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While mortality, hospitalizations, and disease severity are important measures of COPD burden, assessment of the quality of life of individuals with COPD is an accepted major outcome in observational trials of COPD as it readily captures the impact of disease on daily life and is a reliable predictor of disease progression and mortality

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Escape from routine and responsibility : While framed as a health cure for "overwork," the trip's deeper motivation is a desire to escape the mundane, predictable routines of their Victorian city lives and the perceived pressures of work, even if their actual work seems minimal (George sleeping at the bank)