Stroke is considered to be one of the most devastating vascular events (Beekman et al 1998) which can cause death. The patients who survive are developing physical impairment. This impairment can make the patients disable or dependent. As a result of loss of functional activity and normal life style, the stroke survivors may also develop psychosocial disorders. The most common disorders among stroke survivors are depression, anxiety, impatience, impulsivity, insensitivity toward others, poor social perception, memory disabilities, apathy, irritability, and eating disturbance (Barker-Collo 2007, Barskova et al 2006, Bour et al 2009). In my research, I will focus more on the prevalence of post stroke depression in the Arab world. I will also investigate the QOL among the Arabic stroke survivors and the factors that influence their mental health and their QOL.

Stroke, which also called cerebrovascular accident (CVA), is a neurological disorder that results from blood vessels disease (Carr et al, 242). It is caused by a sudden block of blood from flowing to brain leading to irreversible tissue damage result from thrombotic, embolic, or hemorrhagic events (Robinson et al 2010). There are two types of stroke: occlusive and hemorrhage. Occlusive stroke results from closure of a blood vessel while the hemorrhage is due to bleeding from a vessel. It is considered to be a third killer in the world after coronary heart disease and cancer and it is the most cause of disability among people who living in their own homes (Carr et al, 243). In the united state, Europe, and Australia, approximately 400 person per 100,000 populations over age 45 have a stroke (Bruce et al 2005). About 20% of stroke patients die within the first month of onset (Carr et al, 244). However, the reminding 80% of stroke patients can survive with medical management and rehabilitation. The medical management depends on the type of lesion (Carr et al, 245). Surgery is recommended for patients with subarachnoid hemorrhage, well-defined carotid disease, and good surgical risks (Carr et al, 246??). To reduce the muscle spasm, pain, and posture that interfere with patient’s functions, the patients are injected with botulinum toxin into the muscles (Bruce et al. 2005). After the patients are stable medically, they commence active rehabilitation to prevent secondary physical, emotional, and intellectual deterioration (Carr et al 247). The rehabilitation team of stroke survivors usually consists of the followings: physician, nurse, physical therapy, occupational therapy, speech therapy, social worker, and psychologist.

Psychosocial issue:

The clinical picture of the stroke patient is complex and varied between physical and psychological disorder. To insure the patient acceptance to different levels of care, it is important for all health care providers to communicate with information about patient’s moods, general symptoms, and worries and concerns about their own health as well as their neurological handicaps, treatments, and co-morbidity (Skaner et al, 2007). The psychiatric complications of stroke include a higher frequency of depressed mood, anxiety, memory disabilities, apathy, irritability, impatience, impulsivity, poor social perception and insensitivity toward others, and eating disturbance(Bour et al 2009 , Barskova et al 2006). Fatigue and sadness are the most common symptoms and 39% of patients always felt tired that is associated with feeling of depression(Skaner et al 2007).

Depression

Depression is affective disorder characterized by intense feelings of sadness, hopelessness, despair and the inability to experience pleasure in usual activities(Rang et al 2007).It is more common with left anterior hemisphere injury (Robinson et al 2010). It is considered to be significant risk factors for increase death within 7 years from date of onset (Robinson et al 2010). Every year there is 5000,000 new strokes in United State. Approximate 150,000 of them develop depression in the first year of post stroke (Elis et al 2010). The depressed patients complain from loss of interest, impaired ADL, psychomotor impairment, and gastro-intestinal complaints (Bour et al 2009).

Management of Depression:

The treatment of these symptoms can be established by pharmacotherapy and

Non-pharmacotherapy. The pharmacotherapy may include the followings: imipramine, phenelzine, and fluoxetine which have some side effects on patients. It can cause nausea, anxiety, insomnia, weight loss tremor, drowsiness, and orthostatic hypotension (Rang et al 2007). The non-pharmacotherapy can include aerobic exercises and stretching (Foley et al 2008).

Assessment tools:

Despite of previous symptoms, the diagnosis of depression in stroke patients is difficult because of overlap of somatic and neurocognitive symptoms directly related to the cerebral damage of stroke and the symptoms of a depressive episode (coster et al 2005). However, the examiner can observe some behavior or use some instrument to judge if the patient is depressed or not (Robinsion et al 2010). The behaviors include: difficulty falling asleep, waking up early in the morning, not eating, losing weight, frequent tearfulness, social withdrawal, or acts as self-harm(Robinsion et al 2010). Whereas, the instruments include Montgomery Asberg depression rating scale (Farner et al 2009), Mooddepression questionnaire, and Beck’s depression scale (Cohen 2007).

Montgomery Asberg Depression Scale is an assessment tool that measure psychological symptoms of depression as symptoms that can affect physical function. Snaith et al defined four degree of depression severity and recognize the patient as a depressed if the score more than 6 in this scale (Sagen et al 2009). Because it is valid and reliable, it can be used in assess treatment outcome and can also used in research (Zimmerman et al 2004).

Another scale is Beck’s depression scale which was designed by Beck, Rush, Shaw, and Emery (Cohen 2007). The scale, which is a questionnaire, consists of 21groups of statements. The patient selects the most statement that best describes hisher feeling past 2 weeks (Questionnaire form). The patient is considered as a minimal depressed if the scale range between 0-13, mild depressed if range between 14-19, moderate depressed if range between 20-28, and sever depressed if range between 29-63(Barker-Collo 2007). It is valid and reliable measurement and (Beck et al 2002) it translated to Arabic to use in assessment and research (Abdel-Khalek et al 1998).

Manchester Short Assessment of Quality of life (MANSA), which is the LQLP modified and brief version, is another assessment tool (Priebe et al 1999). It is used to measure quality of life of people with mental illness and physical disability (Eklund et al 2006). It is administered as a structured interview and consists of three sections (Priebe et al 1999). First section is about personal details: date of birth, gender, ethnic origin, and diagnosis. Section 2 contains details that can be varying over time: education, employment status, monthly income, state benefits, and living situation (Priebe et al 1999). The last section covers 16 quality of life domains which are work, finances, social relations, leisure, living situation, safety, family relations, sexual relations, and health. Fourteen domains have one item and the reminders two have two domains. These domains are health which assessed as physical health and psychological health and living situation: satisfaction with housing and living with someone or alone. Satisfaction scale are rated on 7-point rating scales started with couldn’t be worse and ended with couldn’t be better. This tool is reliable and valid and has good internal consistency (Eklund et al 2006).

One further measure instrument is Patient Competency Rating Scale (PCRS) which is self rating tool. This instrument is used to assess emotional competencies such as: empathy, social initiative, and communication of one’s own emotional states through 30 items. Its items are divided in four domains which are activities of daily living, emotional, interpersonal, and cognition. It is designed to measure patient’s mental and physical status after traumatic brain injury. Later on, it is used with stroke patients also. It is valid and reliable tool that can be used with stroke (Barskova et al 2006).

Literature Review

Stroke is the third cause of death in the world (Carr et al, 243). It is lead to disability and restricts activity of daily living. As a result of these physical problems, the patients can develop many psychological issues. Depression is considered to be one of these problems. Many studies show that 19.3% among hospitalized patients can develop post stroke depression and 23.3% among outpatients (Robinson 2003) .Here I mention some of studies that were done on post stroke depression.

Townsend and his colleges (2010) did a study to evaluate the relationship between the acceptance of disabilities and depression following stroke. Ninety eight patients who were diagnosed with a stroke before one month and had no cognitive impairment or aphasia participated in this study. Twenty two of them had had a prior stroke. However, only 81 of participants were followed up nine months post stroke. The researchers used a prospective cohort mixed design with them. All participants participated in structured interview which yielded quantitative data one month after stroke. It included diagnostic type interview for depression and self report scale to measure disability and personal beliefs about accepting disability. Depression symptoms were assessed using the Structured Clinical Interview of the Diagnostic and Statistical Manual of the American Psychiatric Association. In addition, they used National Institute for Health Stroke Severity Scale to measure stroke severity, Barthel Index to measured personal activities of daily living, reverse scored Nottingham Extended Activities of Daily Living Scale to measure disability in extended activities of daily living, and adapted version of eight-item Acceptance of Illness Questionnaire to measure non-acceptance of disability.

This structured interview was repeated after nine months of onset. In addition, there was semi-structure interview done in the first month of onset and only sixty participants participated in this interview. It included open-ended questions about patients concerns and it was used to extract thoughts and feeling about their condition. The researchers found that for every three stroke patient one of them complained from depression. In their sample, 29 of 89 (33%) patient developed depression one month after stroke, while 24 of 81 (30%) developed depression after nine months. They also found that there is no relationship between disability and depression or no physiological relationship. The non acceptance of disability, or psychological issue, has been the cause of post stroke depression. The depressed participant described themselves as useless and inadequate.

Skaner and his collages (2007) aimed to investigate the self rated health after stroke and the prevalence of symptoms of depression and general symptoms three and twelve months of onset. Their study included 145 patients (69 were men and 76 were women) with a first -ever stroke and their mean age was 73.3 years. The participants were classified according to Katz ADL Index into seven groups, A-G, to assess the patient’s functional level. The ‘A’ refer to patients that had no need of help, and patients in ‘G’ are dependant and the help is necessary for them. They received questionnaires from the researchers to assess their self -rated health, symptoms of depression, and general symptoms. Self-rating of health was assessed by Goteborg Quality of life Instrument (GQLI). The same instrument was used to assess the prevalence of general symptoms which covered six different symptoms: mental, gastro-intestinal/urinary, musculoskeletal, metabolic, cardio-pulmonary and head/miscellaneous. The prevalence of depression symptoms were evaluated by Montgomery Depression Rating Scale which includes nine items: mood, feeling of unease, sleep, appetite, ability to concentrate, initiative, emotional involvement, pessimism, and zest for life.

In this study the researchers compared the patient’s situation three and twelve months after stroke and they found that more than half of patients suffered from symptoms of depression with no significant change frequency between 3 and 12 months. The most common general symptoms after 3 months were reported by patients were fatigue 69%, sadness 58%, pain in legs 52%, dizziness 48%, and irritability 46%. While the most common symptoms after 12 months were fatigue 58%, impaired hearing 49%, pain the joints 49%, sadness 46%, and pain in the legs 45%.

Barker-Collo (2007) examined the prevalence of depression and anxiety after stroke. He also investigated the relationship between depression and anxiety with age, gender, hemisphere of lesion, functional independence, and cognitive functioning. He included 73 patients who were diagnoses of stroke three months before. Of the participants, 40 were males and 33 were females with a mean age of 51.7 years. Their CT scans showed that 31 of them had left hemisphere damage and 33 were right hemisphere damage. The researcher used many measurement tools to get the results. He used Beck Depression Inventory-II (BDI-II) to measure depression. BDI-II is contain 21 four-choice statements and its total score ranges from 0 to 63. Participants selected the better choice that descripts their emotional and vegetative symptoms in the past two weeks. According to this scale, result between 0-13 is considered to be minimal depression, 14-19 is mild, 20-28 is moderate, and 29-63 is severe.

The researcher also used Beck Anxiety Inventory to examine the anxiety symptoms and California Verbal Learning Test-II to measure recall memory. Visual Paired Associates test was used to examine visual learning and memory, and Digit and spatial spans test was used to test memory working. Additionally, Functional Index Measure which includes 13 motor and 5 cognitive items was also used to assess outcomes of rehabilitation. The motor items include self care, sphincter control, mobility, locomotion, and social cognition. While the five cognitive items cover independence in comprehension of communication, expressive communication, social interactions, problem solving, and memory. Furthermore, the researcher included Integrated Visual Auditory Continuous Performance Test and Victoria Stroop. The mood assessments and neuropsychological took about 120 min to be completed according to standardized procedures.

The researcher found from his measurements that the prevalence of depression and anxiety three months post stroke was 22.8 and 21.1% respectively with one in five patients have either moderate or severe depression or anxiety. According to the site of injury, he found the patients with left hemisphere injury were more likely to get depression or anxiety. Because of the left hemisphere is the part which is responsible about language skills, the lesion in it can cause communication deficits which then can lead patients to feel depressed. Suffering of post stroke depression or anxiety can affect the physical therapy sessions. Depressed patient may lack the motivation to complete the session while the anxious patient can suffer from fearful of falling to attempt to walk without device.

Appelros and Viitanen (2004) also measured the prevalence of post stroke depression in a Swedish Population during 1999-2000. They included 377 patients, 129 were females and 124 were males, with first ever cases of brain infarction, intracerebral hemorrhage, subarachnoid hemorrhage, and stroke of undetermined pathological type and with mean age 74.5 years old. One hundred and nine patients complain of right hemisphere damage while 138 patients were left hemisphere damage. The researchers used Swedish version of the Geriatric Depression Scale (GDS) which include 20 items, and cutoff is >5. The items cover anxiety, panic, insomnia, hypochondria, and pain. Patients in all cases answered the questions which were read aloud for them. Further evaluation was subjected to patients who crossed cutoff on the GDS. One year follow up, Modified Rankin Scale was used to assess dependency. Cognitive impairment was measured by using Mini Mental State Examination which define the cognitive impairment at a score of <24. Also, at one year follow up the patients were asked to describe their satisfaction with life by choice one of four choices: very satisfied, satisfied, dissatisfied, or very dissatisfied. At the end of this study, the researchers conclude that according to GDS the prevalence rate was 27%. The best predictor of depression after one year is functional outcome. However, functional outcome can be improved by active rehabilitation which then influences depression positively. They also conclude that the depression after stroke is strongest predictor for a low life satisfaction.

Purpose of Study

The purpose of this study is to investigate the prevalence of depression among Arabic stroke survivors. The QOL of the Arabic stroke survivors will also be further investigated. The researcher will use Barthel Index to measure level of function of the participants. Additionally, the researcher will investigate the factors influencing the mental health and the QOL of the Arabic stroke survivors in terms of: onset date of injury, site lesion, type of brain injury (infarct, intracerebral hemorrhage, or subarachnoid hemorrhage), functional level, gender, educational level, employment, and productivity level.

Method

Participants

In this study, 200 Arabic patients with first-ever stroke will be included. Inclusion criteria: stroke at least 6 months or above, right and left hemisphere types of stroke, both male and female participants will be recruited from all government hospitals in Kuwait. However, patients with aphasia, cognitive impairments, dementia, and current psychotic episode, and non Arabic patients will be excluded from the study. Patients who will participate in this study will receive a written informed consent.

Data Collection Procedure

After obtaining approval from the Committee for the Protection of Human Subjects in Research at Kuwait University Health Sciences Center, the researchers will initiate the proposed project. This study will be run by two researchers and one research assistance. The research will select all the names of Arabic participants with stroke from the registry from the 5 general hospitals in Kuwait. The hospital include: AL-Adan, AL- Jahra, PMR, and AL-Amiri hospital. Then, the research assistant will randomly select names. Each participant will be asked to voluntarily participate in this study. Upon approval, each participant will sign a consent form indicating his/her willingness to participate in this study.

Measure

The Beck Depression Inventory (BDI), which was translated to Arabic form, will be used to measure depression among the 200 stroke patients in Kuwait Hospitals. BDI-II contains 21 four-choice statements and its total score ranges from 0 to 63. The participants will select the most accurately statement which describe their feelings in relation to emotional, behavior, and vegetative symptoms over the past two week. According to this scale, result between 0-13 is considered to be minimal depression, 14-19 is mild, 20-28 is moderate, and 29-63 is severe. The participants will have one hour to complete the test (Cohen 2007).

Another tool that which will be used is the Arabic version of MANSA. This tool is used to measure the quality of life of people with mental illness and physical disability (Eklund et al 2006).

To assess functional ability and ADL of stroke survivors, the researchers will use the Barthel Index. It has 10 items of ADL which can collect via direct conversation, questionnaire, or phone interview. These items are feeding, bathing, grooming, dressing, bowel and bladder control, toileting, ambulation, transfers, and stairs climbing. The final score is ranged between 0, fully dependant, and 20, independent. It is valid and reliable to be used as outcome measurement for clinical and research purpose (Yang J et al 2008).

Data Analysis: All data will be analyzed by using SPSS (19) for analysis.

Introduction

Law enforcement officers are usually the first to come in contact with a particular crisis in a given setting. As a result, most law enforcement units have established a Crisis Intervention Team in their departments. One of

the aims of crisis intervention in law enforcement is to give all officers the necessary resources to handle individuals who are in a behavioral crisis

. Examples of these subjects include individuals exhibiting signs of mental illness, those experiencing personal crises as well as individuals living with substance use disorder. Crisis intervention is one of the strategies that law enforcement officers use to respond to sexual assault. The law enforcement agencies employ the different approaches in highflying intervention after reported sexual assaults. The basis of the intervention is to ensure that the victims of sexual assault are protected and get justice. In intervening in such a crisis, law enforcement officers undertake a thorough investigation to ensure that the perpetrators are brought to book (Ellis, 2014).

Crisis intervention purposes of minimizing the psychological stress a victim encounters during an immediate crisis.  The intervention assistance may include victim advocacy, 24-hour hotlines, medical supplement, as well as referrals to community-based services (Miller, 2006). The law enforcement officers may work with the victims to create personalized safety plans that can assist victims in reclaiming a sense of safety. It is worth noting that law enforcement delivers services to victims through crisis intervention where trained professionals identify, evaluate, and intervene on behalf of a person in crisis. This research paper examines crisis intervention in law enforcement with an emphasis on highflying crisis intervention responses after reported sexual assault.

Crisis Intervention in Law Enforcement

A crisis can be described as a time of psychological imbalance experienced by an individual or a community instigated by an enduring, dangerous, and traumatic event. Typically, a fact that is considered as traumatic usually generates a considerable and overwhelming problem that cannot be resolved by utilizing standard coping strategies. In essence, crises generally leave individuals feeling helpless and without control. Responses to a crisis are exceptional; what institutes a crisis for one person may not be regarded as a crisis for another.  Miller (2006) asserts that the objective of crisis intervention is to address the most persistent and immediate problems linked with the crisis within a specified period by taking care of the victim’s emotional, mental, physical, medical as well as personal needs. Law enforcement utilizes crisis intervention to help victims deal with the most immediate needs and allow them to start focusing on the future (Miller, 2006).

Hendricks & Hendricks (2014) maintain that law enforcement victim advocates usually respond to the crisis and arrive at the scene with patrol officers and carry out crisis intervention in the aftermath of an incident. Most of the victim assistance programs are based in police departments (Hendricks & Hendricks, 2014). Police-based victim advocates assist the patrol officers and investigators in responding to the incident and accompany victims through the criminal justice system process. The police advocates respond immediately to crisis along with law enforcement. They have a solid understanding of investigations and are critical in providing the victims with continuous information regarding the progress of a case. Furthermore, the advocates can support officers in informing victims regarding their rights and accessibility of the community-based victim services (Ellis, 2014).

New strategies and tactics are all to usually born from crisis. Law enforcement started seeking alternatives to conventional strategic enforcement approaches. The establishment of Crisis Intervention Teams, particularly in law enforcement, is one of the modern approaches emerging from detainee concession methods. The teams help law enforcement in the sufficient resolve of perilous and crisis incidents. Besides, the crisis intervention teams use specific training approaches to neutralize what could be readily become explosive circumstances typically without deadly force and frequently without the use of force. One of the earliest crisis interventions was established in 1988 after an event in Memphis where psychologically ill individual wielding a blade was shot and slayed by law enforcement officers (Ellis, 2014).

The fundamental objective of the original crisis intervention crew was to neutralize crisis incidents while assuring the security of everybody involved. Studies have started to illustrate a considerable increase in the use of crisis interposition and efficacy in dominions, where crisis intervention crews are used. In most urban settings, there are specialized police departments that are committed to managing crisis and mental health calls. Recent studies have shown the prevalence and utilization of crisis intervention in law enforcement, which has continued to grow. Survey shows that more than 400 crisis intervention teams had already began its operations in the U.S (Hendricks & Hendricks, 2014).

The studies on the effectiveness of crisis intervention in law enforcement have shown positive results. Malcolm et al. (2005) indicated that there were reduced rates of injuries sustained by police officers in instances when the crisis intervention teams were used. Lord et al., (2011) reported that law enforcement officers trained and assigned to crisis intervention teams showed more empathy to mentally ill individuals, decreased use of high-intensity police strategies as well as more patience when managing crisis conditions.  Furthermore, crisis intervention teams have been proved to improve traditional law enforcement functions by offering an assortment of response options tailor-made to the needs of mentally ill persons (Lord et al., 2011).

Crisis Intervention After Reported Sexual Assaults

Sexual assault has been one of the significant problems that law enforcement officers have been compelled to deal with. The fundamental focus of crisis intervention in response to sexual assault is to guarantee the health and safety of the victim of the crime. In an incidence of sexual assault, law enforcement agencies are committed to investigating the crime professionally, recognizing and detaining offenders, and helping those affected to receive the needed assistance with criminal justice. In crisis intervention, law enforcement officers can assist the victim of sexual assault in contacting a counselor. Most law enforcement agencies have the Sexual Assault Response and Prevention (SARP) team who are trained to assist victims of sexual assault and other traumatic events (Kinney, Bruns, Bradley, Dantzler & Weist, 2008).

As part of crisis intervention,

law enforcement utilizes programs that are intended to ensure that the victims of sexual assault are protected and provided with a wide range of essential care and services.

The purpose of these interventions is to increase the possibility that the assault can be successfully prosecuted. In this context, the role of law enforcement is to examine and report the facts of the case (Malcolm et al., 2005). Subsequently, law enforcement is usually responsible for the immediate safety requirements of the victim. They also investigate the crime, interview the victim, arresting the suspect as well as organizing for forensic assessment of the suspect when necessary. Crisis intervention strategies enable law enforcement agencies to offer a timely and all-inclusive response to sexual assault

(Malcolm et al., 2005)

.

Law enforcement officers use various strategies in supporting victims in sexual assaults crisis. These strategies may include the use of non-counseling methods, activities associated with response to trauma, and more complex approaches involving strategies for listening, evaluating, and acting in crisis intervention (Lord et al., 2011). Assessment is a deliberate practice that arises during the crisis intervention process. It entails seeking information from a victim, listening actively, and interpreting what she shares so as to understand her coping mechanisms, emotional state, and other resources.

Law enforcement plays a pivotal in establishing an offender-focused investigation. In this context, the investigation of sexual assault focuses on the offender’s use of force and the victim’s lack of consent. Offender-focused investigations are necessary because most sex offenders are usually repeated offenders and regularly commit verge offenses. Ellis (2014) establishes that law enforcement also instigates the preliminary victim statement to acquire vital information. It is crucial for law enforcement to discuss with the medical personnel before commencing the in-depth victim interview. Usually, the interviews take time, and the law enforcement officer ensures there is sufficient time to complete the interview (Ellis, 2014). They are also encouraged to use all the accessible investigative at their disposal.

A victim-centered approach focuses on the concerns and needs of the victims to ensure that investigations are not affected by rulings an investigator makes regarding a victim.  It also proposes to ensure that the victims are treated in a way that takes into consideration the specific traumatic impacts of sexual assault (Roberts, 2005). Perhaps, the apprehension of the victims should be upheld throughout the investigation to avert further trauma. This enables the victim to understand that his or her participation in the investigation process helps the justice system work. Another element of upholding a victim-centered approach entails establishing a relationship and enhancing cooperation with the associates’ outsides the department, such as the victim advocates as well as the community service providers. Perhaps, advocates can offer support to victims of sexual assault and connect them with the necessary resources (Roberts, 2005).

Even though the victims of sexual assault may seek the help of law enforcement, they also usually require medical attention, safety planning, and mental health support to minimize further occurrences of violence and help them through the traumatic experiences. Collaboration among law enforcement agencies warrants constancy in response to victims and reduces the possibility of duplicative, detrimental, or counterproductive services. Law enforcement agencies use the SART as a crisis response team in the event of reported sexual assault. The SARTs offer a steady and established framework that reinforces the criminal justice system and facilitate timely advocacy intervention (Kinney, Bruns, Bradley, Dantzler & Weist, 2008).

The law enforcement officers offer immediate response to an incidence of sexual assault, examine physical safety, and eventually provide evidence for trial. Besides, the police are trained to deescalate crisis situations, evaluate immediate safety, record the incident, and link the victim to the ensuing step in the support process. Forensic examiners and doctors are also called up to address the victim’s immediate medical needs and gather forensic evidence (Kinney, Bruns, Bradley, Dantzler & Weist, 2008).

Law enforcement agencies have been using crisis intervention strategies to address the crime of sexual assault. As a result, the approach have facilitated improvements in the help-seeking experiences of victims. Such developments encompassed more recommendations to services and effective communications between victims and responders. The fundamental objective of law enforcement is to prevent and deter crime proactively. In the highflying crisis of reported sexual assault, law enforcement undertakes various roles. One of these roles is to respond to the grievances of sexual assault (Hendricks & Hendricks, 2014). They are also responsible for assessing sexual assault incidences based on the criminal and practical statutes. Another role is to identify, arrest, and interview the perpetrators. Besides, they collect and preserve evidence as well as prepare investigative reports (Hendricks & Hendricks, 2014).

In cases of reported sexual assault, the role of law enforcement is to ensure the safety of the victim and the public through investigating reports of the crime. The law enforcement intervenes by determining whether the report of sexual assault fulfills the components of a crime as delineated by the laws. This entails piling together an accurate record of the sexual assault by gathering accounts by the victim, suspects, and witnesses (Pieper, 2016). While intervening in such a crisis, law enforcement agencies utilize a victim-centered response to treat each victim with compassion, consideration, and professionalism. A victim-centered law enforcement response to sexual assault acknowledges that victims of sexual abuse are usually the ones who are seen as lacking in reliability (Pieper, 2016).

Ethical Consideration

Effective crisis intervention takes into consideration the ethical principles that help in ensuring that the victims of a crisis are placed in more harm. Ethical principles also help to ensure that the opinions and decisions of the victims are respected in the entire process, and the crisis intervention upholds a rights-based approach (Sommers-Flanagan, 2007). Law enforcement is value-based, and the values focuses on respecting the people’s rights, engaging positively with the community, and respecting the state and constitutional laws. The public reputation of law enforcement agencies is influenced by their day-to-day interaction with the public. It is also determined by the organizational assertions to involve the community and offer quality services. In that case, law enforcement officers should be focused on and understand the needs of crime victims. Furthermore, they should make efforts to address such requirements within the basis of their mission (Sommers-Flanagan, 2007).

Honesty and confidentiality are some of the vital traits that law enforcement is expected to have. The law enforcement officers should ensure the confidentiality of information of the crime victims. Victims fear facing retaliation from perpetrators, and therefore, law enforcement must be mindful of these risks and take caution to maintain confidentiality and protect them. The oath of office for the law enforcement officers constitutes provisions regarding protecting and abiding by the Constitution of the U.S. It also encompasses pledges to behave honestly and honorably. Ethics plays a pivotal role in the line of duty of a law enforcement officer. Police are given a higher degree of trust and authority; as a result, it can inopportunely be much easy for an officer to get into some unethical conduct. Subsequently, these ideas become the foundational ethical guidelines for the law enforcement officers even when dealing with a crisis. Officers are expected to remain honest and obligated to tell the truth. For instance, he or she should not fabricate evidence to get search warrants. A bold officer endeavors to act bravely, whereas a coward one retreats at danger. According to Pramono (2017), Virtue ethics are vital for the success of law enforcement. Alleviating the risk for officer misbehavior necessitates a comprehensive understanding of motivation and human behavior (Pramono, 2017).

In crisis intervention, law enforcement is expected to act impartially in the treatment of victims. Perhaps, it is not always possible to act impartially in a crisis scenario, especially for local and small-town officers. Acting impartially may escalate a crisis because of the inadequacy of the services provided. Barker (2011) argues that law enforcement should abide by the ethics stipulated by the law. Another ethical concern for law enforcement in crisis intervention is profiling (Barker, 2011). This has been one of the most significant aspects of policing. However, due to prevailing stereotypes and incorrect assumptions, crisis intervention has been rife with ethical or racial profiling cases. Besides. Law enforcement officers usually experience ethical issues associated with their off-duty behaviors. Nonetheless, law enforcement ethics compel the officers to abide by higher standards than the citizens.

Another ethical concern is disclosure of the conditions of the strategies used in the crisis intervention. Victims need to understand the purpose of the intervention that law enforcement uses. Perhaps, it is ethically crucial for the participants to understand precisely what they are getting into (Sommers-Flanagan, 2007). Crisis intervention strategies such as the victim-focused strategy have the provisions that enable the victim to understand the purpose of the specified initiative. Also, the disclosure of the victim’s information to other agencies should only be allowed through mutual consent. The ethical guidelines on this basis are primarily those for confidentiality. In that case, the law enforcement agencies take into consideration the several ethical concerns associated with crisis intervention (Sommers-Flanagan, 2007).

Conclusion

In conclusion, law enforcement utilizes crisis intervention strategies to handle highflying crisis situations such as reported sexual assault. The fundamental purpose of crisis intervention is to alleviate the intensity of the crisis among the victims and help them return to their normal functioning and develop new coping skills. Lack of understanding and knowledge on the strategies to handle a crisis can cause another crisis to the victims. The fundamental goal of crisis intervention in law enforcement is to give all officers the necessary resources to handle individuals who are in a behavioral crisis. Based on the topic analyzed, law enforcement employs measures that are intended to ensure that the victims of sexual assault are protected and provided with a wide range of essential care and services. The highlighted strategies and interventions enable law enforcement agencies to establish practical crisis intervention approaches after reported sexual assaults. These techniques have been proven effective in the broader contexts of assuring justice for the victims of sexual assault. Law enforcement interventions must carefully scrutinize their training, strategies, and reward structures to make sure that their agency nurtures a culture of strong ethical values. Ethical conduct considerably influences public trust. Successful law enforcement leaders ensure that the officers understand the appropriate thing to do. Ethics plays a central role in the crisis intervention initiatives for law enforcement agencies.

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  , 17(2), 187-202. doi: 10.1080/10508420701378123

Honey has been used effectively for wound healing since antiquity and has become mainstream medicine in some parts of the world. Some honeys work better than others but Manuka honey has become the “gold standard” that other honeys are tested against because it has the strongest and most widespread positive medical benefits. Research #1 below describes better than I can

what the rest of the research proves. Please read it carefully.

Note; Tee Tree Oil (Melaleuca) also has powerful antibiotic effects. Manuka honey and Tea Tree Oil each have positive things in wound healing that the other doesn’t have. By combining them together the success rate may be much higher than ether alone.

My comments are added to the research in [bold italics within brackets], all other text is from the researchers. PMID #s are provided for anyone that wants to go to PubMed and look at the original.

J Wound Ostomy Continence Nurs. 2002 Nov;29(6):295-300.Honey: a potent agent for wound healing?Lusby PE, Coombes A, Wilkinson JM.School of Biomedical Sciences, Charles Sturt University, Wagga Wagga, Australia.

Comment in:

J Wound Ostomy Continence Nurs. 2002 Nov;29(6):273-4.

Although honey has been used as a traditional remedy for burns and wounds, the potential for its inclusion in mainstream medical care is not well recognized. Many studies have demonstrated that honey has antibacterial activity in vitro, and a small number of clinical case studies have shown that application of honey to severely infected cutaneous wounds is capable of clearing infection from the wound and improving tissue healing.

The physicochemical properties (eg, osmotic effects and pH) of honey also aid in its antibacterial actions. Research has also indicated that honey may possess antiinflammatory activity and stimulate immune responses within a wound. The overall effect is to reduce infection and to enhance wound healing in burns, ulcers, and other cutaneous wounds.

It is also known that honeys derived from particular floral sources in Australia and New Zealand (Leptospermum spp) have enhanced antibacterial activity, and these honeys have been approved for marketing as therapeutic honeys (Medihoney and Active Manuka honey). This review outlines what is known about the medical properties of honey and indicates the potential for honey to be incorporated into the management of a large number of wound types.

PMID: 12439453

2. J Wound Care. 2008 Jun;17(6):241-4, 246-7.Bacteriological changes in sloughy venous leg ulcers treated with manuka honey or

hydrogel: an RCT.Gethin G, Cowman S.Faculty of Nursing and Midwifery, Royal College of Surgeons in Ireland, Dublin,

Ireland. ggethin@rcsi.ie

OBJECTIVE: To determine the qualitative bacteriological changes that occurred

during a four-week treatment period with either manuka honey or a hydrogel

dressing. This was the secondary outcome of a randomised controlled trial (RCT)

that compared the efficacy of the two treatments in desloughing venous leg ulcers.

METHOD: This was a prospective open label multicentre RCT with blinded microbiological outcome analysis. Randomisation was conducted via remote telephone. To be included, the wound bed needed to comprise at least 50% slough. [They were dealing with some nasty wounds]

Wound swabs were taken at the start of treatment and after four weeks.

RESULTS: In all, 108 patients (35 males, 73 females) aged 24-89 years (mean 68) enrolled into the study. Both groups were comparable at baseline. Eighteen patients (17%) were withdrawn due to a wound infection: six in the honey group and 12 in the hydrogel group. [Twice as many as the Manuka group]

Staphylococcus aureus was the most common isolate, being identified in 41 wounds (38%). At baseline, meticillin-resistant Staphylococcus aureus was identified in 16 wounds (10 honey versus six hydrogel). After four weeks 70% (n=7) of the manuka-honey treated wounds versus 16% (n=1) of the hydrogel treated wounds had MRSA eradicated. [Manuka honey cured 70% of the MRSA superbug infections and standard mainstream medical treatments like you will get in any care facility in the US only cured 16%]

Pseudomonas aeruginosa was reported in 14% (n=16) of all wounds at baseline. After four weeks 33% (n=2) treated with honey and 50% (n=5) treated with hydrogel had this eliminated. The number of wounds (n=11 at baseline; n=15 at week 4) with > or =3 bacteria species remained constant over the four weeks. [This looks like a place that Manuka honey and Tea Tree Oil should be combined]

CONCLUSION: Manuka honey was effective in eradicating MRSA from 70% of chronic venous ulcers. The potential to prevent infection is increased when wounds are desloughed and MRSA is eliminated. This can be beneficial to prevent cross-infection.

PMID: 18666717

3. J Clin Nurs. 2009 Feb;18(3):466-74. Epub 2008 Aug 23.

Manuka honey vs. hydrogel-a prospective, open label, multicentre, randomized Controlled trial to compare desloughing efficacy and healing outcomes in venous

ulcers.

Gethin G, Cowman S.

Dip Anatomy, Dip Applied Physiology, Faculty of Nursing and Midwifery, Royal

College of Surgeons in Ireland, Dublin, Ireland. ggethin@rcsi.ie

Comment in:

Evid Based Med. 2009 Oct;14(5):148.

OBJECTIVE: Comparison of desloughing efficacy after four weeks and healing

outcomes after 12 weeks in sloughy venous leg ulcers treated with Manuka honey

(Woundcare 18+) vs. standard hydrogel therapy (IntraSite Gel).

BACKGROUND: Expert opinion suggests that Manuka honey is effective as a desloughing agent but clinical evidence in the form of a randomised controlled trial is not available. There is a paucity of research which uses Manuka honey in venous ulcers.

DESIGN:  Prospective, multicentre, open label randomised controlled trial.

METHOD: Randomisation was via remote telephone. One hundred and eight patients with venous leg ulcers having >or=50% wound area covered in slough, not taking antibiotics or immunosuppressant therapy were recruited from vascular centres, acute and community care hospitals and leg ulcer clinics.

The efficacy of WoundCare 18+ [Manuka]  to deslough the wounds after four weeks and its impact on healing after 12 weeks when compared with IntraSite Gel control was determined. Treatment was applied weekly for four weeks and follow-up was made at week 12.

RESULTS: At week 4, mean % reduction in slough was 67% WoundCare 18+ vs. 52.9% IntraSite Gel (p = 0.054). Mean wound area covered in slough reduced to 29% and 43%, respectively (p = 0.065). Median reduction in wound size was 34% vs. 13% (p = 0.001). At 12 weeks, 44% vs. 33% healed (p = 0.037). Wounds having >50% reduction in slough had greater probability of healing at week 12 (95% confidence interval 1.12, 9.7; risk ratio 3.3; p = 0.029). Infection developed in 6 of the WoundCare 18+ group vs. 12 in the IntraSite Gel group. [Manuka works]

CONCLUSION: The WoundCare 18+ group had increased incidence of healing, effective desloughing and a lower incidence of infection than the control. Manuka honey has therapeutic value and further research is required to examine its use in other wound aetiologies.

RELEVANCE TO CLINICAL PRACTICE: This study confirms that Manuka honey may be considered by clinicians for use in sloughy venous ulcers. Additionally, effective desloughing significantly improves healing outcomes. [Yes this is an endorsement of Manuka honey for medical use by a mainstream medical center]

PMID: 18752540

4. Int Wound J. 2008 Jun;5(2):185-94.

The impact of Manuka honey dressings on the surface pH of chronic wounds.

[The pH of wounds is commonly overlooked and there is little FDA type therapies can do to optimize this. However ph is an important part of the healing environment and something that Manuka honey is effective at helping. Please read the first and last paragraph in bold very carefully]

Gethin GT, Cowman S, Conroy RM.

Research Centre, Faculty of Nursing and Midwifery, Royal College of Surgeons,

Ireland (RCSI), Dublin, Ireland. ggethin@eircom.net

Chronic non healing wounds have an elevated alkaline environment. The acidic pH

of Manuka honey makes it a potential treatment for lowering wound pH, but the

duration of effect is unknown. Lowering wound pH can potentially reduce protease

activity, increase fibroblast activity and increase oxygen release consequently

aiding wound healing.

The aim of this study was to analyse the changes in surface pH and size of non healing ulcers following application of Manuka honey dressing after 2 weeks. The study was an open label, non randomised prospective study. Patients presenting consecutively with non healing chronic superficial ulcers, determined by aetiology and no reduction in wound size in previous 3 weeks.

Single pH measurements recorded using Blueline 27 glass surface electrode and R

315 pH meter set (Reagecon/Alkem, Co. Clare Ireland). Area determined using

Visitrak (Smith & Nephew, Mull, UK) digital planimetry. Apinate (Manuka honey)

(Comvita, Slough, UK) applied to wounds for 2 weeks after which wounds

re-evaluated. Eight males and nine females with 20 ulcers (3 bilateral) were

included: venous, 50% (n = 10); mixed aetiology, 35% (n = 7); arterial, 10% (n =

2) and pressure ulcer, 5% (n = 1).

Reduction in wound pH after 2 weeks was statistically significant (P < 0.001). Wounds with pH >or= 8.0 did not decrease in size and wounds with pH

PMID: 18494624

5. Br J Oral Maxillofac Surg. 2008 Jan;46(1):55-6. Epub 2006 Nov 20.

Manuka honey dressing: An effective treatment for chronic wound infections.

Visavadia BG, Honeysett J, Danford MH.

Maxillofacial Unit, Royal Surrey County Hospital, Egerton Road, Guildford Surrey,

UK. bhavin.visavadia@nwlh.nhs.uk

Comment in:

Br J Oral Maxillofac Surg. 2008 Apr;46(3):258.

The battle against methicillin-resistant Staphylococcus aureus (MRSA) wound

infection is becoming more difficult as drug resistance is widespread and the

incidence of MRSA in the community increases. Manuka honey dressing has long been available as a non-antibiotic treatment in the management of chronic wound

infections. We have been using honey-impregnated dressings successfully in our

wound care clinic and on the maxillofacial ward for over a year. [This is a British medical center so they can endorse and use Manuka honey without fear of FDA legal actions]

PMID: 17113690

6. Int Wound J. 2005 Mar;2(1):10-5.

Case series of use of Manuka honey in leg ulceration.

Gethin G, Cowman S.

Royal College of Surgeons in Ireland, Dublin 2, Ireland (Republic).

ggethin@eircom.net

Gethin G, Cowman S. Case series of use of Manuka honey in leg ulceration.

Abstract The historical and current literature reports the successful use of

honey to manage a diversity of wound aetiologies. However, only in the last 40

years is research on its mode of action and contribution to wound healing being

investigated. The challenge of managing chronic non healing wounds generated

interest in researching non standard therapies. The aims of the study were to

gain insight into the practical use of Manuka honey in wound management.

The objective was to test the feasibility of further rigorous research into the use

of honey in the management of chronic wounds. Instrumental case series were used

to examine the use of Manuka honey in eight cases of leg ulceration. To collect

the necessary data, photographs, acetate tracings, data monitoring and patient

comments and observations were used to add greater reliability and validity to

the findings.

The wounds were dressed weekly with Manuka honey. The results obtained showed three males and five females with ulceration of different aetiologies were studied. A mean initial wound size for all wounds of 5.62 cm(2) was obtained. At the end of four-week treatment period, the mean size was 2.25 cm(2). Odour was eliminated and pain reduced. The conclusions drawn were that the use of Manuka honey was associated with a positive wound-healing outcome in these eight cases. [Most types of wounds respond well to Manuka honey] Arterial wounds showed minimal improvement only. [Remember all of these are chronic non healing wounds so minimal improvement on Manuka honey is better than previous mainstream medical treatments]

PMID: 16722850

[Sometimes clostridial spores (botulism) end up in honey around the world. The only reported cases of this causing problems that I can find is when a small amount is given to infants under one year of age. This happens because their digestive system is ideal for botulism and the small amount of honey is too diluted to stop botulism. After one year it never seems to happen. Medically there was some worry about botulism in wounds treated with honey. Many different honeys have been used on wounds worldwide since antiquity and currently in many medical practices and I find no report of it happening so the risk seems remote. The best guess is that the honey in the concentration used on wounds keeps the pH far too acidic for botulism. (Honey is pH 3.2 – 4.5 and botulism needs above 4.6.) Also Manuka honey increases the available oxygen to the wound (See research #4 above) and botulism cannot survive in an oxygen environment. Because Manuka honey is so effective at killing the hospital superbugs that constantly infect wounds and kill people it doesn’t seem logical to withhold honey wound treatment over worry about a theoretical but apparently nonexistent problem. However this report wouldn’t be complete without this next piece of research.  There are two things of interest here first; heat ruins Manuka honeys medical value and second; commercial sterilization procedure using gamma-irradiation doesn’t.  Any medical center wanting to use Manuka honey but worried about the theoretical possibility of  botulism can put it through the gamma-irradiation process.]

7. J Pharm Pharmacol. 1996 Nov;48(11):1206-9.

The effect of gamma-irradiation on the antibacterial activity of honey. Molan PC, Allen KL.

Department of Biological Sciences, University of Waikato, Hamilton, New Zealand.

There is increasing usage of honey as a dressing on infected wounds, burns and ulcers, but there is some concern that there may be a risk of wound botulism from the clostridial spores sometimes found in honey. It is well-established that the antibacterial activity is heat-labile so would be destroyed if honey were sterilized by autoclaving, but the effect of gamma-irradiation on the antibacterial activity of honey is not known. Therefore an investigation was carried out to assess the effect on the antibacterial activity of honey when the honey was subjected to a commercial sterilization procedure using gamma-irradiation (25 kGy). Two honeys with antibacterial activity due to enzymically-generated hydrogen peroxide and three manuka honeys with non-peroxide antibacterial activity were investigated. The honeys were tested against

Staphylococcus aureus in an agar well diffusion assay. There was no significant change found in either type of antibacterial activity resulting from this form of sterilization of honey, even when the radiation was doubled (to 50 kGy). Testing of honey seeded with spores of Clostridium perfringens and C. tetani (10000 and 1000 spores g-1 of honey, respectively) showed that 25 kGy of gamma-irradiation was sufficient to achieve sterility.

PMID: 8961174

[I always try to look at all sides of a medical problem to see if there are negative reports. This is the most negative thing I found on Manuka honey. Manuka honey dressings healed 55.6% of the leg ulcers compared to standard care that healed 49.7% of the leg ulcers and they said it didn’t significantly improve healing.  My calculator says that when standard medical care heals 100 leg ulcers then Manuka honey will heal 112 leg ulcers. If I had a leg ulcer I would consider that significant.]

8. Br J Surg. 2008 Feb;95(2):175-82.

Randomized clinical trial of honey-impregnated dressings for venous leg ulcers.

Jull A, Walker N, Parag V, Molan P, Rodgers A; Honey as Adjuvant Leg Ulcer Therapy trial collaborators.

Clinical Trials Research Unit, University of Auckland, Auckland, New Zealand.

a.jull@ctru.auckland.ac.nz

Comment in:

Evid Based Nurs. 2008 Jul;11(3):87.

BACKGROUND: The efficacy of honey as a treatment for venous ulcers has not been evaluated, despite widespread interest. This trial aimed to evaluate the safety

and effectiveness of honey as a dressing for venous ulcers.

METHODS: This community-based open-label randomized trial allocated people with a venous ulcer to calcium alginate dressings impregnated with manuka honey or usual care. All participants received compression bandaging. The primary outcome was the proportion of ulcers healed after 12 weeks. Secondary outcomes were: time to healing, change in ulcer area, incidence of infection, costs per healed ulcer, adverse events and quality of life. Analysis was by intention to treat. RESULTS: Of 368 participants, 187 were randomized to honey and 181 to usual care. At 12 weeks, 104 ulcers (55.6 per cent) in the honey-treated group and 90 (49.7 per

cent) in the usual care group had healed (absolute increase 5.9 (95 per cent confidence interval (c.i.) -4.3 to 15.7) per cent; P = 0.258). Treatment with honey was probably more expensive [Where did they buy Manuka honey that was more expensive than there standard medical supplies?] and associated with more adverse events (relative risk 1.3 (95 per cent c.i. 1.1 to 1.6); P = 0.013). There were no

significant differences between the groups for other outcomes.

CONCLUSION: Honey-impregnated dressings did not significantly improve venous ulcer healing at 12 weeks compared with usual care. [I think that the extra people that had their leg ulcers heal on Manuka honey thought it was significant]

Registration number: ISRCTN 06161544

(http://www.controlled-trials.com). 2008 British Journal of Surgery Society Ltd.

Published by John Wiley & Sons, Ltd.

PMID: 18161896

9. J Appl Microbiol. 2002;93(5):857-63.

The sensitivity to honey of Gram-positive cocci of clinical significance isolated

from wounds.

Cooper RA, Molan PC, Harding KG.

Centre for Biomedical Sciences, School of Applied Sciences, University of Wales

Institute Cardiff, Llandaff Campus, Cardiff, Wales. rcooper@uwic.ac.uk

AIMS: To determine the sensitivity to honey of Gram-positive cocci of clinical

significance in wounds and demonstrate that inhibition is not exclusively due to

osmotic effects. [Osmotic effects have little to do with how Manuka honey works]

METHODS AND RESULTS: Eighteen strains of methicillin-resistant

Staphylococcus aureus [The deadly MRSA hospital superbug] and seven strains of vancomycin-sensitive enterococci were isolated from infected wounds and 20 strains of vancomycin-resistant enterococci [Another deadly hospital superbug] were isolated from hospital environmental surfaces. [A common source of infections] Using an agar incorporation technique to determine the minimum inhibitory concentration (MIC), their

sensitivity to two natural honeys of median levels of antibacterial activity was established and compared with an artificial honey solution.

For all of the strains tested, the MIC values against manuka and pasture honey [this honey uses hydrogen peroxide and is often neutralized by catalase produced in our body or sometimes by the bacteria] were below 10% (v/v), [It doesn’t take a high concentration of Manuka honey to have an effect] but concentrations of artificial honey at least three times higher were required to achieve equivalent inhibition in vitro.

Comparison of the MIC values of antibiotic-sensitive strains with their respective antibiotic-resistant strains demonstrated no marked differences in their susceptibilities to honey. [Manuka honey bypasses superbug resistance]

CONCLUSIONS: The inhibition of bacteria by honey is not exclusively due to

osmolarity. [Current research shows osmolarity has little to do with Manuka honeys affect on bacteria]  For the Gram-positive cocci tested, antibiotic-sensitive and

-resistant strains showed similar sensitivity to honey. [Honey works different than antibiotics so bacteria defenses are useless on honey]

SIGNIFICANCE AND IMPACT OF THE STUDY: A possible role for honey in the treatment of wounds colonized by antibiotic-resistant bacteria is indicated. [This sounds a lot like an endorsement of honey therapy for superbugs to me]

PMID: 12392533

10. J Dermatolog Treat. 2001 Mar;12(1):33-6.

Healing of an MRSA-colonized, hydroxyurea-induced leg ulcer with honey.

Natarajan S, Williamson D, Grey J, Harding KG, Cooper RA.

Wound Healing Research Unit, University of Wales College of Medicine, Heath Park,

Cardiff, UK. subramanian_natarajan@hotmail.com

BACKGROUND: With the ever increasing emergence of antibiotic-resistant pathogens, in particular methicillin-resistant Staphylococcus aureus (MRSA) in leg ulcers, a means of reducing the bacterial bioburden of such ulcers, other than by the use of either topical or systemic antibiotics, is urgently required. [The medical world is losing the battle with superbugs and is desperate]

METHODS: We report the case of an immunosuppressed patient [Typical of an organ transplant patient] who developed a hydroxyurea-induced leg ulcer with subclinical MRSA infection [That can easily kill an immunosuppressed patient]  which was subsequently treated with topical application of manuka honey, without cessation

of hydroxyurea [hydroxyurea is used on organ transplant patients which is probably why they didn’t stop giving it to the patient] or cyclosporin [Typical of transplant patient] .

RESULTS: MRSA was eradicated from the ulcer and rapid healing was successfully achieved. CONCLUSION: Honey is recognized to have antibacterial properties, and can also promote effective wound healing. A traditional therapy, therefore, appears to have enormous potential in solving new problems. [These Drs are in England so they can use Manuka honey to save lives without worry of the FDA]

PMID: 12171686

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The information that you have just read is the final result of a process that, more often than not, takes well in excess of 200 hours. The presentations and subjects already on the website represent merely 1% of the research that I have available to the public but need to get into understandable presentations. I have a vast amount of research showing very powerful and available natural compounds from different parts of the world and how they can be extremely effective on many medical conditions.  I also have a lot of research showing serious problems created by some FDA drugs and over the counter medications. It is all written in medical terminology which varies with each medical specialty and from country to country. It makes no sense without the background and related information that is needed to put it into perspective. With enough donations I could afford to hire the help needed and speed up the process of getting this information into an understandable form and available to the public. Therefore, I am pleading for your help. Your donations will help me to help others and will also allow the website to move forward.  Your generosity is greatly appreciated.  THANK YOU!

TNYMED

2 Responses to “MANUKA HONEY FOR WOUND HEALING”

PaulPablo777 says:

March 8, 2010 at 5:04 pm

The certain type of species of honey is effective. What if I want to use the honey in my cupboard? Not excluding the tea tree oil, how effective is the usual honey?

reply

Tnymed says:

March 10, 2010 at 6:24 pm

Hello. In answer to your inquiry, it appears that all honey has some antibacterial and wound healing effects. But how much depends upon the types of plants the bees got it from. The honey in your cupboard may be mild or strong but it probably will help wound healing although nothing stacks up across the board like the Manuka honey. It does not make sense to refuse antibiotics and/or other standard therapies but it makes more sense to use it with standard infection fighting and wound healing treatments. We appreciate your questions and feel free to contact us anytime. TnyMED