People are marching in the streets demanding better care for older Australians in aged care homes after increasing media reports of neglect, abuse and negligence.
If we want to improve the situation for residents, we need more registered nurses in aged care homes. When registered nurses are on duty, residents have better health outcomes, a higher quality of life and fewer hospital admissions.
When I worked as a critical care nurse in hospitals, there was a one-to-one ratio of registered nurses to patients. Some days were busy, others were not. However, because society values "saving lives", legislation ensures every intensive care unit is well staffed.
There are also mandated ratios in childcare centres because society values the safety and welfare of children. Yet we don't take the same approach when it comes to aged care homes.
Is this because we don't value older people?
The 2011 Productivity Commission Report Caring for Older Australians described staffing ratios as "a fairly blunt instrument for ensuring quality care because of the heterogeneous and ever-changing care needs of aged care recipients.".
129S-PARP1tm1Zqw/J (PARP1-/-) mice were crossed with C57BL/6 mice to generate PARP1-/- mice on 129S/BL6 genetic background. PARP1-/- mice were bred with WT mice to generate PARP1+/- mice. All breeding pairs were purchased from Jackson Laboratory (Bar Harbor ME), and a standard PCR was performed to confirm the genotype of WT (PARP1+/+), PARP1+/- and PARP1-/- mice (S1A Fig).
T. cruzi (SylvioX10/4, ATCC 50823) was propagated by in vitro passage in C2C12 cells. The WT, PARP1+/- and PARP1-/- mice (all 129S/BL6 background, 6-weeks-old) were infected with T. cruzi (10,000 trypomastigotes/mouse, intraperitoneal). For some studies, C57BL/6 mice were infected as above, and then mice were given a treatment of 2-(dimethylamino)-N-(6-oxo-5,6-dihydrophenanthridin-2-yl)acetamide hydrochloride (PJ34, Sigma-Aldrich, St Louis MO). PJ34 is a cell-permeable, water-soluble, selective PARP1 inhibitor PJ34 (EC50 = 20 nM) and shown to be ~10,000 times more potent than the prototypical PARP inhibitor, 3-aminobenzamide [20,21]. PJ34 (12.5 mg/kg) was delivered intraperitoneally for three weeks (twice a week) beginning at 45 days’ post-infection (pi) when acute parasitemia was controlled. All mice were harvested at 150 days’ pi corresponding to chronic disease phase. Sera/plasma and tissue samples were stored at 4°C and -80°C, respectively.
Human cardiomyocyte cells (AC16, cat#SCC109, EMD Millipore, Burlington MA) were cultured and maintained in Dulbecco’s modified Eagle’s medium (DMEM)/F-12 medium containing 12.5% fetal bovine serum (FBS). Human cervix epithelial cells (HeLa, ATCC, Manassas VA) were propagated in DMEM media supplemented with Earle's salts, 2 mM L-glutamine and 10% FBS. Cells were infected with T. cruzi (cell: parasite ratio: 1:5) for various studies.