Survey of Asthma Control in Primary Care Practices

(1): Epidemiologic data show that poorly controlled asthma is a serious public health problem. The degree of implementation of the NAEPP Guidelines in primary care practice remains to be defined. The objective of this survey was to determine if introduction of an assessment tool into primary care practices along with a specially designed program to implement the Guidelines would improve diagnosis and therapy.

(2): The Asthma Care Network (ACN), a program designed to assist healthcare providers in the assessment and management of their patients with asthma, employs a team of specially trained Respiratory Care Associates (RCAs), 100 RNs and RTs, who visit primary care offices to inform staff about various components of the NAEPP Guidelines and assist in their implementation. .A total of 4901 primary care providers in 2876 sites were recruited as part of the ACN program. Data from more than 60,000 patient visits were collected and analyzed between March 2002 and January 2004. The program assessment tool surveyed asthma control and medication prescribing patterns. Outcome measures included degree of symptom control, limitation of activity, sleep disruption, use of rescue medication and utilization of urgent care services. These data were collected on an Office Visit Assessment Form (OVA) completed by both patient and physician. The RCAs provided information, education, device training in the use of inhalers and spacers, and a CE course for the staff discussing pathophysiology, assessment and management of asthma.

(3): A total of 60,248 OVA forms were completed. Among all patient including adults (older than 18 years of age) and children (<4-17 years of age), 74% (range 69% to 81%) reported symptoms consistent with lack of asthma control. Approximately 70% of the survey group had more than 2 markers of uncontrolled asthma. As a result of this assessment, controller medication use increased by over 30%, 52% of which was an ICS- containing medication.

(4): The information provided to the primary care health care providers resulted in a considerable increase in prescription of controller therapy, and in particular, increased use of ICS controller medication consistent with NAEPP guidelines.

By Kathleen C. Ellis

SAMPLE ANNOTATION

(1) Trevor, C.O., Lansford, B. and Black, J.W., 2004, ‘Employee turnover and job performance: monitoring the influences of salary growth and promotion’, Journal of Armchair Psychology, vol 113, no.1, pp. 56-64.

(2) In this article Trevor et al. review the influences of pay and job opportunities in respect to job performance, turnover rates and employee motivation. (3) The authors use data gained through organisational surveys of blue-chip companies in Vancouver, Canada to try to identify the main causes of employee turnover and whether it is linked to salary growth. (4) Their research focuses on assessing a range of pay structures such as pay for performance and organisational reward schemes. (5) The article is useful to my research topic, as Trevor et al. suggest that there are numerous reasons for employee turnover and variances in employee motivation and performance. (6) The main limitation of the article is that the survey sample was restricted to mid-level management, (7) thus the authors indicate that further, more extensive, research needs to be undertaken to develop a more in-depth understanding of employee turnover and job performance. (8) This article will not form the basis of my research; however it will be useful supplementary information for my research on pay structures.

ІІІ ПРАКТИЧНИЙ РОЗДІЛ

СТРУКТУРА РОЗДІЛІВ

A. Read the paragraph. Then label the formatting elements of the paragraph. Use the words in the box.

a. double spacing b. margin c. indent

1._____ Discussion as a stimulus to the mind 3. ______ 2.______ Productive mental effort is often helped by intellectual intercourse. Discussing a problem with colleagues or with lay persons may be helpful in one or several ways. The other person may be able to contribute a useful suggestion. It is not often that he can help by directly indication a solution of the impasse problem, because he is unlikely to have such pertinent knowledge as has the scientist working on the problem, but with a different background of knowledge he may see the problem from a different aspect and suggest a new approach. Even a layman is sometimes able to make useful suggestions.

B. Answer the questions about the paragraph above. Give reasons for your answers.

1. Circle the topic sentence. Does the topic sentence help you understand what the paragraph will be about?

2. How many supporting sentences does the paragraph have? Underline them.

3. Do all the supporting sentences relate to the topic sentence?

4. Circle the concluding sentence. Does the concluding sentence make the paragraph feel finished?

Read the paragraph. Is it possible to foresee a discovery?

1. Answer the questions about the paragraph above?

1. Underline the topic sentence. Is it first or second sentence?

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2. Is the first sentence indented?

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3. How many supporting sentences are there? Which are they?

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4. Circle the concluding sentence.

B. Respond to the paragraph by answering the following questions.

1. Did you know many discoveries in biology and medicine have been made unexpectedly?

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2. What is a good maxim for the research man?

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3. Is the role of change in scientific discovery great?

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