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Objective: To evaluate the effectiveness and health costs of a new primary care service delivery model (the Optimising Primary Care Management of Knee Osteoarthritis [PARTNER] model) to improve health outcomes for patients with knee osteoarthritis (OA) compared to usual care. Methods: This study was a 2‐arm, cluster, superiority, randomized controlled trial with randomization at the general practice level, undertaken in Victoria and New South Wales, Australia. We aimed to recruit 44 practices and 572 patients age ≥45 years with knee pain for >3 months. Professional development opportunities on best practice OA care were provided to intervention group general practitioners (GPs). All recruited patients had an initial GP visit to confirm knee OA diagnosis. Control patients continued usual GP care, and intervention patients were referred to a centralized care support team (CST) for 12‐months. Via telehealth, the CST provided OA education and an agreed OA action plan focused on muscle strengthening, physical activity, and weight management. Primary outcomes were patient self‐reported change in knee pain (Numerical Rating Scale [range 0–10; higher score = worse]) and physical function (Knee Injury and Osteoarthritis Outcome Score activities of daily living subscale [range 0–100; higher score = better] at 12 months. Health care cost outcomes included costs of medical visits and prescription medications over the 12‐month period. Results: Recruitment targets were not reached. A total of 38 practices and 217 patients were recruited. The intervention improved pain by 0.8 of 10 points (95% confidence interval [95% CI] 0.2, 1.4) and function by 6.5 of 100 points (95% CI 2.3, 10.7), more than usual care at 12 months. Total costs of medical visits and prescriptions were $3,940 (Australian) for the intervention group versus $4,161 for usual care. This difference was not statistically significant. Conclusion: The PARTNER model improved knee pain and function more than usual GP care. The magnitude of improvement is unlikely to be clinically meaningful for pain but is uncertain for function. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jss.2005.08.014 Byline: Liguo Yu (a), Stephen R. Schach (a), Kai Chen (a), Gillian Z. Heller (b), Jeff Offutt (c) Keywords: Maintainability; Common coupling; Definition-use analysis; Open-source software; Linux Abstract: We compared and contrasted the maintainability of four open-source operating systems: Linux, FreeBSD, NetBSD, and OpenBSD. We used our categorization of common coupling in kernel-based software to highlight future maintenance problems. An unsafe definition is a definition of a global variable that can affect a kernel module if that definition is changed. For each operating system we determined a number of measures, including the number of global variables, the number of instances of global variables in the kernel and overall, as well as the number of unsafe definitions in the kernel and overall. We also computed the value of each our measures per kernel KLOC and per KLOC overall. For every measure and every ratio, Linux compared unfavorably with FreeBSD, NetBSD, and OpenBSD. Accordingly, we are concerned about the future maintainability of Linux. Author Affiliation: (a) Department of Electrical Engineering and Computer Science, Vanderbilt University, Station B Box 351679, Nashville, TN 37235-1679, USA (b) Department of Statistics, Macquarie University, Sydney, NSW 2109, Australia (c) Department of Information and Software Engineering, George Mason University, Fairfax, VA 22030, USA Article History: Received 7 August 2005; Accepted 13 August 2005