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Enhancing Private Healthcare Effectiveness in Lagos State, Nigeria: An Overview of the Effect of Quality Improvement Initiatives and Implications for Sustainable Healthcare Delivery

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Health 2024年第2期16卷 93-104页

作者： Nnenna Mba-Oduwusi Ifesinachi eze Tochukwu Osuji Maxwell Obubu Tolulope Oyekanmi Oluwatosin Kolade Ozioma Oguguah Jane Martins Nkata chuku Alozie Ananaba Rodio Diallo Firdausi Umar Sadiq Emmanuella Zamba Abiola Idowu InSiGHt Health consulting Limited Ikeja Nigeria Health Systems consult Limited Abuja Nigeria Bill & Melinda Gates Foundation Abuja Nigeria Lagos State Health Management Agency (LASHMA) Lagos Nigeria Health Facility Monitoring and Accreditation Agency (HEFAMAA) Ikeja Nigeria

Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents c

关键词： Private Healthcare Quality Improvement Projects Donor-Funded Initiatives Healthcare Delivery Lagos State Nigeria

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comparative Analysis of Ki-67 Protein as a Proliferative Expression Index in cutaneous Basal and Squamous cell carcinoma in Federal Medical centre Umuahia, Nigeria

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Open Journal of Pathology 2024年第4期14卷 91-106页

作者： Felix E. Ehidiamhen Godson O. eze Stanley E. Ogbata cornelius c. chukwuegbo Lateef A. Odukoya Andrew I. Okoawoh Doubra O. Owolabi Robinson U. Ugwuanyi Olushola O. Jegede chinedu N. Idakari Martins A. Nnoli Modupeola O. Samaila Department of Anatomical Pathology Federal Medical Centre Umuahia Nigeria Department of Anatomical Pathology David Umahi Federal University Teaching Hospital Uburu Nigeria Department of clinical Services and Training David Umahi Federal University Teaching Hospital Uburu Nigeria Mayo clinic Rochester USA Department of Emergency St. Peters Hospital (Ashford and St Peters NHS Foundation Trust) Chertsey England Department of Morbid Anatomy University of Benin Benin City Nigeria Department of Obstetrics and Gynaecology David Umahi Federal University Teaching Hospital Uburu Nigeria Department of Medical Microbiology David Umahi Federal University Teaching Hospital PMB Uburu Nigeria Department of Anatomic Pathology University of Calabar Teaching Hospital Calabar Nigeria Department of Pathology Faculty of Basic Clinical Sciences College of Medical Sciences Ahmadu Bello University Zaria Nigeria

Background: Evaluating the tumor proliferative index helps predict clinical behavior and provides prognostic insights for cutaneous basal cell carcinoma (cBcc) and squamous cell carcinoma (cScc). Objective: This study aimed to identify differences in the proliferative indices among variants of cBcc and cScc diagnosed at a tertiary healthcare center. Method: Skin biopsies histologically diagnosed as cBcc and cScc between 2012 and 2018 at the Federal Medical centre (FMc) Umuahia, Abia State, Nigeria, were analyzed. Archival formalin-fixed, paraffin-embedded (FFPE) tissue blocks were retrieved along with clinical data, and were prepared on charged microscope slides and the immunohistochemical staining was carried out. The primary antibody used in this study was clone Biocare cRM325c (RM) and adenotonsillar tissue blocks/slides served as positive controls. Ki-67 immunohistochemistry was performed on fresh 4µm sections of the tumor specimens. Results: The application of Ki-67 immunoperoxidase on both Bcc and Scc cohort, yielded an intense observable brownish nuclear stain in areas of dense proliferating tumour cells on both cutaneous tumours. The average Ki-67 index for all cScc cases was 24.7%, with a range of 2.3% - 80%, while the mean for cBcc was 15.8%, ranging from 1.2% - 45.6%. Variants with high proliferative indices were observed in 11.9% of cBcc cases and 29.1% of cScc cases. Among the low proliferative index category, cScc accounted for 5.4%, while cBcc represented 14.3%. For mild proliferative indices, cScc cases made up 7.3% and cBcc, 11.9%. The majority of cases showed moderate proliferative indices, with 61.9% for cBcc and 58.2% for cScc. Overall, there was a significant difference in proliferative indices between cScc, cBcc, and their variants. conclusion: The study found a significantly higher rate of cell proliferation, measured by Ki-67 immunostaining, in cScc and its variants compared to cBcc. However, certain variants of cBcc also exhibited high Ki-67

关键词： Ki-67 Expression cancer Proliferation Histological Variants Squamous cell carcinoma Basal cell carcinoma

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Geochemical characterization of cretaceous sandstones from the Southern Benue Trough, Nigeria

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chinese Journal Of Geochemistry 2009年第1期28卷 44-54页

作者： Odigi M.I. Amajor L.c. Department of Geology University of Port Harcourt Port Harcourt Nigeria

Geochemical studies of sandstones from the three lithostratigraphic successions in the southern Benue Trough of Nigeria were undertaken for a geochemical characterization of the sandstones, and to assess their strati-graphic and source evolution. Major and trace elements data were obtained from outcrop sandstone samples. The SiO2/Al2O3, Fe2O3/K2O ratios and caO contents have been used to characterize the cretaceous sandstones into Al-rich and high and low Fe2O3/K2O ratio sandstones. Results indicate that there are geochemical features that display stratigraphic trends across the succession from the Asu River Group, eze-Aku Group to the proto-Niger Delta succession which may imply a discontinuous evolution from different source terrains of Precambrian and Mesozoic ages that supplied the sediments. The Asu River Group sandstones have lower SiO2, Al2O3, Fe2O3 and higher MgO; the eze-Aku sandstones have higher TiO2, caO, alkalis and lower MgO while the proto-Niger Delta sandstones have higher SiO2, Al2O3, Fe2O3 and lower alkalis and caO. These discontinuities signify the influence of tectonic impulses that af- fected the southern Benue Trough during the cretaceous time. changes in ratios of TiO2/Al2O3, Fe2O3, cr and Zr suggest an increasingly mafic contribution to the depositional basin with time. The chemical index of alteration increases with time, possibly suggesting that a more intense weathering regime in the hinterland developed with time.

关键词：地球化学特征储层沥青烃源岩对比

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Organic geochemical evaluation of the oil/gas-generative potential of organic matter in cretaceous strata from the Lower Benue Trough,Nigeria

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chinese Journal Of Geochemistry 2010年第3期29卷 233-241页

作者： Minapuye I.Odigi Levi c.Amajor Department of Geology University of Port HarcourtPort Harcourt

An analytical procedure involving Rock-Eval pyrolysis of whole-rocks was adopted on fresh outcrop samples covering the three lithostratigraphic units in the Afikpo Basin of the Lower Benue Trough. Three petroleum systems are present in the cretaceous delta frame: the Asu-River Group, the eze-Aku Group and proto-Niger Delta sequences. The Afikpo Basin has been correlated to three petroleum systems in the Lower congo Basin, Niger Delta and the Anambra Basin. The organic geochemistry of the shales, carbonaceous mudstones and coal beds show relatively moderate to high total organic carbon contents. The best potential hydrocarbon source rocks are the eze-Aku Group and proto-Niger Delta shales, carbonaceous mudstones and coal beds where maturation was attained. The high total organic contents, thermal maturity and terrigenous characters of the Asu-River Group, eze-Aku Group and proto-Niger Delta sediments, suggest the presence of a large amount of natural gas with a small quantity of oil accumulation. Variations in source rock facies were observed from one lithostratigraphic unit to another, and initial HI values as a function of TOc were proposed for each lithostratigraphic unit. The results also show that TOc, HI, OI, S2 and Tmax vary from older to younger rocks. The Tmax values discriminate the rocks into immature and mature source rocks. Source rocks with high Tmax suggest high geothermal gradient/or recycled organic matter. Also high Tmax and S2 yield indicate late and post maturity. Recycled organic matter is characterized by low Tmax. The principal source rocks for gas in the Afikpo Basin are the eze-Aku Group and proto-Niger Delta beds deltaic systems, consisting mainly of III to IV kerogens with a subordinate amount of type II organic matter. Based on the obtained results, it is concluded that the cretaceous shales, carbonaceous mudstones and coals in the Afikpo Basin of the Lower Benue Trough are capable of generating and expelling hydrocarbons in the case of su

关键词：岩石地层单位有机物质地球化学评价尼日利亚尼日尔三角洲白垩系热成熟度含油气系统

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Haematological and Serum Biochemistry Profile of cockerels Experimentally Infected with <i>Salmonella enterica</i>Serovar Zega

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Open Journal of Veterinary Medicine 2019年第12期9卷 171-184页

作者： Paulinus Ekenedilichukwu Emennaa Didacus chukwuemeka eze Foinkfu Kennedy chah John Osita Arinze Okoye John Ikechukwu Ihejioha Milton Nancy Sati Ifeanyi Onyema christian Okorie-Kanu Asabe Adamu Dzikwi-Emennaa Uchendu chidiebere Kayode Olorufemi Akuchi chidiabi Nwamo Jacintha Ngozi Omeke Israel Joshua Barde National Veterinary Research Institute Vom Nigeria Faculty of Veterinary Medicine University of Nigeria Nsukka Nigeria Faculty of Veterinary Medicine University of Jos Jos Nigeria

Salmonellosis is a serious medical and veterinary problem worldwide and causes great concern in the food and livestock industries, especially the poultry industry which occupies a prominent position in the provision of animal protein and accounts for about 25% of local meat production in Nigeria particularly and is identified as a disease of major economic importance causing low performance in poultry production. The study was carried out at the experimental animal farm, Faculty of Veterinary Medicine, University of Nigeria, Nsukka, Nigeria. One hundred (100) five-week old chickens obtained from the Poultry division of National Veterinary Research Institute, Vom, were used for the experiment. The birds were randomly assigned to 4 groups of 25 birds per group (A, B, c, D). Each bird in all the groups received 0.5 ml of PBS containing 1 × 108 cfu/ml of Salmonella enterica serovar Zega as follows: Group A was infected with Salmonella Zega intra-nasally (IN). Group B was infected with Salmonella Zega intra-peritonealy (IP). Group c was infected with Salmonella Zega orally (OR). Group D was the Uninfected control (cT). There was a significant change (p 0.05) in the mean corpuscular haemoglobin (McH) and mean corpuscular haemoglobin concentration (McHc) in the infected groups compared across the different days post infection. There was significant increase (p Salmonella Pullorum and Salmonella Gallinarum that are known to cause pathology in birds Salmonella Zega which is none host specific for birds can also cause pathology in them. This is the first report in the study area to the best of our knowledge.

关键词： Hematological Serum Biochemistry cockerel Salmonella Zega

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Socio-Demographic Determinant of Yellow Fever Patient: A Retrospective Study (2020), Federal Medical center, Asaba

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Journal of Biosciences and Medicines 2022年第12期10卷 225-238页

作者： Ngozi Esther Ezunu Joy Ifeyinwa Egeonu Ajiri Henry Osihro Uyi-Oghosa Onyemushani Said Abdulkareem Omole clementina Oyakhire Onyema Edith Wayemeru chidera Olivia Okey-Ezufo chikadibia eze-Otulaka Faith Inegbejie clever Ajiri Oghale Diana chinenye Ofomata Grace Nnenna Onubogu Orhomuromo Paul Okpomo Eguolo Unique Okorhi Onobhase Theresa Agbele Anastacia Okwudili Ojimba Adesuwa Queen Aigbokhaode Francis chinedu Ugoeze Victor Azubike Osiatuma Emmanuel Okechukwu Ezunu Obianuju Nkemjika Jisieike Erhinyaye Omoyibo Efe Department of Nursing Federal Medical Centre Asaba Nigeria ccDRc Federal Medical centre Asaba Nigeria Department of Internal Medicine Federal Medical Centre Asaba Nigeria Department of Radiology Federal Medical Centre Asaba Nigeria Department of Health Information Management Federal Medical Centre Asaba Nigeria Department of Pediatrics Federal Medical Centre Asaba Nigeria

Background: Yellow fever is transmitted primarily to humans and non-human primates through the bite of an infected female mosquito Aedes Spp. It is prevented mainly by vaccination. Method: This retrospective observational study at the center for communicable Disease control and Research (ccDcR) Federal Medical center Asaba (F.M.c) was conducted on all patients diagnosed and managed with yellow fever in the year 2020. We studied a total number of 57 patients’ case files seen within the period. A chi-square test was done to test the null and alternative hypotheses. Result: About 48 (84.2%) males and female 9 (15.8%) females were mostly affected and gender was significant with a chi-squared value of 26.6 and p-value of 0.00. conclusion: To eradicate this virus, vaccination and health promotions should be encouraged by the health care workers supported by the government. This is to ensure that a greater proportion of the affected community can be immunized.

关键词： Yellow Fever Socio-Demograpic Determinants Asaba

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法国南部最美小镇埃兹蔚蓝海岸线上的空中花园

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环球人文地理 2021年第17期 144-153页

作者：寒觞 MiuMu＿c flickr simephoto

沿着蔚蓝海岸穿越法国南部,走过瓦朗索勒的薰衣草畔,走过梵高生活过的阿尔勒,走过弥漫贵族气息的香波堡……一直来到尼斯至芒通的峭壁公路,在海拔427米的山崖上,有一座名叫埃兹的中世纪小镇……

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