant death rate. China and Hong Kong can be grouped as ”most death rate” group whereas Taiwan and Canada can be grouped as ”non-significant death rate” group. This separation could have been done easily because of the distinct difference in the number of deaths.

The very distinct similarities that ”most death rate” group shared was the exponential growth of number of death from April to late May. The green and blue graphs showed almost an identical exponential growth during that time span and slowly stopped increasing and remained almost constant from June to July with constant death rate of 380 and 300 for China and Hong Kong respectively.

Other than the information from given graph, one can also assume that the ”most death rate” group were similar in a sense that they were both sharing / touching the border of China. This may be very obvious and does not seem like an important fact but can’t be ignored as both SARS and COVID-19 were emerged in China and spread to other countries rapidly. (Add another graph with percentage deaths (death rate) as a percent of cases to compare countries)

The similarities between the countries that did not have many cases From the figure 1, one can also notice the similarities between the countries that did not have such high death cases; Taiwan and Canada. It is that compared to ”most death rate” group, the increase of the death case of these two countries was not very exponential but quite steady. Canada showed very linear increase of death cases along time and Taiwan with small exponential growth during May but not as significant as that of China or Hong Kong.

The another distinct similarity that one can know is that these two countries, Canada and Taiwan, are not touching China’s national border directly. There may be a lot of Chinese immigrants in Taiwan and Canada but they both are not directly touching China in terms of country’s borer line.

7. Worst Experienced Country

In order to pin down which country experienced the worst outbreak, one has to define ”worst experience” first. This is important because one could think the country with most death cases had the worst experience whereas another can argue that the worst experience should be based on the percentage of number of death per national population. In this report, the ”worst experience” will be based on the total number of SARS case. This is because the absolute amount of people who suffered from this disease matters more than the numbers of death rate or the number of deaths. According to figure 2, it is clear that China had the highest cumulated number of SARS case among 4 countries with overwhelming 4800 cases, almost the double of Hong Kong’s SARS case

8. Worst Impacted Country Among Top Rated Countries

Just like how ”worst experienced” was defined in the past paragraph, ”impact” will be defined as how much of a shock SARS brought to a country. In other words, ”impact” will be measured based on the percentage of death per the nation’s population.

Taiwan: 24 mil Canada: 38 mil Hong Kong: 7.5 mil China: 1.4 bil

Even without the detail calculation, one can see that the death / nation pop-ulation is the highest for Hong Kong as it has the smallest number of population but almost the same number of death cases according to figure 1. Therefore, one can argue that Hong Kong had the worst impact among the four given countries.

9. Seriousness of SARS Crisis

Unlike other diseases like cancer or heart disease, the problem with SARS was the fact that this disease was so contagious. This is important because person with cancer or heart disease can live their normal life even after recognizing they have those diseases. However, in case of SARS, the other people who do not carry the disease cannot function properly because of the fear that this unseeable virus might be traveling as an aerosol in mid air and infect them. This fear cannot be sorely explained or quantified with graphs and numbers on figures. Which also explains why the numbers and the figures can not properly explain the seriousness of SARS. SARS did not only kill people but killed the economics of not only these four countries but the many other countries who were closely related to China. Obviously, the death of many people is a deep pain that can not be forgotten but the economic damage that SARS caused was very significant.

From figure 3, one can distinguish the differences and similarities between four countries.

First of all, Canada showed a very distinctive characteristic that other 3 countries never shown. During the late February, the deaths/cumnumber of Canada spiked all the way up to 0.3 but it soon died to 0.1 and slowly increased and remained constant at about 0.15. This kind of instant spike, decrease and remaining of the rate has not been shown in any other countries. The other two countries, Hong Kong, and Taiwan, never shown an instant spike like Canada did but rather slower exponential increases. However China has shown a very different rate graph as well. China was the only country that had linear increase among 4 countries in figure 3.

For the death rates why does death rates stop dramatical increases during June?

From the figure 1, one can see that the exponential growth of death rate for China and Hong Kong has been remained until early June but the growth has significantly died from June. A lot of reasons could be the answer to this dra-matic ease of SARS such as the change of weather, countless efforts of scientists, researchers, and doctors to stop the disease. As all four countries’ death rate has decreased dramatically as time went by, one could assume that the obvious change of weather (from winter to summer) along time has helped the human population to stop the contagious disease, SARS. Another reason for a sudden ease of exponential growth of SARS would be the fact that all four countries’ governments were well aware of the situation with the help of WHO and well managed to stop the spread of virus.

There could be multiple reasons for a stop of dramatical increase during June. One is the change of weather from winter to summer and the increased temperature. Another is the cumulated effort of human beings to stop the virus with research for cures and governments’ desperate effort to stop people from going out.

The country that had most severe crisis and what happened to their country Among these four countries, Hong Kong had the most severe crisis with the highest percentage of both death and cumulated case number per nation’s pop-ulation. The death rate of SARS case in Hong Kong were usually around 20% but it went up close to 55% among elders.

Because other normal respiratory diseases’ death rate were about 1% back then, the SARS did not seem to be a significant issue at the beginning of the outbreak. However, the death rate was significantly high specifically in Hong Kong since they were most vulnerable to the disease as they had the highest portion of elders among the four given countries in the data. This was a very significant fact that changed the SARS’ outcome back in 2003. Furthermore, Hong Kong was not very well prepared for these kind of outbreaks as they have one of the highest population density in the world which meant Hong Kong was the best possible option for SARS outbreak to exponentially damage the country and the economics of it.

Due to SARS outbreak in 2003, Hong Kong’s tourism industry had to face the worst period so far. As you could imagine, with this outbreak ongoing in Hong Kong, no one in other countries would have voluntarily wanted to visit and explore Hong Kong because of the SARS. According to Paul Chan Mo Po, finance minister of Hong Kong in 2003, the number of foreign visitors decreased to 40% compared to that of 2002. This kind of economic impact did not only hurt the tourism industry but the local and international economics of Hong Kong as well. This damage was more severe for Hong Kong since they had such a dense country compared to others like Canada or China in terms of both landscape and population density. It completely frozen the economics and the country and took years of effort for Hong Kong and their people to recover from SARS.

10. Prediction

Compare the conclusion of sars and the current cove pandemic SARS could have been completely controlled within only 6 months of time with international effort back in 2003 but the current ongoing COVID 19 pandemic already has surpassed 12 months of time and does not seem to end in the near future. This could be explained with the fact that back in 2003, the world was not as connective as it is now. For instance, traveling was treated as a huge privilege back in 2003 and was not a very common. However, as the world started to globalize exponentially, traveling was not a big privilege for mange people and became common for everyone in 2021. One can believe that the significant reason why SARS could have ended much faster, only in 6 months, compared to COVID was because it was not as globalized back in 2003 as it is now in 2021.

SARS ended only in 6 months and only caused 774 deaths but the current COVID already has killed more than 1.9 million people internationally all over the world. It is very distinct that the SARS was only spread to few countries whereas COVID has been spread to more than 200 countries. This may be the reason why COVID is not concluding like how SARS has concluded, the exponent globalization of the world.

11. Comparison Between SARS and COVID 19

SARS and COVID 19 share the very same virus called coronavirus which is very contagious and causes respiratory diseases. These two also are very similar in a sense that these diseases are much more dangerous for elders or one with existing diseases like obesity, cancer or respiratory disease than others.

It is also similar how the outbreak originated from China and spread to other close countries. As Hong Kong is literally next to China and easy to travel, the virus was able to spread in Hong Kong rapidly just like how COVID19 had spread in Hon Kong as one of the earliest countries in the first several months of the outbreak.

12. Conclusion

In conclusion, the SARS and COVID 19 share the very similar characteristic in a sense that both of them are caused by coronavirus, are very contagious, and are dramatically more dangerous to elders and people with existing diseases. Back in 2003, people were able to successfully stop the SARS as the world was not as globalized as it is now with efforts of scientists, researchers, doctors, and the governments as the virus only spread to few countries. However, the COVID19 now has been spread to more than 200 countries and caused almost 2 million deaths. From the close observation of SARS case, one can conclude that it has surpassed singularity point but the time, effort from researchers and governments will stop this COVID19 in foreseeable future.

13. References

Seladi-Schulman, J. S. S. (2020, April 2). COVID-19 vs. SARS: How Do They Differ? Healthline. https://www.healthline.com/health/coronavirus-vs-sars

Severe Acute Respiratory Syndrome (SARS). (2019, November 1). World Health Organisation. https://www.who.int/health-topics/severe-acute-respiratory-syndrome

E.P.M.K.U.G.D.H.H.N.P.F.C. (2020, July 3). Comparing SARS-CoV-2 with SARS-CoV and influenza pandemics. The Lancet. https://www.thelancet.com/journals/laninf/article/PIIS147 3099(21)00054-2/fulltext

About the author

Seoyeon Cho

The post SARS Data Analysis appeared first on Exploratio Journal.