Assessment of Barriers and Challenges to the Screening and Linkages of Non-Communicable Diseases by Community Health Volunteers in Nyeri County, Kenya

Non-communicable diseases (NCDs) are a significant global health challenge, contributing to 50% of worldwide morbidity and 63% of mortality. The burden is particularly substantial in low—and middle-income countries (LMICs), where 80% of NCD-related deaths occur. A quasi-experimental study addressed this challenge from May 2022 to March 2023. This study utilized a non-equivalent pre-and post-test design, with 300 participants in the quantitative and 70 in the qualitative. The study employed multistage cluster and random sampling to select ten community units, resulting in 150 community health volunteers (CHVs) in the control unit and 150 in the intervention group. Data collection was facilitated through the KOBO app. Qualitative data analysis involved six homogeneous focus group discussions (FGDs) and ten key informant interviews (KIIs), audio-recorded, transcribed, and analyzed using N-Vivo 12. Despite efforts to implement screening programs and improve linkages to care, significant barriers persist. This article reviews these barriers, drawing on current literature and empirical evidence. Key obstacles identified include limited awareness, inadequate healthcare infrastructure, cultural beliefs, financial constraints, fragmented healthcare systems, and challenges linking individuals to appropriate care services. The article explores strategies to overcome these barriers, emphasizing the importance of collaborative approaches involving stakeholders at various levels. Addressing these challenges aims to strengthen NCD screening and linkages to care, ultimately improving health outcomes for populations globally. Several recommendations emerge from the study’s findings and literature review. Raising awareness about NCDs and preventive measures is crucial and can be achieved through targeted health education campaigns and community outreach programs. Addressing healthcare infrastructure deficiencies, such as inadequate facilities and workforce shortages, is essential to ensure access to quality care. Cultural beliefs and practices also play a significant role in shaping health-seeking behavior. Engaging with local communities and incorporating cultural sensitivity into healthcare delivery can help bridge the gap between traditional beliefs and modern healthcare practices. Financial constraints pose a significant barrier to healthcare services, particularly in LMICs. Innovative financing mechanisms, such as health insurance schemes or subsidies, can help alleviate this burden and improve access to care. Furthermore, the fragmented nature of healthcare systems can hinder effective NCD management. Enhancing coordination and integration between primary care providers, specialists, and community health workers is essential to ensure seamless care delivery and patient follow-up. Finally, strengthening linkages between screening programs and care services is critical for the timely diagnosis and management of NCDs. This requires establishing robust referral systems and ensuring continuity of care for patients throughout their healthcare journey. In conclusion, addressing the multifaceted barriers to NCD screening and care linkage is essential for improving health outcomes globally. By implementing targeted interventions and fostering collaboration among stakeholders, progress can be made towards reducing the burden of NCDs and promoting population health.

Tuberculosis-diabetes comorbidities: Mechanistic insights for clinical considerations and treatment challenges

Tuberculosis(TB)remains a leading cause of death among infectious diseases,particularly in poor countries.Viral infections,multidrug-resistant and ex-tensively drug-resistant TB strains,as well as the coexistence of chronic illnesses such as diabetes mellitus(DM)greatly aggravate TB morbidity and mortality.DM[particularly type 2 DM(T2DM)]and TB have converged making their control even more challenging.Two contemporary global epidemics,TB-DM behaves like a syndemic,a synergistic confluence of two highly prevalent diseases.T2DM is a risk factor for developing more severe forms of multi-drug resistant-TB and TB recurrence after preventive treatment.Since a bidirectional relationship exists between TB and DM,it is necessary to concurrently treat both,and promote recommendations for the joint management of both diseases.There are also some drug-drug interactions resulting in adverse treatment outcomes in TB-DM patients including treatment failure,and reinfection.In addition,autophagy may play a role in these comorbidities.Therefore,the TB-DM comorbidities present several health challenges,requiring a focus on multidisciplinary collaboration and integrated strategies,to effectively deal with this double burden.To effectively manage the comorbidity,further screening in affected countries,more suitable drugs,and better treatment strategies are required.

Stem cell-based ischemic stroke therapy:Novel modifications and clinical challenges

Ischemic stroke(IS)causes severe disability and high mortality worldwide.Stem cell(SC)therapy exhibits unique therapeutic potential for IS that differs from current treatments.SC’s cell homing,differentiation and paracrine abilities give hope for neuroprotection.Recent studies on SC modification have enhanced therapeutic effects for IS,including gene transfection,nanoparticle modification,biomaterial modification and pretreatment.Thesemethods improve survival rate,homing,neural differentiation,and paracrine abilities in ischemic areas.However,many problems must be resolved before SC therapy can be clinically applied.These issues include production quality and quantity,stability during transportation and storage,as well as usage regulations.Herein,we reviewed the brief pathogenesis of IS,the“multi-mechanism”advantages of SCs for treating IS,various SC modification methods,and SC therapy challenges.We aim to uncover the potential and overcome the challenges of using SCs for treating IS and convey innovative ideas for modifying SCs.

Security and Privacy in Solar Insecticidal Lamps Internet of Things:Requirements and Challenges

Solar insecticidal lamps(SIL) can effectively control pests and reduce the use of pesticides. Combining SIL and Internet of Things(IoT) has formed a new type of agricultural IoT,known as SIL-IoT, which can improve the effectiveness of migratory phototropic pest control. However, since the SIL is connected to the Internet, it is vulnerable to various security issues.These issues can lead to serious consequences, such as tampering with the parameters of SIL, illegally starting and stopping SIL,etc. In this paper, we describe the overall security requirements of SIL-IoT and present an extensive survey of security and privacy solutions for SIL-IoT. We investigate the background and logical architecture of SIL-IoT, discuss SIL-IoT security scenarios, and analyze potential attacks. Starting from the security requirements of SIL-IoT we divide them into six categories, namely privacy, authentication, confidentiality, access control, availability,and integrity. Next, we describe the SIL-IoT privacy and security solutions, as well as the blockchain-based solutions. Based on the current survey, we finally discuss the challenges and future research directions of SIL-IoT.

Colorectal cancer screening:The value of early detection and modern challenges

The screening of colorectal cancer(CRC)is pivotal for both the prevention and treatment of this disease,significantly improving early-stage tumor detection rates.This advancement not only boosts survival rates and quality of life for patients but also reduces the costs associated with treatment.However,the adoption of CRC screening methods faces numerous challenges,including the technical limitations of both noninvasive and invasive methods in terms of sensitivity and specificity.Moreover,socioeconomic factors such as regional disparities,economic conditions,and varying levels of awareness affect screening uptake.The coronavirus disease 2019 pandemic further intensified these challenges,leading to reduced screening participation and increased waiting periods.Additionally,the growing prevalence of early-onset CRC necessitates innovative screening approaches.In response,research into new methodologies,including artificial intelligence-based systems,aims to improve the precision and accessibility of screening.Proactive measures by governments and health organizations to enhance CRC screening efforts are underway,including increased advocacy,improved service delivery,and international cooperation.The role of technological innovation and global health collaboration in advancing CRC screening is undeniable.Technologies such as artificial intelligence and gene sequencing are set to revolutionize CRC screening,making a significant impact on the fight against this disease.Given the rise in early-onset CRC,it is crucial for screening strategies to continually evolve,ensuring their effectiveness and applicability.

Realm of hepatitis E:Challenges and opportunities

Hepatitis E virus(HEV),responsible for widespread viral hepatitis,infects approximately 2.3 billion individuals globally,with a significant mortality burden in Asia.The virus,primarily transmitted through contaminated water and undercooked meat,is often underdiagnosed,particularly in immunocompromised patients.Current HEV treatments,while effective,are limited by adverse effects,necessitating research into safer alternatives.Moreover,HEV’s extrahepatic manifestations,impacting the nervous and renal systems,remain poorly understood.This study underscores the imperative for enhanced HEV research,improved diagnostic methods,and more effective treatments,coupled with increased public health awareness and preventive strategies.

Interdepartmental miscommunication regarding radiology:Addressing chronic challenges and exploring solutions

Effective communication and collaboration among healthcare professionals are crucial for delivering high-quality patient care.Interdepartmental miscommunication poses a significant challenge to healthcare systems,potentially undermining the quality of healthcare services provided.In the same manner,communication barriers between referring physicians and radiologists can specifically affect radiology services and patient outcomes.This article attempts to put the spotlight on the ever-present chronic challenges of this issue and prompt readers to recognize the relevant potential pitfalls in their daily clinical practice.Practical solutions are explored and proposed,which should be tailored to the specific needs and issues that each individual institution may face.

Opportunities, Challenges, and Countermeasures of China Myanmar Economic and Trade Cooperation under the Background of RCEP

China and Myanmar are geographically adjacent and have close economic and trade cooperation. China has been Myanmar’s largest trading partner and largest source of investment for many consecutive years. With the official entry into force of RCEP (Regional Comprehensive Economic Partnership) for Myanmar on May 1, 2022, the reduction of trade tariffs on goods and flexible rules of origin between China and Myanmar will undoubtedly bring more practical results to China Myanmar economic and trade cooperation. However, the implementation of RCEP in Myanmar may face a series of challenges such as poor business environment, weak human resource management, and outdated infrastructure construction. Finally, the article provides countermeasures for China Myanmar economic and trade cooperation from three aspects: optimizing the business environment to attract Chinese investment, increasing investment in education and training to improve labor quality, strengthening infrastructure construction to enhance economic support.

Potential applications of 7 Tesla magnetic resonance imaging in paediatric neuroimaging:Feasibility and challenges

The integration of 7 Tesla magnetic resonance imaging(7 T MRI)in adult patients has marked a revolutionary stride in radiology.In this article we explore the feasibility of 7 T MRI in paediatric practice,emphasizing its feasibility,applications,challenges,and safety considerations.The heightened resolution and tissue contrast of 7 T MRI offer unprecedented diagnostic accuracy,particularly in neuroimaging.Applications range from neuro-oncology to neonatal brain imaging,showcasing its efficacy in detecting subtle structural abnormalities and providing enhanced insights into neurological conditions.Despite the promise,challenges such as high cost,discomfort,and safety concerns necessitate careful consideration.Research suggests that,with precautions,7 T MRI is feasible in paediatrics,yet ongoing studies and safety assessments are imperative.

Challenges to establishing and maintaining kidney transplantation programs in developing countries:What are the coping strategies?

Kidney transplantation(KT)is the optimal form of renal replacement therapy for patients with end-stage renal diseases.However,this health service is not available to all patients,especially in developing countries.The deceased donor KT programs are mostly absent,and the living donor KT centers are scarce.Single-center studies presenting experiences from developing countries usually report a variety of challenges.This review addresses these challenges and the opposing strategies by reviewing the single-center experiences of developing countries.The financial challenges hamper the infrastructural and material availability,coverage of transplant costs,and qualification of medical personnel.The sociocultural challenges influence organ donation,equity of beneficence,and regular follow-up work.Low interests and motives for transplantation may result from high medicolegal responsibilities in KT practice,intense potential psychosocial burdens,complex qualification protocols,and low productivity or compensation for KT practice.Low medical literacy about KT advantages is prevalent among clinicians,patients,and the public.The inefficient organizational and regulatory oversight is translated into inefficient healthcare systems,absent national KT programs and registries,uncoordinated job descriptions and qualification protocols,uncoordinated on-site investigations with regulatory constraints,and the prevalence of commercial KT practices.These challenges resulted in noticeable differences between KT services in developed and developing countries.The coping strategies can be summarized in two main mechanisms:The first mechanism is maximizing the available resources by increasing the rates of living kidney donation,promoting the expertise of medical personnel,reducing material consumption,and supporting the establishment and maintenance of KT programs.The latter warrants the expansion of the public sector and the elimination of non-ethical KT practices.The second mechanism is recruiting external resources,including financial,experience,and training agreements.

The Challenges in Electrical and Electronic Technology Courses in Vocational Colleges

This paper addresses the challenges in the teaching of electrical and electronic technology in higher vocational colleges and proposes specific countermeasures to improve teaching quality and effectiveness.The countermeasures include optimizing teaching content,emphasizing practical application and innovation,innovating teaching methods,introducing modern instructional approaches,strengthening the teaching team,enhancing teacher quality and practical expertise,upgrading experimental equipment and facilities,enriching curriculum resources,and incorporating digital teaching materials.These measures aim to cultivate high-quality skilled talents,promote social and economic development,and enhance national competitiveness.By adjusting the course structure,incorporating real-world industry cases,and fostering collaboration with enterprises,students can better understand and apply electrical and electronic technology.The introduction of project-based teaching,flipped classrooms,and multimedia technology can enhance student engagement and facilitate independent learning.Furthermore,the improvement of experimental resources and the establishment of online teaching platforms can enhance students’practical skills and provide a variety of learning resources.These measures contribute to the overall improvement of electrical and electronic technology teaching in higher vocational colleges.

Opportunities and Challenges of College Mental Health Education from the Perspective of Big Data

This paper explores the opportunities and challenges of college mental health education from the perspective of big data.Firstly,through literature review,the importance of mental health education and the current issues are elucidated.Then,from the perspective of big data,the potential opportunities of big data in college mental health education are analyzed,including data-driven personalized education,real-time monitoring and warning systems,and interdisciplinary research and collaboration.At the same time,the challenges faced by college mental health education under the perspective of big data are also pointed out,such as data privacy and security issues,insufficient data analysis and interpretation capabilities,and inadequate technical facilities and talent support.Lastly,the research content of this paper is summarized,and directions and suggestions for future research are proposed.

Facing Challenges and Shocks with Rationality

The Iraqi War breaking out on March 20, 2003 undoubtedly marks a turning point in current international relations. The international disputes around this war is not only an embodiment of differentbeliefs and positions on the issue of war and peace, but more importantly a demonstration of the deep skepticism and worry throughout the international community on the possible outcome of the war, as well as the future development of American diplomatic and military policies. All these will exert a profound and extensive influence on the trend of development of international relations in the future.

New Challenges for Occupational Health Services Facing Economic Reform in China

In China, which is facing economic reform and the rapid development of small-scale industries, various occupational hazards are reappearing. The problems are related to the ignorance of the managers and the workers, a lack of capital, the insufficiency of occupational health services, and the transfer of some hazardous work from large factories in the cities to small plants in the towns and villages. The change in life-style, especially in smoking habits, has aggravated occupational hazards. The problems may be solved by renewing the concept of health among the managers and workers, enforcing legislation related to occupational hazards, strengthening health personnel training, and reinforcing health education and self-help. 1989 Academic Press, Inc.

World Military Situation and Challenges Facing China

Although peace was still the main theme last year, various kinds of uncertainties piled up quickly. Many of the traditional security issues were still there, while new threats like terrorism made things look even worse. Some major powers were busy to rethink their military strategies in the new century. Japan and Germany, the two "defeated countries" of World War Two, sent their troops abroad for the

Challenges in pediatric inherited/metabolic liver disease: Focus on the disease spectrum, diagnosis and management of relatively common disorders

The clinical scenario of pediatric liver disease is becoming more intricate due to changes in the disease spectrum,in which an increasing number of inherited/metabolic liver diseases are reported,while infectious diseases show a decreasing trend.The similar clinical manifestations caused by inherited/metabolic diseases might be under-recognized or misdiagnosed due to nonspecific characteristics.A delayed visit to a doctor due to a lack of symptoms or mild symptoms at an early stage will result in late diagnosis and treatment.Moreover,limited diagnostic approaches,especially liver biopsy,are not easily accepted by pediatric patients,leading to challenges in etiological diagnosis.Liver dysfunction due to inherited/metabolic diseases is often caused by a variety of metabolites,so precision treatment is difficult;symptomatic treatment is a compelling option for inherited disorders.

Challenges Facing Women Caring for a Spouse Having Cancer Treatment: A Critical Literature Review

Introduction: Cancer affects patients and families, especially female spouses. Female carers are affected emotionally, psychologically, spiritually and physically. Challenges while caring for husbands with cancer include: higher stress;poorer health-related quality of life;emotional strain;impaired immune system;low appetite;high blood pressure;depression and anxiety. Female spousal carers also experience satisfaction that they rendered appropriate care to their spouse. Aim: To analyse challenges facing women caring for a spouse on cancer treatment. Method: Systematic critical literature review through CASP. Thematic analysis of data. Results: 16 studies met the inclusion criteria;12 were selected by critical analysis. 4 themes emerged: “Quality of marital relationship”, “Effective communication”, “Carers” burden and need for support’, and “Coordination of care among providers”. Discussion: 4 themes are discussed in detail and related to literature outside the review. Conclusion: Women caring for a spouse on cancer treatment is affected by the cancer, symptoms, hospital admission and caring. They withhold information from their spouse to protect him. They have poor quality of life and poor health. HCP rarely recognize their role or needs.

Analysis of the Key Challenges Facing Potato Farmers in Oljoro-Orok Division, Kenya

The objective of this study was to evaluate the key challenges facing potato production in Oljoro-Orok division. Primary data were obtained from randomly selected farmers through questionnaires. Purposive sampling was used to select 300 farmers in the division. Proportionate sampling was used to select the sample of farmers in each of the four locations. The data collected were analyzed using descriptive statistics namely frequencies, percentages and means with the?aid of Statistical Package for Social Science (SPSS) version 17.0 and a SWOT matrix computed. Rainfall variations, lack of clean seeds and crop diseases have been found to be the major challenges facing potato production in the division. 45% of the respondents see rainfall variation as the main cause of decreased potato yields, 33% lack of clean seeds and 6% crop diseases. The study found that farmers use crop diversification and off season approaches to adapt to rainfall variability. The study recommends adaptation measure to be applied to cope with rainfall variation. Such measures include irrigation using water available in Jacob, Terracin and Kivindo dams during dry spelt. A lot of emphases on the use of certified seeds should be done by the agriculture field officers to caution farmers from planting the same potatoes they harvested in the previous harvest.

Endoscopic transluminal drainage and necrosectomy for infected necrotizing pancreatitis:Progress and challenges

Infected necrotizing pancreatitis(INP)represents a severe condition in patients with acute pancreatitis.Invasive interventions are recommended in symptomatic INP.Growing evidence has suggested interventional strategies of INP evolving from traditional surgery to minimally invasive step-up endoscopic procedures.However,there is still no standardized protocol for endoscopic interventions.Recently,various studies have been published about the endoscopic management of INP.This article reviews published articles and guidelines to present the progress and challenges of endoscopic transluminal drainage and necrosectomy in INP.