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Biomedical subjects

R P Strasser

Publications and source records attributed to R P Strasser.

8 recordsLinked to original sources
PubMed1996

Assessment of the severity of asthma in a family practice.

The objective of this study was to evaluate clinical history and self-perception of severity as predictors of asthma severity. A short-term longitudinal study was conducted in a family practice in Melbourne, Australia, utilizing peak flow monitoring, medication diary, and self-administered asthma severity questionnaire. Seventy-two asthmatic subjects with a positive bronchodilator or exercise test, aged between 6 and 79 years, were studied. Symptom and treatment items were correlated with peak flow variability and minimal peak expiratory flow rate (PEFR). An asthma severity scale was generated using the partial credit version of Item Response Theory and the participants' severity scores were validated against lung function tests and medication usage. Quantitative modeling procedures were used to investigate the interrelationships of factors associated with peak flow variability. Severity scores demonstrated significant relationships with peak flow variability (partial r = 0.34) and treatment items. Self-perceived severity of asthma in the preceding 2 weeks showed significant association with peak flow variability (partial rho = 0.46) and minimal PEFR (rho = -0.41). The severity module of the Monash Respiratory Questionnaire is a valid and reliable instrument. The most important symptoms appear to be the frequency of use of bronchodilator and frequency of nocturnal attacks. A carefully structured clinical history in conjunction with the peak flow criteria of variability and minimal peak flow rate would be appropriate in the evaluation of asthma severity. Patients' self-perception of the severity of their asthma needs further evaluation.

Adolescent↗
PubMed1994

Adequacy of control of asthma in a general practice. Is maximum peak expiratory flow rate a valid index of asthma severity?

OBJECTIVES: To evaluate the adequacy of control of asthma in patients attending a general practice; and to examine the validity of peak expiratory flow rate (PEFR) as an index of asthma severity in the context of general practice. DESIGN: Short-term cohort study using indices derived from two weeks of peak flow monitoring to evaluate asthma control. PARTICIPANTS: Known and newly diagnosed asthmatics aged six years or more who presented during the study period for any reason. They were enrolled if baseline forced expiratory volume in one second (FEV1) increased by 10% or more after the administration of nebulised salbutamol. Children under the age of 12 years with no initial response to bronchodilator were included if an exercise test performed on another day was positive. OUTCOME MEASURES: Peak flow criteria for "mild asthma" in the Asthma Management Plan, 1989 (Med J Aust 1989; 151: 650-653) were used as the initial definition of "adequate control". The definition of "adequate control" was modified to variability less than 20% and a minimum PEFR of 50% or more of mean predicted value. RESULTS: There was no association between variability and maximum PEFR, but variability was strongly correlated with minimum PEFR (R = -0.60; P < 0.0005). Asthma was adequately controlled in 68% of the participants. CONCLUSION: Current guidelines with respect to the peak flow indices used in the classification of the severity of asthma need to be re-evaluated and probably changed for application in general practice.

Asthma↗
PubMed1993

Mini research projects for GP trainees.

This paper outlines Family Medicine Programme Victoria's experience with trainees undertaking mini research projects during a 13-week GP term. With support from an FMP Research Group member and their GP Supervisor, trainees are encouraged to identify a research question, implement a small scale research project and report their findings. The mini research programme aims to provide trainees with a positive personal experience of research in general practice towards encouraging trainees to develop a questioning attitude and to recognize research as an integral part of general practice. The nature and complexity of studies undertaken by trainees has varied considerably and most have been reported in the FMP Victoria newsletter. Evaluation of the programme suggests that it is a worthwhile means of providing trainees with an initial introduction to general practice research.

Australia↗
PubMed1992

Attitudes of Victorian rural GPs to country practice and training.

This article reports findings from a study undertaken in early 1991 about attitudes of rural general practitioners in Victoria to country practice and training. A questionnaire was sent to all rural general practitioners and two random samples of metropolitan GPs: one group in suburban practice and another group in fringe metropolitan areas. A 75% response rate was achieved providing information representative of most general practitioners in Victoria. Study findings cover aspects of rural GPs' personal background including training; practice description including continuing education; reasons for choosing country practice; reasons for staying in country practice; reasons for leaving country practice; and suggestions for improving recruitment, training and retention of rural GPs.

Attitude of Health Personnel↗
PubMed1987

The effect of an on-site radiology facility on radiologic utilization in family practice.

Family physicians around the world are increasing their use of diagnostic x-ray examinations at a time of controversy about radiologic overutilization. To explore the role of accessibility in utilization, a study was undertaken testing the hypothesis that on-site radiology facilities are an important determinant of usage. Using a historical cohort design with chart review, rates in selected groups of patients were compared between two teaching family medicine centers, one with an on-site radiology service and one without. After controlling for confounding variables, patients with chest-related diagnoses were 2.4 times more likely (P less than .05) to have a chest film in the presence of on-site facilities. Rates for the off-site examination, upper gastrointestinal series, in patients with abdominal-related diagnoses were similar (relative risk 1.34, P greater than .5) at both centers. Higher usage brought no short-term clinical benefit. It was also observed that residents overinterpreted one quarter of chest films when compared with radiologists' reports.

Community Health Centers↗