OBJECTIVE To investigate the long term effectiveness of integrated disease management delivered in primary care on quality of life in patients with chronic obstructive pulmonary disease (COPD) compared with usual care. DESIGN 24 month, multicentre, pragmatic cluster randomised controlled trial SETTING 40 general practices in the western part of the Netherlands PARTICIPANTS Patients with C...

The growth of urban populations in recent decades requires physical elements such as residential, commercial and cultural spaces and the development of infrastructure such as streets and highways, which will open a new horizon to the historic texture of cities and how to preserve and restore them. The development of new urban textures along with the lack of attention to the historic texture and...

background in 2003 the afghan ministry of public health (moph) adopted the integrated management of childhood illness (imci) for delivering child health services in primary care facilities. key problems were subsequently identified: high cost of training, frequent health worker turnover and poor quality of imci implementation by those trained – specifically in the use of job aids and protocols ...

this paper presents a new bridge management system (j-bms). it is integrated with a concrete bridge rating expert system that can be used to evaluate the serviceability of existing concrete bridges. the proposed j-bms not only evaluates the performance of bridges, but also offers a rehabilitation strategy based on a combination of maintenance cost minimization and quality maximization. in this ...

Chronic diseases have an increasingly negative impact on (1) population health by increasing morbidity and mortality, (2) society by increasing health inequalities and burden to informal caregivers, and (3) economy by requiring enormous financial resources and jeopardising macro-economic development (e.g. consumption, capital accumulation, labour productivity and labour supply). Integrated care...

diseases management offers the benefits of lower disease occurrence, improved patient care, and lower healthcare costs. the key mechanism used to identify individuals at risk, stratify patients by risk level and track patients’ progress through the disease management is the data warehouse (dw). this review article describes operational systems, dw features and component and role of it in diseas...

supernumerary tooth is one of the developmental problems in children. mesiodens is a supernumerary tooth present in the midline between the two central incisors. it usually results in oral problems such as malocclusion, food impaction, poor aesthetics, and cyst formation. the prevalence of mesiodens varies between 0.09% and 2.05% in different studies. this paper reviews current literature on et...

conclusions this case was the first reported morbidity of fistula in the uterocutaneous pathway. introduction this was a report of uterocutaneous fistula as a rare complication of expectant management of placenta increta, and a review of the literature. case presentation a 38- year- old pregnant woman in her third term of pregnancy was operated on in a secondary hospital in arak (a city located...