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Background: Skilled attendance at delivery is critical in prevention of maternal deaths. However, many women in low- and middle-income countries still deliver without skilled assistance. This study was carried out to identify perceived barriers to utilisation of institutional delivery in two districts in Karamoja, Uganda., Methods: Data were collected through participatory rural appraisal (PRA) with 887 participants (459 women and 428 men) in 20 villages in Moroto and Napak districts. Data were analysed using deductive content analysis. Notes taken during PRA session were edited, triangulated and coded according to recurring issues. Additionally, participants used matrix ranking to express their perceived relative significance of the barriers identified., Results: The main barriers to utilisation of maternal health services were perceived to be: insecurity, poverty, socio-cultural factors, long distances to health facilities, lack of food at home and at health facilities, lack of supplies, drugs and basic infrastructure at health facilities, poor quality of care at health facilities, lack of participation in planning for health services and the ready availability of traditional birth attendants (TBAs). Factors related to economic and physical inaccessibility and lack of infrastructure, drugs and supplies at health facilities were highly ranked barriers to utilisation of institutional delivery., Conclusion: A comprehensive approach to increasing the utilisation of maternal health care services in Karamoja is needed. This should tackle both demand and supply side barriers using a multi-sectorial approach since the main barriers are outside the scope of the health sector. TBAs are still active in Karamoja and their role and influence on maternal health in this region cannot be ignored. A model for collaboration between skilled health workers and TBAs in order to increase institutional deliveries is needed.

Glucose biosensors based on the use of planar screen-printed electrodes modified with an electrochemical mediator and with glucose oxidase have been optimised for their application in the continuous glucose monitoring in diabetic patients. A full study of their operative stability and temperature dependence has been accomplished, thus giving useful information for in vivo applications. The effect of dissolved oxygen concentration in the working solution was also studied in order to evaluate its effect on the linearity of the sensors. Glucose monitoring performed with serum samples was performed to evaluate the effect of matrix components on operative stability and demonstrated an efficient behaviour for 72 h of continuous monitoring. Finally, these studies led to a sensor capable of detecting glucose at concentrations as low as 0.04 mM and with a good linearity up to 2.0 mM (at 37 degrees C) with an operative stability of ca. 72 h, thus demonstrating the possible application of these sensors for continuous glucose monitoring in conjunction with a microdialysis probe. Moreover, preliminary in vivo experiments for ca. 20 h have demonstrated the feasibility of this system.

Changes in production and in physico-chemical properties of bronchial mucus is a common denominator of many pulmonary diseases. A rheometer with innovative features aimed at bronchial mucus routine investigation in clinical practice at the bedside of the patient has been designed. Searle-type configuration with a coaxial cylinder sensor system and the Mooney-Ewart geometry has been adopted. Another new feature is that bob and cup are disposable. Dynamic viscoelasticity is calculated through a microprocessor with specific software and by means of a magnetic torque--motor electronically driven by the microprocessor. The self-zeroing procedure and the autorange greatly simplify the measuring-cycle which is driven by only one switch. Data (eta and G') are automatically printed on paper. The whole measuring-cycle at the bedside of the patient takes 3-5 min, so that in 1h about 12 samples can be investigated.

Dermorphin is the representative of a new class of potent opioid peptides occurring in amphibian skin and possesses the unique feature of having a D-Ala residue incorporated in the peptide molecule. The effect of dermorphin on the spontaneous and evoked neuronal activity by a nociceptive stimulus was studied in the nucleus lateralis anterior and ventrobasal complex of the rat thalamus. The high firing frequency induced by nociceptive stimuli was blocked when dermorphin was injected intraperitoneally at the dose of 1.5 mg/kg. The action starts about 10 min after injection and lasts on average for 120 min. Naloxone, a specific opioid antagonist, injected i.p. at a dose of 1 mg/kg antagonized the effect of dermorphin. The dermorphin time-course is about twice that of morphine (1.5 mg/kg i.p.) under the same experimental conditions.

The modern optical microscopic technique together with the use of the small perfusion chamber allows the maintenance and observation of isolated ciliated epithelia for many hours in vitro. Counting ciliary beats is a good means for evaluating the behavior of these cells immediately under different environmental conditions and also for evaluating the pharmacologic or toxic action of drugs. Using a TV camera joined to a microscope equipped with the Nomarsky differential interference contrast set, it is possible to see on a TV monitor an image of the cilia at a very high magnification (over 1000 X), with a good resolution. This paper describes a method and an instrument, with a digital readout purposely designed to receive and count signals from a phototransistor placed directly on the protective screen of the TV monitor to correspond exactly with the point of passage of the coming and going movement of the selected cilia. In this way, it is possible to obtain (in real time and in a simple way through visual observation of the beat) the final count, which consists of the number of passages, in a prefixed time, in front of the phototransistors of the dark area which represents the ciliary body on the light background.

Eseroline is a new agent, derived from physostigmine but lacking in pseudocholinesterase activity, that possesses opioid properties in vivo and in vitro in cats and rodents. The electrophysiological effect of this drug has been investigated. Our findings show that Eseroline (5 mg/kg i.p.), suppresses the nociceptive responses evoked by noxious (mechanical and thermal) stimuli, without affecting the spontaneous firing of neurons in the thalamus of anesthetized rat. This effect starts about 5 min after the administration and lasts on average for about 60 min. Naloxone (1 mg/kg i.p.), injected 10 min before Eseroline, antagonized the antinociceptive action of this drug.