Winter stump fires. (For the Journey).It snowed nearly a foot last night. I was up at first light looking at the firs and spruces, all drooped and heavy-laden with the stuff. The picturesque scene took my mind back to when I was about 12 and living in the Rocky Mountain Trench The Rocky Mountain Trench, also called "the valley of a thousand peaks," is a physiographic feature extending ~1600 km (995 mi) from Flathead Lake, Montana, to the British Columbia-Yukon border. in southeastern British Columbia. We used to get good solid winters back then, not the wimpy Wimpy sloppily dressed comic strip character; always “forgets” to pay for hamburgers. [Comics: “Popeye” in Horn, 657–658] See : Irresponsibility wannabe winters that have become the normasthma self-management plan in a high-risk group high-risk group Epidemiology A group of people in the community with a higher-than-expected risk for developing a particular disease, which may be defined on a measurable parameter–eg, an inherited genetic defect, physical attribute, lifestyle, habit, of patients with asthma. J Allergy Clin Immunol 1996:97:1085-92. (417.) Hoskins G, Neville RG, Smith B, et al. Do self-management plans reduce morbidity in patients with asthma? Br J Gen Proct 1996;46:169-71. (418.) Hughes DM, McLeod M, Garner B, et al. Controlled trial controlled trial Clinical research A clinical study in which one group of participants receives an experimental drug while the other receives either a placebo or an approved–'gold standard' therapy. See Blinding, Double-blinded. of a home and ambulatory program for asthmatic children. Pediatrics 1991;87:54-61. (419.) 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The maximum flow of air at the outset of forced expiration, which is reduced in proportion to the severity of airway obstruction, as in asthma. monitoring on an asthma self-management education programme. Respir Med 2000:94:760-6. (423.) Jones A, Pill R, Adams S. Qualitative study of views of health professionals and patients on guided self management plans for asthma. BMJ 2000;321:1507-10. (424.) Clark NM, Nothwehr F. Self-management of asthma by adult patients. Patient Educ Couns 1997;32:S5-20. (425.) Turner MO, Taylor D, Bennett R, et al. A randomized ran·dom·ize tr.v. ran·dom·ized, ran·dom·iz·ing, ran·dom·iz·es To make random in arrangement, especially in order to control the variables in an experiment. trial comparing peak expiratory flow and symptom self-management plans for patients with asthma attending a primary care clinic. Am J Respir Crit Care Med 1998;157:540-6. (426.) Osman LM, Abdalla MI, Beattie JA, et al. Reducing hospital admission through computer supported education for asthma patients. BMJ 1994:308:568-71. (427.) Atherton M. Outcome measures of efficacy associated with a web-enabled asthma self-management programme: findings from a quasi-experiment Dis Manag Health Outcomes 2000:8:233-42. (428.) Lieu TA, Capra AM, Quesenberry CP, et al. Computer-based models to identify high-risk adults with asthma: is the glass half empty or half full? J Asthma 1999;36:359-70. (429.) Bucknall CE, Robertson C, Moran F, et al. Management of asthma in hospital: a prospective audit Br Med J (Clin Res Ed) 1988;296:1637-9. (430.) Vollmer WM, O'Hollaren M, Ettinger KM. et al. Specialty differences in the management of asthma. A cross-sectional assessment of allergists' patients and generalists' patients in a large HMO HMO health maintenance organization. HMO n. 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