Preventing Aerosol-Transmissible Diseases in Healthcare Settings: The Need for Protective Guidelines and Standards-Workshop Report.

There is an urgent need for stronger protection from aerosol-transmissible diseases in healthcare settings-for workers, patients, volunteers, and visitors. Concerned that the Centers for Disease Control and Prevention (CDC) Healthcare Infection Control Practices Advisory Committee (HICPAC) lacks diversity in expertise and experience and has not consulted widely with all concerned parties regarding a planned update to the 2007 Guideline for Isolation Precautions, a workshop was developed to consider the science and lessons learned before and during the COVID-19 pandemic. Sponsored by the New York/New Jersey Occupational Safety and Health Center, Preventing Aerosol-Transmissible Diseases in Healthcare Settings: The Need for Protective Guidelines and Standards was held on October 13, 2023, with these goals: describe current CDC/HICPAC infection prevention guidelines, review current scientific understanding of aerosol-transmissible pathogens, and consider perspectives from a wide range of groups currently excluded from the CDC HICPAC process.

Public Health Experts Ask CDC Director to Broaden Input on Revisions to Key Infection Control Guidelines.

On July 20, 2023 a letter was sent to the Director of the Centers for Disease Control and Prevention requesting the agency's Healthcare Infection Control Practice Advisory Committee seek input from more stakeholders and the public, recognize the importance of infectious disease transmission by inhalation of human-generated aerosols, and ensure the application of interventions from all levels of the control hierarchy.

Blockchain in Healthcare: 2023 Predictions From Around the Globe.

Over the past 50 years, although categorized as the "Information Age" or "Digital Age," the vast amounts of digitized data have been sorely underutilized. Only recently, in response to the COVID-19 pandemic, efforts have accelerated to harness these data using blockchain technology as it pertains to healthcare. Today, through the blockchain infrastructure and its tokenization applications, we are able to leverage healthcare data effectively into more efficient business processes. In addition, we can secure better patient engagement and outcomes, while generating new revenue streams for an array of healthcare stakeholders. It is in the application of blockchain technology to compile these stockpiled data into new, compliant business models that we can reap the full potential of the blockchain. Here are predictions by members of the BHTY editorial board members on how we might further advance the role of blockchain in healthcare in 2023.

"Then They Trust You ": Managing Ergonomics in Home Care.

The home care workforce, already at 2.7 million caregivers, will become the nation's fastest growing occupation by 2024 as the senior boom generation accelerates the demand for in home services to meet its long-term care needs. The physically challenging work of assisting clients with intimate, essential acts of daily living places home care workers (HCWs) at risk for musculoskeletal disorders (MSDs); yet, HCWs typically receive little formal job training and may lack appropriate assistive devices. In this qualitative pilot study, HCW focus groups described workplace MSD risk factors and identified problem-solving strategies to improve ergonomic conditions. The results revealed that HCWs rely on their behavioral insights, self-styled communications skills and caring demeanor to navigate MSD risks to themselves and increase clients' physical independence of movement. We suggest changes in employer and government policies to acknowledge HCWs as valued team members in long-term care and to enhance their effectiveness as caregivers.

Working together to get back to basics--finding health system solutions.

This paper highlights the key changes to the health system over the past 20 years, including the impact of the Organic Law on Provincial Governments and Local-level Governments, the politicization of the system, the changing balance between government and development partners in financing the health system, and the development of a sector-wide approach in the Papua New Guinea health sector. It discusses reform efforts at bureaucratic and regulatory level to address these problems. Key health sector policy issues and lessons learned over the past two decades are highlighted. The paper concludes with an examination of what is needed to 'get back to basics' through mobilizing all health sector partners with the aim of getting the health system delivering improved health outcomes.

Public-private partnerships for health--what does the evidence say?

This paper provides an overview of the literature regarding public-private partnerships (PPPs) by examining several case studies from around the world and documenting the lessons learned across different PPP models. In addition, it focuses on experience in the facilitation of two PPPs between the public and private sectors in Papua New Guinea (PNG) and discusses the potential benefits that may be delivered to PNG communities through pursuing further such PPPs for health.

Working together for a better future.

In this review we reflect upon the papers within this focus issue of the Papua New Guinea Medical Journal on the theme of health system strengthening, and provide a summary of lessons learnt and ways forward from the lessons and experiences of the past. Priority areas have been identified for consideration by the health sector and its various players and stakeholders moving forward, particularly in the context of the next National Health Plan. The imperative need to focus on the basics is emphasized: to make sure that key health interventions are implemented; that health workers have requisite skills and are placed where services are needed; that there is an uncompromising focus on ensuring, by whatever means, that the essential logistical elements are there to enable the health worker to provide the interventions; that key messages are communicated to, and provide support for, communities to attend care and practise health-promoting behaviours; and that population coverage is increased. The need for a long-term, systematic approach to getting the basics in place is essential. In developing and implementing this approach, caution needs to be taken with regard to confusion between means and ends. It is important to maintain focus on the desired outcome--improved health of Papua New Guineans; and to use, but not be distracted by, the means for getting there--including the various health sector reforms being implemented. It is essential to identify and focus on ways in which the existing capacity within the system can be harnessed, and to ensure that the environment supports the effective and efficient use of existing capacities. The capacity of the health sector--and the careful, measured use of partnerships--to extend service delivery to underserved populations is discussed in broad terms.

Working together for a better future

In this review we reflect upon the papers within this focus issue of the Papua New Guinea Medical Journal on the theme of health system strengthening, and provide a summary of lessons learnt and ways forward from the lessons and experiences of the past. Priority areas have been identified for consideration by the health sector and its various players and stakeholders moving forward, particularly in the context of the next National Health Plan. The imperative need to focus on the basics is emphasized: to make sure that key health interventions are implemented; that health workers have requisite skills and are placed where services are needed; that there is an uncompromising focus on ensuring, by whatever means, that the essential logistical elements are there to enable the health worker to provide the interventions; that key messages are communicated to, and provide support for, communities to attend care and practise health-promoting behaviours; and that population coverage is increased. The need for a long-term, systematic approach to getting the basics in place is essential. In developing and implementing this approach, caution needs to be taken with regard to confusion between means and ends. It is important to maintain focus on the desired outcome--improved health of Papua New Guineans; and to use, but not be distracted by, the means for getting there--including the various health sector reforms being implemented. It is essential to identify and focus on ways in which the existing capacity within the system can be harnessed, and to ensure that the environment supports the effective and efficient use of existing capacities. The capacity of the health sector--and the careful, measured use of partnerships--to extend service delivery to underserved populations is discussed in broad terms.

Public-private partnerships for health--what does the evidence say?

This paper provides an overview of the literature regarding public-private partnerships (PPPs) by examining several case studies from around the world and documenting the lessons learned across different PPP models. In addition, it focuses on experience in the facilitation of two PPPs between the public and private sectors in Papua New Guinea (PNG) and discusses the potential benefits that may be delivered to PNG communities through pursuing further such PPPs for health.

Working together to get back to basics--finding health system solutions

This paper highlights the key changes to the health system over the past 20 years, including the impact of the Organic Law on Provincial Governments and Local-level Governments, the politicization of the system, the changing balance between government and development partners in financing the health system, and the development of a sector-wide approach in the Papua New Guinea health sector. It discusses reform efforts at bureaucratic and regulatory level to address these problems. Key health sector policy issues and lessons learned over the past two decades are highlighted. The paper concludes with an examination of what is needed to 'get back to basics' through mobilizing all health sector partners with the aim of getting the health system delivering improved health outcomes.

The mental health of young people attending a Youth Offending Team: a descriptive study.

This study documents the health needs of young offenders aged 10-17 attending a community Youth Offending Team (YOT). All young people known to a YOT on a selected date were identified. Health information was collected via semi-structured interviews and standardized questionnaires. Potential mental health problems that required further specialist assessment were identified in 56% of those assessed. Alcohol was consumed more than twice per week by 68%, with 47% having recently smoked cannabis, and, 11% recently using heroin, methadone or crack cocaine. Use of secondary health-care services was common although contact with primary-care services was less frequent with almost half having no contact with a GP in the past year. The process of meeting the physical and mental health needs of young offenders in the community is discussed.