Scope of practice and educational needs of infection prevention and control professionals in Australian residential aged care facilities

Abstract

Snake venom three-finger α-neurotoxins (α-3FNTx) act on postsynaptic nicotinic acetylcholine receptors (nAChRs) at the neuromuscular junction (NMJ) to produce skeletal muscle paralysis.The discovery of the archetypal α-bungarotoxin (α-BgTx), almost six decades ago, exponentially expanded our knowledge of membrane receptors and ion channels. This included the localisation, isolation and characterization of the first receptor (nAChR); and by extension, the pathophysiology and pharmacology of neuromuscular transmission and associated pathologies such as myasthenia gravis, as well as our understanding of the role of α-3FNTxs in snakebite envenomation leading to novel concepts of targeted treatment. Subsequent studies on a variety of animal venoms have yielded a plethora of novel toxins that have revolutionized molecular biomedicine and advanced drug discovery from bench to bedside. This review provides an overview of nAChRs and their subtypes, classification of α-3FNTxs and the challenges of typifying an increasing arsenal of structurally and functionally unique toxins, and the three-finger protein (3FP) fold in the context of the uPAR/Ly6/CD59/snake toxin superfamily. The pharmacology of snake α-3FNTxs including their mechanisms of neuromuscular blockade, variations in reversibility of nAChR interactions, specificity for nAChR subtypes or for distinct ligand-binding interfaces within a subtype and the role of α-3FNTxs in neurotoxic envenomation are also detailed. Lastly, a reconciliation of structure-function relationships between α-3FNTx and nAChRs, derived from historical mutational and biochemical studies and emerging atomic level structures of nAChR models in complex with α-3FNTxs is discussed.

Identifying barriers and enablers to participation in infection surveillance in Australian residential aged care facilities

“…Participants in the survey and focus groups felt that knowledge among RACF staff and education about infection surveillance and related topics was lacking. Previous studies engaging IPC staff, including in Australian RACFs, have similarly found an absence of access to IPC education, with one study reporting no education programs about infection surveillance provided in surveyed facilities [ 30 – 32 ]. Consistent with prior studies, our study found that IPC staff are most often responsible for infection surveillance activities in RACFs [ 30 ].…”

“…Previous studies engaging IPC staff, including in Australian RACFs, have similarly found an absence of access to IPC education, with one study reporting no education programs about infection surveillance provided in surveyed facilities [ 30 – 32 ]. Consistent with prior studies, our study found that IPC staff are most often responsible for infection surveillance activities in RACFs [ 30 ]. IPC staff are now required by the Australian Government to complete specific IPC training [ 20 ].…”

Practical infection control training for Victoria’s aged care workforce at the time of COVID-19 pandemic: a community case study

“…Infection prevention and control guidelines and training programs are often based on evidence collected in acute healthcare settings and not always relevant for the RACF context ( 18 ). Although IPC is the most commonly reported specialist skill among direct care workers in RACFs ( 19 ), little is known about the quality, relevance and frequency of training, or the undertaking of competency assessments ( 20 ). There are challenges implementing education programs in RACFs due to the diverse workforce with varied knowledge and educational experience, time to participate in education, and relevance, accessibility and sustainability of education programs ( 19 , 21 ).…”

Educação gerontológica e procedimentos de limpeza em ILPI: manual de apoio ao gestor

“…De acordo com com o manual sobre prestação de serviços de limpeza, asseio e conservação da Secretaria de Logística e Tecnologia da Informação (Brasil, 2014) A tabela a seguir mostra respectivamente a área total, área construída e a proporção de funcionários da área de limpeza recomendados pela atual RDC nº 502/2021 e a real quantidade de funcionários contratados. (Shaban et al, 2020).…”