Effects of Honey as a Treatment for Acne

Effects of Honey as a Treatment for Acne Kanuka Randomised Controlled Trial Critical Appraisal Acne, a common inflammatory cutaneous disease, with a recent analysis reporting an 85% prevalence in those aged between 12 and 24 years of age in the USA. A new treatment option could prove successful if alongside being efficacious avoids the many shortcomings of current treatment options e.g. antibiotics, hormone-therapy etc. These treatment options are ineffective in some sufferers, thus are untenable in improving patient care outcomes. Methodology The papers objective: To investigate the efficacy of Honevo, a topical 90% medical-grade kanuka honey, and 10% glycerine (honey product) as a treatment for facial acne, is a strong foundation whereupon to run a trial. Establishing inclusion criteria prior to participant selection optimise the overall validity; the criteria comprises of a clinical diagnosis of acne and a score of two or more on a Investigators Global Assessment (IGA) scale. Conversely participant exclusion criteria was extensive, being clearly delineated, precluding sufferers with systemic illness, those currently or recently taking topical corticosteroids and antibiotics in the previous 4 weeks. There were 136 selected participants between the ages of 16 40, who were randomised to the honey product group arms using a concealed computer-generated sequence, this randomisation algorithm was used to eliminate bias, accidental or otherwise. Opaque envelopes were used to preserve participant allocation concealment, thus preventing researchers influencing outcomes through preceding knowledge of research outcomes. Furthermore, potential for bias was minimised by having a second investigator perform the IGA at each visit without knowledge of participant treatment allocation. In my opinion the sample size seems sufficient, the size allows for equal randomisation to both treatment arms. Furthermore, recruitment of 136 participants allows for a build-in quantity to account for a 10% dropout rate, accounting for up to 13.6 (14) withdrawals. The study has predetermined specific criteria that it will use to define success when considering the primary outcome aim, the researchers defines success as a à ¢Ã¢â‚¬ °Ã‚ ¥2 point decrease in IGA score from baseline at 12à ¢Ã¢â€š ¬Ã¢â‚¬ ¦weeks. There were also several secondary outcomes, summarised as follows: the average IGA score at weeks 12 and 14;an overall change in acne using a visual analogue scale (VAS); overall VAS severity at week 4 when contrasted to baseline; applications per day; weekly-reported severity using a VAS scale; and withdrawing participation should acne worsen. RCTs have several points of interest when contrasted with other study types, commonly allowing for optimal assessment of efficacy, randomisation to abstain from confounding the results, and minimisation of bias by allocation disguise and blinding. The kanuka-based treatment has an intrinsic impediment in its appearance and smell; the innate restriction of this study prevented comprehensive blinding of members and researchers, which diminishes the studies adequacy when contrasted with comparable RCTs. This issue was tempered by blinding the researchers in charge of measuring the primary result variable. The blinding of the assessors producing the results considered allowed for the avoidance of assessment bias. By providing a thorough methodology section, this research is reproducible, this was done by providing the treatment regime, number of assessments conducted, and the interval between these assessments. It is stated by the author that the setting was Outpatient primary care from 3 New Zealand localities, albeit rather vague as New Zealand covers a wide area. The issue of adherence and compliance in this study was addressed, treatment constituted twice daily application to affected areas for 30 and 60 minutes. Participant adherence was important, this is supported via daily recording of applications with a check for diary completeness at each visit. Outcomes The researchers calculated 80% power at 5% significance to detect an absolute difference of 25% responders. It is therefore possible to infer that the study had an 80% chance of identifying any treatment effect, with less than a 5% risk that this was due to chance. The primary outcome of participants showing a à ¢Ã¢â‚¬ °Ã‚ ¥2 improvement in IGA assessment at week 12 reveals that only a very small proportion of participants showed an improvement. Compared with baseline only, or the Hodges-Lehmann estimator with 95% Confidence Limit showed a 4.2 (0.5 to 39.3), with a p=0.17; in the honey product group there were 4/53 (7.6%) participants and 1/53 (1.9%) participants in the control group who met the primary outcome. Participant withdrawal must be considered, with 15 and 14 participants who withdrew from the honey product group and control group, respectively. The outcomes at week 12 show marginal improvement in the honey product group compared to the control group. This is shown in the proportional odds logistic regression for the IGA score at week 12, which estimated the OR (95% Cl) for improvement of 1.4 (0.7 to 2.9), p=0.33, without adjustment for baseline, and 2.0 (CI 0.9 to 4.2), p=0.075, after adjustment. In regards to daily self-reported use of treatment, it was found that using the The Hodges-Lehmann estimate (95% Cl), between the two study groups was à ¢Ã‹â€ Ã¢â‚¬â„¢7 (à ¢Ã‹â€ Ã¢â‚¬â„¢13 to à ¢Ã‹â€ Ã¢â‚¬â„¢1), p=0.01, with honey product users having less applications. When considering the IGA results, there is a prominent difference in the responses amongst the participants, some participant results would indicate a worsening of symptoms. When considering whether the secondary outcomes were efficacious there was no evidence found to support the use of the honey based product as a treatment option. Subject-rated improvement according to a VAS at both weeks 4 and 12 was better overall for the honey treatment. Bias is an issue with the VAS as it wasnt possible to mask which participants were using the honey based treatment. There may be a type 1 error rate inflation with this variable as it was also an outcome other secondary outcome variables. Conclusions This study has given a sound premise to methodological and factual contemplations that will be worthwhile for planning comparative studies, maybe helping in defeating the inadequacies inside this study. When contrasted with current treatment options, this study doesnt give much evidentiary support to the therapeutic utilization of kanuka honey with 10% glycerine in the treatment of acne. Advances within this field are fundamental for improving patient care, in my opinion I would recommend waiting until further research has been conducted contrasting kanuka as a treatment alternative against other treatment choices. Word Count: 1085 I am aware of the requirements of good academic practice and the potential penalties for any breaches.

National Honors Society Essay Essay

To me, National Honors Society’s four pillars are essential elements to being a member of this society. Scholarship and leadership are the two pillars that I feel complement each other because one should be a leader in the community and school without forgetting to be a good student and scholar. Service and character go well together because in order to provide services to students or members of the community, it is necessary to have a good character in order to help others. Leadership is one of the most important traits to have not only in school but outside too. In school, one can take up the position of being a leader by tutoring classmates. By helping a peer understand a topic they were confused about, a feeling of accomplishment and happiness comes along. One can also be a leader by being a part of a club and helping the club officers and other members reach their club goals. For example, I am part of the Environmental Club and I have been an active member since freshmen year. I have participated in many of the events put together by this club and have helped them in planning these events to ensure things run smoothly. At the moment, I am working with two friends on a marketing project for the tower gardens in school. If I am accepted into the National Honors Society, I will be able to gain more experience in being a leader and I will then be able to help the Environmental Club more in fulfilling more club goals. If accepted, I plan to take everythi ng I learn from being a part of this society and apply it to my life. Along with leadership comes the other pillar: scholarship. To me, this pillar is essential because one can be an outstanding leader with good but have bad grades. So although those two pillars are important, the scholarship pillar is equally as important. If someone is capable of having all those good traits while having good grades and being a scholar, they are perfect for joining NHS. I always try to make time for everything like doing homework and studying while also doing volunteer work and helping friends. It’s  difficult to do, but I try my best to make time to accomplish things I need to get done without feeling like I’m tipping the scale on one side more than the other. If I am selected to join this society, I will not forget about my schoolwork. Instead, it would motivate me to do better in my classes in order to keep my GPA in the right place so I would be able to continue participating in NHS without forgetting the importance of being a scholar. The next pillar, service, is one of great importance. I am aware that National Honors Society is a service organization. There will be many activities that will help not only our school but also members of the community and others who are in need of help. Personally, I feel that serving others should be done with a kind heart and not expecting anything in return. One should provide services to those in need because it is the right thing to do and it is truly helpful to those who need it. In the past, I have helped members of my church raise money to give to kids who cannot afford to go on field trips the church goes on. And I have helped raise money for the American Cancer Society each year since freshmen year because the money goes to a good cause and benefits many people. If I am inducted into NHS I will be happy to get the opportunity to participate in other events and activities that help people in need. This would help me give back to the community and our school and also show m e how I should be grateful to have what I have. The last pillar, character, is something we work on everyday to try to improve. Abraham Lincoln once said: â€Å"Reputation is the shadow. Character is the tree.† What I love about this quote is that he is stating that our character is not just what we show to others, but whom we are when no one is around. If one has a superb character, then it is likely that one also has the other three pillars as well. Having a good character helps you in becoming a great leader without forgetting to be a scholar. And in order to provide services to others, having a good character is a must. To me character includes being responsible, trustworthy, respectful, fair, and caring. If I were chosen to be part of the NHS, I would definitely try to improve my character in all of those areas because it is important. Character is what makes people believe in you and it also helps you succeed  in your personal life. I strongly believe that all four pillars: leadership, scholarship, service, and character, are crucial not only for National Honors Society but also crucial for life. If I were to join NHS, I would be given the opportunity to improve in all of these areas and learn from others who are doing the same. I would be able to get to know students that I’ve never seen before or talked to before, and I would get time to spend helping others which is truly gratifying. Joining NHS would be an honor and would help me become a better student, classmate, and friend.

Biography of William Wordsworth Essay

William Wordsworth was born April 7th, 1770, in Cockermouth, Cumberland. He attended school at Saint John’s College, University of Cambridge. He was said to have loved nature. During school breaks he visited places known for their scenic beauty. While in France, he fell in love with Annette Vallon. They had a daughter in December of 1770, shortly before he moved back to England. Wordsworth had written poetry while he was still a schoolboy, but none of his poems were published until 1793.His first published poems were An Evening Walk and Descriptive Sketches. These poems exhibit the influence of the formal way of poetry in England throughout the 18th century. Wordsworth had met Samuel Taylor Coleridge, a fellow poet, and in 1797 Woodsworth moved to Alfoxden, Somersetshire, alongside his sister Dorthy. Their residence was near Coleridge’s home in Nether Stowey. This move created a sustained friendship between Wordsworth and Coleridge, and they both worked on a volume of poems entitled Lyrical Ballads, which was published 1798. Lyrical Ballads is said to have indicated the beginning of the Romantic Movement in English poetry. Wordsworth wrote the majority of the poems in the book, such as â€Å"Tintern Abbey†. Coleridge’s main contribution was Rime of the Ancient Mariner. Lyrical Ballads was met with hostility from most critics, as it represented an uprising against contemporary English poetry. In justification of his unconventional philosophy of poetry, Wordsworth wrote a â€Å"Preface† to the second edition of Ballads, which emerged in 1800. His idea was that the basis of poetic genuineness was the sincere occurrence of the sense. He said that poetry derives from â€Å"emotion recollected in tranquility.† He insisted that the scenes and actions of every-day life and the speech of common people were the basic material of which poetry should consist of. Prior to his publication of the â€Å"Preface†, Wordsworth went with Coleridge to Germany in 1798-99. During this time period, Wordsworth wrote a number of his best lyrical verses. Many critics consider theses verses as Wordsworth’s greatest work. William and his sister returned to England in 1799, and moved to Dove Cottage in Grasmere, Westmorland. This area is near the English Lake District. Robert Southey, another poet, and Coleridge, lived nearby. Wordsworth, Southey, and Coleridge became known as the Lake Poets. Wordsworth married Mary Hutchinson in 1802. She was a childhood friend, who was depicted in â€Å"She was a Phantom of Delight†. Poems in Two Volumes was published in 1807. Wordsworth’s poetic ability and insight became dull as he became older. His later poetry cannot measure up to the poetry written during his youth. Wordsworth was awarded a government pension in 1842. He died at Rydal Mount, on April 23rd in 1850. He was buried in the Grasmere cemetery.

The American Tax Code How Our Government s The Wealthy

The American Tax Code: How Our Government Subsidizes the Wealthy Tax deductions, credits, special rates and homeowner deductions will allow the richest 20 percent of Americans to receive more than half of the $900 billion in tax benefits in 2013 (CBO). America does not treat all sources of earnings equally. Currently, the American tax code’s approach to income tax progressivity is focused on economic models in which labor is the only source of income. Since the upper class often accumulates large quantities of wealth through assets and capital, the tax code lacks progressivity. With the omission of the refundable earned income tax credit, the American tax code perpetuates inequality by offering tax benefits that solely benefit the†¦show more content†¦A study by economist Thomas Hungerford of the Economic Policy Institute found that, â€Å"By far, the largest contributor to increasing income inequality (regardless of income inequality measure) was changes in income from capital gains and dividends† (HUNGERFORD). In order to comprehend the effects of reducing the capital gains tax rate, the Internal Revenue Service offers data on the top 400 earners average tax rates from the year 1992 till 2009. The very top 400 earners received an average tax rate of 26.38 percent in 1992, and it then dropped to 19.91 percent by the year 2009. When the date for the average tax rate for top 400 earners is graphed against the maximum capital gains rate, the relationship is nearly perfect with 95 percent of the changes in the average tax rate being accounted for by capital gains tax cuts. The data clearly shows that by lowering the capital gains tax, America is significantly increasing the wealth of the top earners and widening the wealth inequality gap. A common misconception that often prevents significant policy reform on this issue is the myth that decreasing tax rates on capital gains will dramatically help the economy. Since the 1950’s capital gains have been taxed at lower rates than income, and has been billed as a way to fuel economic growth (CNN). However, although a lower rate may spur risk-taking investments, it doesn’t have a proven correlation with economic growth. 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