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Citations since 2017
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In the December issue Iliffe1 assured us that our article ‘anticipatory care of older patients represented the triumph of hope over experience’.2 We find this a bewildering claim in view of the extensive research evidence to the contrary. No less than six controlled trials between 1979 and 1993 showed that a programme of care, tailored to the speci...
The projected doubling of the >75-year-old population in the next 20 years presents a major challenge.1 While standards of care in general practice have risen steadily over the past 30 years, for vulnerable older people the picture is different. The term ‘vulnerable’ covers multimorbidity, functional incapacity, and socioeconomic and psychological...
We contest D’Souza and Guptha’s claim that “no convincing evidence exists that increases in the provision of community services reduce the length of stay for frail older people.”1 There are two commonly used markers of the effectiveness of such programmes in older patients—the number of institutional referrals and time spent in institutional care....
Objective: Thoraco-abdominal asynchrony (TAA), the discordant movement of the abdomen and thorax, may impact upon health-related variables. Here, we investigated the extent to which TAA is associated with health-related variables, particularly perceived asthma control and quality of life. Methods: Ambulatory respiratory data from 43 patients dia...
Eating disorders are becoming more apparent in primary care. Descriptions of character traits related to people with eating disorders are rarely reported in the primary care literature and there is little awareness of the implications of alexithymia--a concept that defines the inability to identify or express emotion. We hypothesised that many indi...
Implementation of the Community Care Act makes it essential that clients' needs for services are accurately assessed. A study was undertaken by a general practice to identify whether clients with physical disabilities were satisfied with the service they received.
The general practice records of 68 children with secretory otitis media (SOM) were studied. A control group was matched one-for-one on the basis of sex, year of birth and general practice list. The SOM group had twice the incidence of recorded atopy, twice the incidence of recorded previous upper respiratory tract infections (URTI), and three times...
In a double-blind between-patient study of aspirin and benorylate carried out in 72 outpatients with rheumatoid arthritis, benorylate 4 g twice daily was shown to be an effective analgesic and anti-inflammatory drug, its effects being indistinguishable from those of aspirin 1.2 g four times daily. Compared with the pretreatment values both drugs pr...
Overbreathing resulting in Hypocapnia - reduced carbon dioxide in the body and out breath - accompanies threat. When threat is prolonged it results in the individual moving beyond their tolerance or anxiety and resulting fight, flight or fold responses.
Reducing CO2 tightens arterioles resulting in the shunting of blood into large arteries, enabling the flight response to proceed. Similar physiological mechanisms move blood supply away from the cerebral cortex to the deep mid-bearing areas controlling emotions.
These are adapted responses and accompanied - if threat is prolonged - by respiratory alkalosis (Henderson - Hasselbalcht equation) and via the Bohr Effect a reduction of available oxygen to tissues which affects limbic system regulation via autonomic, HPA, axis, immune, and neuro-peptide mechanisms.
How robust and consistent has the effects of Hypocapnia been in preparing us to respond to threat?
Increased well being and functional gains in mobility, energy & return to work Next course running: The location is Churchfield Medical Centre, 322 Crawley Green Road Luton LU2 9SB and the course dates are 6-8 March. We are hoping to recruit 12 people, and have 3 signed up so far.