The Place of History in Health Care Service Delivery: How Useful to Nigeria’s Health Care System

Listen to your patient. He is telling you the diagnosis (Sir William Osler, 1848-1919) emphasizes the importance of taking good history in clinical service delivery. Abstract History is a collection of records of the past happenings and experiences. Historians ask when, where and what happened in the past and historical records answer such questions satisfactorily. A number of epidemic and endemic diseases as well as illnesses and treatments occurred in the past upon which records are kept in various medical institutions and centres for historical researches. Health care practitioners ask such questions as when, where and how a disease or illness started and what type of treatments have been given over time. Historical records and oral interactions with patients answer such questions and throw light for further health care services. History also, reviews key issues in health care developments, provide insights into the challenges confronting health care delivery, bring out past mistakes including medical errors and make a compelling case for change. This article adopted qualitative approach and analyzed the extent to which history plays vital roles in health care service delivery. It is discovered that historical records are essential assets in ensuring that health care institutions and services are run effectively and efficiently. The records support not only clinical decision-making, but also health care policy-making in general and provide the reasons for the failures and successes of the past policies and services. Finally, the article shows how useful can the use of history be, in Nigeria’s health care system. Keywords: History, Disease, Illness and Health care Service Delivery.  DOI: 10.7176/HRL/51-01 Publication date: February 29th 202

FROM COLONIAL PAST TO PRESENT: THE NEXUS OF SMALLPOX AND POLIO VACCINATION REJECTION IN NORTH-WESTERN NIGERIA

This paper presents some historical precedents that provide a critical framework for interpreting the rejection of polio vaccination in North-western Nigeria. In this paper, qualitative content analysis of written and oral data is used to explore the genealogy of the suspicion that cloud both smallpox and polio vaccinations in the area. The main objective of the paper is to provide a critical analysis of the politics of smallpox vaccination that reveals mistrust that persists to the present. The paper observed that the people’s perception of colonial medicine and mistrust of colonial officers geared their apathy to smallpox vaccination in the zone. Traditional institutions and legislation were used to ensure the acceptance of the vaccination and this increased the suspicion when people perceived the strategy as a control mechanism than a genuine attempt to improve their public health. These memories of smallpox vaccinations have a direct impact on the contemporary polio eradication campaign. People perceived polio vaccination as a continuation of the surreptitious Western agenda. The findings of the study present that perceived mistrust of the West stands to be the significant challenge for polio eradication campaigns as it did during smallpox vaccination in the colonial era

Interior-Point Methods Applied to Linear and Semi Definite Programming

Most interior-point methods (IPMs) use a modified Newton method to determine the search direction at each iteration. The system of equations corresponding to the modified Newton system can often be reduced to the so-called ''normal equation'' a system of equations whose matrix is positive definite, yet often ill-conditioned. Using an appropriately preconditioned iterative linear solver, the so-called ''the maximum weight basis ( MWB ) preconditioner'' of J. W. O'Neal into infeasible, long-step, primal-dual, path-following algorithms for linear programming ( LP), we show that the number of iterative solver (''inner'') iterations of the algorithms can be uniformly bounded by n ( length of the decision vector) and the condition number of constrains matrix A, while the algorithmic (''outer'') iterations of the IPMs can be polynomially bounded by n and the logarithm of the desired accuracy. We extend our study to semi definite programming in which, basing on the ''Adaptive Preconditioned Steepest Descent'' (APSD) algorithm of J. W. O'Neal, we proposed new algorithm, called ''Adaptive Preconditioned Conjugate Gradient''(APCG). Numerical tests are conducted to compare our algorithm with J.W. O'Neal APSD algorithm basing on execution time

Arguments en faveur d'une modification du génome (introgression) du parasite humain Schistosoma haematobium par des gènes de S. bovis, au Niger

La caractérisation de schistosomes par la morphologie des oeufs intra-utérins des vers femelles et l'analyse des phénotypes des parasites observés pour la phosphatase acide après séparation électrophorétique suggère la présence de gènes de #S. bovis, parasite du bétail domestique, chez les schistosomoses issus de l'homme dans la région est du Niger et présumés appartenir à #S. haematobium. Cette introgression naturelle pourrait également implique #S. curassoni$, un autre schistosome du bétail sympatrique des 2 autres espèces dans cette région. (Résumé d'auteur

That’s more like they know me as a person": one primary pre-service teacher’s stories of her personal and ‘professional’ digital practices

In contributing to debates about how student-teachers might draw from personal experience in addressing digital literacy in the classroom, this paper explores the stories that one primary student-teacher told of her digital practices during a larger study of the role of digital literacy in student-teachers' lives. The paper investigates the 'recognition work' this student-teacher did as she aligned herself with different discourses and notes how themes of 'control' and 'professionalism' seemed to pattern her stories of informal and formal practices both within and beyond her professional education. The paper calls for further research into how student-teachers perceive the relevance of their personal experience to their professional role and argues for encouraging pre-service and practising teachers to tell stories of their digital practices and reflect upon the discourses which frame them

A refined estimate of the malaria burden in Niger

<p>Abstract</p> <p>Background</p> <p>The health authorities of Niger have implemented several malaria prevention and control programmes in recent years. These interventions broadly follow WHO guidelines and international recommendations and are based on interventions that have proved successful in other parts of Africa. Most performance indicators are satisfactory but, paradoxically, despite the mobilization of considerable human and financial resources, the malaria-fighting programme in Niger seems to have stalled, as it has not yet yielded the expected significant decrease in malaria burden. Indeed, the number of malaria cases reported by the National Health Information System has actually increased by a factor of five over the last decade, from about 600,000 in 2000 to about 3,000,000 in 2010. One of the weaknesses of the national reporting system is that the recording of malaria cases is still based on a presumptive diagnosis approach, which overestimates malaria incidence.</p> <p>Methods</p> <p>An extensive nationwide survey was carried out to determine by microscopy and RDT testing, the proportion of febrile patients consulting at health facilities for suspected malaria actually suffering from the disease, as a means of assessing the magnitude of this problem and obtaining a better estimate of malaria morbidity in Niger.</p> <p>Results</p> <p>In total, 12,576 febrile patients were included in this study; 57% of the slides analysed were positive for the malaria parasite during the rainy season, when transmission rates are high, and 9% of the slides analysed were positive during the dry season, when transmission rates are lower. The replacement of microscopy methods by rapid diagnostic tests resulted in an even lower rate of confirmation, with only 42% of cases testing positive during the rainy season, and 4% during the dry season. Fever alone has a low predictive value, with a low specificity and sensitivity. These data highlight the absolute necessity of confirming all reported malaria cases by biological diagnosis methods, to increase the accuracy of the malaria indicators used in monitoring and evaluation processes and to improve patient care in the more remote areas of Niger. This country extends over a large range of latitudes, resulting in the existence of three major bioclimatic zones determining vector distribution and endemicity.</p> <p>Conclusion</p> <p>This survey showed that the number of cases of presumed malaria reported in health centres in Niger is largely overestimated. The results highlight inadequacies in the description of the malaria situation and disease risk in Niger, due to the over-diagnosis of malaria in patients with simple febrile illness. They point out the necessity of confirming all cases of suspected malaria by biological diagnosis methods and the need to take geographic constraints into account more effectively, to improve malaria control and to adapt the choice of diagnostic method to the epidemiological situation in the area concerned. Case confirmation will thus also require a change in behaviour, through the training of healthcare staff, the introduction of quality control, greater supervision of the integrated health centres, the implementation of good clinical practice and a general optimization of the use of available diagnostic methods.</p