Sources

Graphic Sources List
Detailed references for individual TooShaky educational graphics and graphic series.

Agent Orange / Toxic Exposure Research Series — Sources

GRAPHICS 10-4-26-13-2026
AGENT ORANGE DESCENDANTS UPDATE — OCTOBER 2026
* U.S. Department of Veterans Affairs (VA) — Agent Orange health effects, birth defects, and benefits information. VA Agent Orange information
* National Academies of Sciences, Engineering, and Medicine — Veterans and Agent Orange: Update 11 (2018), including reproductive health effects and effects on descendants.
* Kelsey, K. T., et al. (2019). “Serum dioxin and DNA methylation in the sperm of Operation Ranch Hand veterans exposed to Agent Orange.” Environmental Health, 18, 91.
Study / PubMed record
* Corsaro, L. (2024). “A new approach to study stochastic epigenetic mutations in sperm methylome of Vietnam war veterans directly exposed to Agent Orange.” Environmental Epigenetics, 10(1).
* Atienza, S., et al. (2026). “Second-generation Agent Orange: Phenomenology of the health experiences of Vietnam veteran progeny.” Nursing Outlook, 74(1),
* Congress.gov — Molly R. Loomis Research for Descendants of Toxic Exposed Veterans Act of 2025, S.2061 and H.R.6005.
S.2061 on Congress.gov
H.R.6005 on Congress.gov
* Agency for Toxic Substances and Disease Registry (ATSDR) — Camp Lejeune Health Studies. ATSDR has studied service members, civilian workers, families, pregnancy outcomes and childhood outcomes.
ATSDR Camp Lejeune Health Studies
* ATSDR — Camp Lejeune Future Generations FAQ. ATSDR states that whether these exposures affect future generations remains uncertain and that human studies have not answered the question.
ATSDR Camp Lejeune FAQ
* ATSDR — Assessment of Evidence for Camp Lejeune Drinking-Water Contaminants. Reviews evidence concerning TCE, PCE, benzene, vinyl chloride and associated diseases.
* Dorsey, E. R., & Okun, M. S. The Parkinson’s Plan: A New Path to Prevention and Treatment. — Environmental contributors to Parkinson’s disease, including pesticides and industrial solvents.
* PubMed / peer-reviewed medical literature — Research concerning pesticides, TCE/PCE, environmental exposures, Parkinson’s disease, epigenetics and possible intergenerational effects.
*U.S. Congress - S. 2061, Molly R.
*Loomis Research for Descendants of Toxic Exposed Veterans Act › - Bill information and legislative actions.
*Official text of S. 2061 › - Research requirements, federal coordination, and public reporting.
Govinfo +1
*Molly Loomis website x - Advocacy resources and information about contacting legislators. This is an advocacy source, not an official government source.
*U.S. Senate Committee on Veterans’ Affairs (March 18, 2026)
Committee Passes Blumenthal’s Bill to Expand Research for Children of Toxic-Exposed Veterans.
Confirms that the Senate Veterans’ Affairs Committee unanimously approved the Molly R. Loomis research legislation. Committee approval does not mean the bill became law.
*https://www.veterans.senate.gov/2026/3/committee-passes-blumenthal-s-bill-to-expand-research-for-children-of-toxic-exposed-veterans
*U.S. Congress — S.2061 (119th Congress)
Molly R. Loomis Research for Descendants of Toxic Exposed Veterans Act of 2025.
Official legislative record for the Senate bill, including its text, actions, and status.
https://www.congress.gov/bill/119th-congress/senate-bill/2061
*National Academies of Sciences, Engineering, and Medicine (2018)
Veterans and Agent Orange: Update 11 (2018). Chapter 8: Reproductive Health Effects and Effects on Descendants.
Reviews scientific evidence concerning reproductive health and possible health effects in veterans’ children and later generations. Concludes that evidence remains inadequate or insufficient to determine associations with the descendant health outcomes reviewed.
https://www.nationalacademies.org/read/25137/chapter/10
*U.S. Department of Veterans Affairs — VA Public Health
Birth Defects in Children of Vietnam and Korea Veterans.
Explains existing VA recognition and benefits involving spina bifida and certain other qualifying birth defects.
https://www.publichealth.va.gov/exposures/agentorange/birth-defects/index.aspAbout these sources: TooShaky uses government health agencies, peer-reviewed research, major scientific reviews, and established medical organizations whenever possible. Inclusion of a study does not mean that the study proves causation. Research involving toxic exposure and future generations is evolving, and sources will be updated as new evidence becomes available.

Diabetes Education Series — SourcesAmerican Diabetes Association (ADA). Understanding Type 2 Diabetes.
Covers insulin resistance, symptoms, treatment, and differences between diabetes types.
American Diabetes Association — Type 2 DiabetesAmerican Diabetes Association (ADA). Diabetes Diagnosis.
Covers A1C, fasting glucose, oral glucose tolerance testing, and diagnostic ranges for diabetes and prediabetes.
American Diabetes Association — Diabetes DiagnosisAmerican Diabetes Association (ADA). Diabetes Complications.
Covers cardiovascular disease, kidney and eye disease, nerve damage, and prevention or reduction of complications.
American Diabetes Association — Diabetes ComplicationsCenters for Disease Control and Prevention (CDC). Diabetes Basics.
General reference for Type 1, Type 2, prediabetes, insulin, risk factors, management, and long-term complications.
CDC — Diabetes BasicsCenters for Disease Control and Prevention (CDC). Diabetes Complications.
Covers heart disease, stroke, kidney disease, neuropathy, eye disease, foot complications, and other effects of diabetes.
CDC — Diabetes ComplicationsCenters for Disease Control and Prevention (CDC). Diabetes and Your Heart. Covers diabetes-related cardiovascular disease and stroke risk.National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK/NIH). Gastroparesis. Covers diabetes as a cause of gastroparesis and its effects on digestion.Buzzetti, R., Tuomi, T., Mauricio, D., et al. (2020). Management of Latent Autoimmune Diabetes in Adults: A Consensus Statement From an International Expert Panel. Diabetes, 69(10), 2037–2047. DOI: 10.2337/dbi20-0017.
This is particularly useful for the part of the series discussing LADA (Type 1.5 diabetes), including autoimmune diabetes in adults, C-peptide testing, progression, and treatment considerations.
American Diabetes Association — LADA Consensus Statement
. Diabetes Series — “Sick Days & Diabetes” (Sept. 23/24)
• American Diabetes Association. Planning for Sick Days / Sick Day Guide for People with Diabetes. https://professional.diabetes.org/clinical-support/patient-education-library
Recovery note: The finished graphic footer specifically named the American Diabetes Association — Planning for Sick Days.
Diabetes Education — Whole-Body Effects / “Beyond Blood Sugar” (Sept. 9)
• American Diabetes Association — diabetes complications and patient-education resources. https://diabetes.org/
• American Diabetes Association — Patient Education Library. https://professional.diabetes.org/clinical-support/patient-education-library
Episode 9 10/14/26
1. American Diabetes Association (ADA) Low Blood Glucose (Hypoglycemia) https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose Signs, Symptoms, and Treatment for Hypoglycemia https://diabetes.org/living-with-diabetes/hypoglycemia-low-blood-glucose/symptoms-treatment 2. Mayo Clinic Diabetic Hypoglycemia — Symptoms and Causes https://www.mayoclinic.org/diseases-conditions/diabetic-hypoglycemia/symptoms-causes/syc-20371525 3. Cleveland Clinic Hypoglycemia (Low Blood Sugar): Symptoms & Causes https://my.clevelandclinic.org/health/diseases/11647-hypoglycemia-low-blood-sugar 4. Endocrine Society Hypoglycemia https://www.endocrine.org/patient-engagement/endocrine-library/hypoglycemia Severe Hypoglycemia https://www.endocrine.org/patient-engagement/endocrine-library/severe-hypoglycemia Be Prepared for Hypoglycemia https://www.endocrine.org/patient-engagement/endocrine-library/pdf-library/be-prepared-for-hypoglycemia

Disability Costs & Financial Realities — “Things People Don’t Think About Until They’re Disabled” (Oct. 1)
• Primary source: Dawn’s original personal-experience text and figures used to build the graphic.
• No external source line was printed on the finished graphic.
Recovery note: This one was intentionally an awareness/personal-experience graphic rather than a research-summary graphic.
“Things People Don’t Think About Until They Are Disabled” — Please Don’t Walk So Fast (Sept. 20)
• Parkinson’s Foundation. Freezing. https://www.parkinson.org/living-with-parkinsons/management/activities-daily-living/freezing
• Parkinson’s Foundation. Trouble Moving or Walking. https://www.parkinson.org/understanding-parkinsons/movement-symptoms/trouble-moving

Dream Reflections — Episodes 1–3 Sources* Parkinson’s Foundation. Sleep Disorders. Covers vivid dreaming, sleep talking/yelling, acting out dreams, REM sleep behavior disorder (RBD), and the high prevalence of sleep problems in Parkinson’s.
Parkinson’s Foundation — Sleep Disorders
* Parkinson’s Foundation. Understanding Sleep Problems in Parkinson’s. Covers vivid dreams, RBD, nighttime movement, medication effects, sleep apnea, and other causes of disrupted sleep in Parkinson’s.
Parkinson’s Foundation — Understanding Sleep Problems in Parkinson’s
* Parkinson’s Foundation. Understanding REM Sleep Disorder in Parkinson’s. Discusses why people with RBD may talk, yell, move or physically act out vivid dreams, along with sleep safety and symptom tracking.
Parkinson’s Foundation — REM Sleep Behavior Disorder
* Boeve, B. F. (2010). REM Sleep Behavior Disorder: Updated Review of the Core Features, the RBD-Neurodegenerative Disease Association, Evolving Concepts, Controversies, and Future Directions. Annals of the New York Academy of Sciences, 1184, 15–54. DOI: 10.1111/j.1749-6632.2009.05115.x. This review supports the educational material about vivid/frightening dreams, dream enactment and RBD’s relationship with neurodegenerative disease.
PubMed record
* St. Louis, E. K., & Boeve, B. F. (2017). REM Sleep Behavior Disorder: Diagnosis, Clinical Implications, and Future Directions. Mayo Clinic Proceedings, 92(11). Covers diagnosis of RBD, loss of normal REM muscle atonia, dream enactment and its strong association with Parkinson’s and related disorders.
• American Academy of Sleep Medicine (AASM) Clinical Practice Guideline for RBD. SLEEP. 2023.
• Postuma RB, et al. Diagnosis and Treatment of REM Sleep Behavior Disorder. Neurology. 2023.
• Zhao Y, et al. Pharmacologic Treatments for RBD:
Systematic Review. Sleep Medicine Reviews. 2026.
*http://ClinicalTrials.gov

MS & PARKINSON’S — A SHARED HISTORYEpisode 1: Two Different Diseases1. Parkinson, James (1817)
An Essay on the Shaking Palsy.
Original historical publication describing the condition later named Parkinson’s disease.https://www.gutenberg.org/cache/epub/23777/pg23777-images.html2. Goetz, Christopher G. (2011)
The History of Parkinson’s Disease: Early Clinical Descriptions and Neurological Therapies. Cold Spring Harbor Perspectives in Medicine, 1(1), a008862.
Explains the early history of Parkinson’s disease and Charcot’s role in distinguishing it from multiple sclerosis and other neurological disorders.https://pmc.ncbi.nlm.nih.gov/articles/PMC3234454/3. One Hundred and Fifty Years Ago Charcot Reported Multiple Sclerosis as a New Neurological Disease (2018)
Historical review describing Jean-Martin Charcot’s 1868 lectures and the recognition of multiple sclerosis as a distinct neurological condition.https://pmc.ncbi.nlm.nih.gov/articles/PMC6262215/4. Jean-Martin Charcot and Parkinson’s Disease: Teaching and Teaching Materials (2018)
Revue Neurologique, 174(7–8), 491–505.
Reviews Charcot’s historical research, clinical observations, and teaching on Parkinson’s disease.https://pubmed.ncbi.nlm.nih.gov/29653830/

Parkinson's Graphic Sources👁️ Parkinson’s & Vision Changes* American Parkinson Disease Association (APDA). Eye & Vision Issues in Parkinson’s Disease. Covers dry eye/reduced blinking, blurred and double vision, eye movement and tracking difficulties, reading problems, and other visual symptoms associated with Parkinson’s.
* Stanford Medicine — Parkinson’s Community Outreach. Vision Issues in Parkinson’s Disease. Educational information regarding visual and eye-related changes that can occur with Parkinson’s.
* Michael J. Fox Foundation for Parkinson’s Research. Vision and Parkinson’s Disease. Educational information about vision changes and Parkinson’s.Parkinson’s Dystonia in the Foot
* Factor, S. A., & Weiner, W. J. Parkinson’s Disease: Diagnosis and Clinical Management. Demos Medical Publishing, 2020.
* Parkinson’s Foundation. Dystonia. Covers painful muscle twisting and cramping, curled toes, foot inversion, medication timing, physical/occupational therapy and botulinum toxin treatment.
* Albanese, A., et al. Dystonia in Parkinson Disease: Clinical Aspects and Treatment. Lancet Neurology. 2019;18(9):881–892.
* Tinazzi, M., et al. Pain in Parkinson’s Disease: A Review of the Literature. Parkinsonism & Related Disorders. 2012;18(Suppl 1):S131–S135.
* Jankovic, J. Medical Treatment of Dystonia. Movement Disorders. 2013;28(7):1001–1011.Understanding the Different “Kinesias” in Parkinson’s
* Parkinson’s Foundation. Movement Symptoms. Covers bradykinesia, dyskinesia, dystonia, rigidity, freezing and other Parkinson’s movement symptoms.
* Parkinson’s Foundation. Understanding Bradykinesia and Dyskinesia. Explains the important distinction between bradykinesia (slowness of movement related to Parkinson’s) and dyskinesia (involuntary movements commonly associated with dopaminergic medication).
* Parkinson’s Foundation. Dystonia. Explains sustained or repetitive muscle contractions, painful cramping, toe curling and foot inversion, including dystonia associated with medication wearing off.
Parkinson’s Education — “The Itch Nobody Warned You About” (Sept. 30)
• Parkinson’s Foundation. Skin Changes. https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/skin
• American Parkinson Disease Association (APDA). Sweating and Other Skin Problems in People with Parkinson’s Disease. https://www.apdaparkinson.org/article/sweating-and-skin-problems/“Same Disease. Different Parkinson’s.” (Sept. 27)
• Parkinson’s Progression Markers Initiative (PPMI), sponsored by The Michael J. Fox Foundation for Parkinson’s Research.
• Michael J. Fox Foundation — PPMI/Data Resources. https://www.michaeljfox.org/data-resources
• Dashtipour K, et al. “One patient, one destiny: A cluster analysis of the Parkinson’s Progression Markers Initiative (PPMI) cohort.” Clinical Parkinsonism & Related Disorders, 2026. https://pubmed.ncbi.nlm.nih.gov/41938802/
The graphic footer abbreviated this as “PPMI • Michael J. Fox Foundation • Peer-reviewed research (2026).” The 209-person, five-year PPMI study is the paper listed above.
Parkinson’s Medication Education — “Dyskinesia: Parkinson’s Symptom or Medication Effect?” (Sept. 23/24)
• Parkinson’s Foundation. Dyskinesia. https://www.parkinson.org/understanding-parkinsons/movement-symptoms/dyskinesia
. “Living with Parkinson’s: Nausea, Vomiting and Medication Concerns” (Sept. 16)
• Parkinson’s Foundation. Constipation & Nausea / gastrointestinal problems in Parkinson’s. https://www.parkinson.org/understanding-parkinsons/non-movement-symptoms/constipation
• Parkinson’s Foundation. Constipation and Other Gastrointestinal Problems in Parkinson’s Disease (fact sheet). https://www.parkinson.org/library/fact-sheets/constipation
The graphic text did not include its footer source line, so these are the official Parkinson’s Foundation sources supporting the medication absorption, gastroparesis and nausea information used.

Stroke Graphics — Sources thru 10/13/26*American Stroke Association / American Heart AssociationAmerican Stroke Association — Stroke Facts
*American Stroke Association — Stroke Diagnosis
* Stroke Facts / Stroke Explained — stroke definition, warning signs, B.E. F.A.S.T., risk factors, prevention and recovery.
* Stroke Diagnosis — CT, MRI, laboratory testing, neurological examination and other diagnostic testing.
* Types of Stroke and Treatment — ischemic stroke, hemorrhagic stroke, TIA and cryptogenic stroke.
American Stroke Association — Types of Stroke* Stroke Risk Factors — hypertension, diabetes, cholesterol, atrial fibrillation, smoking and other modifiable/nonmodifiable risks.
American Stroke Association — Stroke Risk Factors
* Recovery After Stroke / Life After Stroke — rehabilitation, cognitive and communication changes, physical effects, emotional effects and long-term recovery.
American Stroke Association — Recovery After Stroke*Centers for Disease Control and Prevention (CDC)* Signs and Symptoms of Stroke — sudden weakness/numbness, confusion or speech difficulty, vision problems, dizziness/balance problems and severe headache; emphasizes calling 911 immediately.
*CDC — Signs and Symptoms of StrokeNational Institute of Neurological Disorders and Stroke (NINDS)* Stroke Overview — causes, brain injury, symptoms, urgency of treatment, disability and prevention.
NINDS — Stroke Overview
* Stroke Recovery — neuroplasticity, rehabilitation and recovery of function over months and years.
NINDS — Stroke Recovery*Parkinson’s Disease & Stroke — Peer-Reviewed Research* Liu Y, Xue L, Zhang Y, Xie A. Association Between Stroke and Parkinson’s Disease: a Meta-analysis. Journal of Molecular Neuroscience. 2020;70(8):1169–1176. DOI: 10.1007/s12031-020-01524-9. The pooled analysis reported an OR of 1.72 (95% CI 1.19–2.49) for the association between Parkinson’s disease and stroke.
PubMed — Liu et al. meta-analysis
* Hu Y, Xu Y. Association between Parkinson’s disease and the risk of adverse cardiovascular events: a systematic review and meta-analysis. Frontiers in Cardiovascular Medicine. 2023. This newer analysis included 16 studies and found an OR of 1.49 (95% CI 1.30–1.72) for stroke among people with PD, while noting that the overall certainty of evidence was very low.
PubMed — 2023 Parkinson's and cardiovascular events meta-analysis
* American Stroke Association — Changes Caused by Stroke
* American Stroke Association — Cognitive Effects Stroke
* American Stroke Association — Post-Stroke Fatigue
* CDC — Stroke Treatment and Recovery
* NINDS — Stroke Overview
Stroke Education Episode 10 — “Stroke Recovery Isn’t a Straight Line” (Sept. 21)
• American Stroke Association. Stroke Recovery / Stroke Rehabilitation. https://www.stroke.org/en/life-after-stroke/stroke-rehab
• National Institute of Neurological Disorders and Stroke (NINDS). Recovery After Stroke. https://www.ninds.nih.gov/health-information/stroke/recovery
• Mayo Clinic. Stroke Rehabilitation: What to Expect as You Recover. https://www.mayoclinic.org/diseases-conditions/stroke/in-depth/stroke-rehabilitation/art-20045172
Recovery note: The finished graphic listed American Stroke Association (2024), NINDS (2023), and Mayo Clinic (2024). The live pages may now show newer review/update dates.
*American Stroke Association - Auditory.
Overload x - Noise sensitivity, symptoms, and practical strategies.
*American Stroke Association -
Concentration Problems › - Difficulty filtering distractions and processing information.
*American Stroke Association - Fighting Through Fatigue › - Mental fatigue and managing daily activities.
*American Stroke Association - Cognitive
Effects of Stroke › - Attention, information processing, and other cognitive changes.

Stress & Parkinson’s — “A Tough Cycle That Affects More Than Our Mood” (Oct. 2)
• Parkinson’s Foundation. Stress Management for PD. https://www.parkinson.org/library/fact-sheets/stress
• American Parkinson Disease Association (APDA). Anxiety and Parkinson’s disease.
• National Institute of Neurological Disorders and Stroke (NINDS). Parkinson’s disease / non-motor symptoms, including mood and sleep.
• Hartley, S. et al. Review of stress/cortisol and Parkinson’s disease, Frontiers in Neurology (2021).
“Same Disease. Different Parkinson’s.” (Sept. 27)
• Parkinson’s Progression Markers Initiative (PPMI), sponsored by The Michael J. Fox Foundation for Parkinson’s Research.“When Health Care Gets It Wrong” — Episode 1 (Sept. 24)
• World Health Organization (WHO). World Patient Safety Day 2024 — Improving diagnosis for patient safety. https://www.who.int/campaigns/world-patient-safety-day/world-patient-safety-day-2024
• Agency for Healthcare Research and Quality (AHRQ). Diagnostic Safety Across Transitions of Care Throughout the Healthcare System. https://www.ahrq.gov/diagnostic-safety/resources/issue-briefs/dxsafety-care-transitions1.html
Note: WHO was the source for the graphic’s statement that diagnostic errors contribute to about 16% of preventable patient harm; AHRQ supports the sections on cognitive bias, communication gaps and care transitions.

Words Matter — Sources* Austin, K. W., Ameringer, S. W., & Cloud, L. J. (2016). An Integrated Review of Psychological Stress in Parkinson’s Disease: Biological Mechanisms and Symptom and Health Outcomes. Parkinson’s Disease, 2016, 9869712. https://doi.org/10.1155/2016/9869712
* van der Heide, A., Speckens, A. E. M., Meinders, M. J., Rosenthal, L. S., Bloem, B. R., & Helmich, R. C. (2021). Stress and mindfulness in Parkinson’s disease—a survey in 5000 patients. npj Parkinson’s Disease, 7, 7. https://doi.org/10.1038/s41531-020-00152-9
* van der Heide, A., Meinders, M. J., Bloem, B. R., & Helmich, R. C. (2021). Stress and Mindfulness in Parkinson’s Disease: Clinical Effects and Potential Underlying Mechanisms. Journal of Parkinson’s Disease, 11(2), 435–448. This review discusses how psychological stress can worsen tremor, freezing of gait, dyskinesia and non-motor symptoms, and how dopaminergic medication may be less effective during stress.

Master source list
• American Diabetes Association — https://diabetes.org/
• American Parkinson Disease Association (APDA) — https://www.apdaparkinson.org/
• American Stroke Association — https://www.stroke.org/
• Agency for Healthcare Research and Quality (AHRQ) — https://www.ahrq.gov/
• Mayo Clinic — https://www.mayoclinic.org/
• Michael J. Fox Foundation / PPMI — https://www.michaeljfox.org/
• National Institute of Neurological Disorders and Stroke (NINDS) — https://www.ninds.nih.gov/
• Parkinson’s Foundation — https://www.parkinson.org/
• PubMed — https://pubmed.ncbi.nlm.nih.gov/
• World Health Organization (WHO) — https://www.who.int/