Journal of the Royal Society of Medicine
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Multicenter Study
Diabetes prevalence, process of care and outcomes in relation to practice size, caseload and deprivation: national cross-sectional study in primary care.
To examine the association between practice list size, deprivation and the quality of care of patients with diabetes. ⋯ Our study provides some evidence of a volume-outcome association in the management of diabetes in primary care; this appears most pronounced in deprived areas.
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The chemosensory functions of the human nose are underappreciated. Traditional teaching is that the sense of smell detects volatile compounds, which may then allow the identification of substances that may be beneficial or harmful--such as good versus putrefied food. However, increasing evidence from research in other animals suggests that olfaction may serve another and more important purpose, that of mate selection in sexual reproduction; indeed, olfaction may be an essential impetus for evolution.
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Biography Historical Article
Joseph Asbury Bell and the birth of randomized trials.
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Chronic obstructive pulmonary disease (COPD) is a progressive condition characterized by airflow obstruction which ultimately kills many patients. It is common in both men and women and there is a 24-30% 5-year survival rate in the UK for those with severe disease. The annual death rate in the UK from COPD approaches that from lung cancer. ⋯ The strict application of advance care planning and directives may not be feasible or appropriate, but there is evidence that attitudes towards resuscitation and artificial ventilation can be explored without distress. The requirement by patients and carers for surveillance and timely support is acknowledged, but how to provide such input is as yet unclear, with little evidence to support the widespread implementation of nurse-led management interventions. The hospice movement has become increasingly involved in the management of life-threatening, non-malignant disease and should be involved in the multidisciplinary care of patients dying from COPD.