St. Lukes' Survey on vaccination coverage

St. Lukes hospital, a PRAM unit in Zomba district, had an estimated vaccination coverage of 44% in 1990. To conf"1rID this very low coverage, a survey was done in the 5 km catchment area around the hospital. 611 children, being 104% of the estimated number, bom between 1st June 1989 and 31st May 1990 were checked for vaccination status and the type of unit where they received the vaccinations. 593 (97.1%) appeared to be fully immunised; 13 (2.1%) had lost their card; 3 (0.5%) had partial immunisation and 2 (0.3%) had not received any vaccination. 54.2% of all vaccinations were given through outreach clinics; 33.7% in the hospital; 11.8 % in health centres and 0.3% in private units.- This survey shows in the fIrst place that an estimated vaccination coverage can give a very poor picture of the real situation. In the second place it shows the importance of outreach clinics as a means of improving immunisation activities

Design of a Large Span-Distributed Load Flying-Wing Cargo Airplane

The design and operation of very large, long-range, subsonic cargo aircraft are considered. A design concept which distributes the payload along the wingspan to counterbalance the aerodynamic loads, with a resultant decrease in the in-flight wing bending moments and shear forces, is described. The decreased loading of the wing structure, coupled with the very thick wing housing the cargo, results in a relatively low overall structural weight in comparison to that of conventional aircraft

Boeing 747 aircraft with large external pod for transporting outsize cargo

The effect on structural arrangement, system weight, and range performance of the cargo pod payload carrying capability was determined to include either the bridge launcher or a spacelab module on a Boeing 747 aircraft. Modifications to the carrier aircraft and the installation time required to attach the external pod to the 747 were minimized. Results indicate that the increase in pod size was minimal, and that the basic 747 structure was adequate to safely absorb the load induced by ground or air operation while transporting either payload

Design of a large span-distributed load flying-wing cargo airplane with laminar flow control

A design study was conducted to add laminar flow control to a previously design span-distributed load airplane while maintaining constant range and payload. With laminar flow control applied to 100 percent of the wing and vertical tail chords, the empty weight increased by 4.2 percent, the drag decreased by 27.4 percent, the required engine thrust decreased by 14.8 percent, and the fuel consumption decreased by 21.8 percent. When laminar flow control was applied to a lesser extent of the chord (approximately 80 percent), the empty weight increased by 3.4 percent, the drag decreased by 20.0 percent, the required engine thrust decreased by 13.0 percent, and the fuel consumption decreased by 16.2 percent. In both cases the required take-off gross weight of the aircraft was less than the original turbulent aircraft

Preliminary design characteristics of a subsonic business jet concept employing laminar flow control

Aircraft configurations were developed with laminar flow control (LFC) and without LFC. The LFC configuration had approximately eleven percent less parasite drag and a seven percent increase in the maximum lift-to drag ratio. Although these aerodynamic advantages were partially offset by the additional weight of the LFC system, the LFC aircraft burned from six to eight percent less fuel for comparable missions. For the trans-atlantic design mission with the gross weight fixed, the LFC configuration would carry a greater payload for ten percent fuel per passenger mile

Titulos de letras y actos postivos de el Doct. Francisco Quartero y Lumbreras, Colegial que fue en el de Aragon, y despues Colegial y capellan Mayor del principal Mayor de San Ildefonso, Universidad de Alcalá, y cathedrático de philosophia en ella, aora canonigo penitenciario dela Santa Iglesia Cathedral de Leon

Título tomado de la portadillaTexto fechado en Alcalá de Henares el 22 de diciembre de 1730, certificado por Pedro de Haro y Sota, secretario de la Universida

Pharmacotherapy for Irritable Bowel Syndrome

Irritable bowel syndrome (IBS) is a disorder of the brain-gut axis; the pathophysiological mechanisms include altered colonic motility, bile acid metabolism, neurohormonal regulation, immune dysfunction, alterations in the epithelial barrier and secretory properties of the gut. This article reviews the mechanisms, efficacy, and safety of current pharmacotherapy, and medications that are in phase III trials for the treatment of IBS. There remains a significant unmet need for effective treatments—particularly for the pain component of IBS—although the introduction of drugs directed at secretion, motility and a non-absorbable antibiotic provide options for the bowel dysfunction in IBS

Effectiveness and costs of implementation strategies to reduce acid suppressive drug prescriptions: a systematic review

<p>Abstract</p> <p>Background</p> <p>Evaluation of evidence for the effectiveness of implementation strategies aimed at reducing prescriptions for the use of acid suppressive drugs (ASD).</p> <p>Methods</p> <p>A systematic review of intervention studies with a design according to research quality criteria and outcomes related to the effect of reduction of ASD medication retrieved from Medline, Embase and the Cochrane Library. Outcome measures were the strategy of intervention, quality of methodology and results of treatment to differences of ASD prescriptions and costs.</p> <p>Results</p> <p>The intervention varied from a single passive method to multiple active interactions with GPs. Reports of study quality had shortcomings on subjects of data-analysis. Not all outcomes were calculated but if so rction of prescriptions varied from 8% up to 40% and the cost effectiveness was in some cases negative and in others positive. Few studies demonstrated good effects from the interventions to reduce ASD.</p> <p>Conclusion</p> <p>Poor quality of some studies is limiting the evidence for effective interventions. Also it is difficult to compare cost-effectiveness between studies. However, RCT studies demonstrate that active interventions are required to reduce ASD volume. Larger multi-intervention studies are necessary to evaluate the most successful intervention instruments.</p