Lara Howells

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Rates of type 2 diabetes mellitus have risen rapidly over the past three to four decades. This article describes a typical patient presenting with intermediate hyperglycaemia in primary care. We suggest the appropriate action to reduce the risk of diabetes developing. Population-level preventive interventions, and adequate recognition and early management(More)
Pain is a common and distressing symptom experienced by intensive care patients. Assessing pain in this environment is challenging, and published guidelines have been inconsistently implemented. The Pain Assessment in INTensive care (PAINT) study aimed to evaluate the frequency and type of physician pain assessments with respect to published guidelines.(More)
OBJECTIVES To review the clinical outcomes of combined diet and physical activity interventions for populations at high risk of type 2 diabetes. DESIGN Overview of systematic reviews (search dates April-December 2015). SETTING Any level of care; no geographical restriction. PARTICIPANTS Adults at high risk of diabetes (as per measures of glycaemia,(More)
A GENERAL review of the more important aspects of diabetes mellitus is desirable before proceeding to a consideration of the particular problem of the ocular complications. Diabetes mellitus, already a common disease, is likely to become more common in the future. It has been estimated that in the United States of America there are about 1 million diabetics(More)
BACKGROUND People with psoriasis report high levels of undermanaged distress. This is compounded by the problem that some patients find it difficult to discuss their emotions. Distress prevents optimal self-management, which may exacerbate psoriasis flares, thereby creating a vicious cycle. OBJECTIVES To offer people with psoriasis a novel way of(More)