Is there a relationship between spirituality/religiosity and resilience? A systematic review and meta-analysis of observational studies.

Resilience is the ability to recover or cope with adverse situations. Spiritual and religious beliefs may be associated with important "resilience resources." To investigate whether there is a relationship between spirituality/religiosity (S/R) and resilience. This is a systematic review (observational studies) with meta-analysis following the PRISMA guidelines. From a total of 2468 articles, 34 observational studies were included. We identified a moderate positive correlation between S/R and resilience (r = 0.40 (95% CI, 0.32-0.48], p < 0.01). When only high-quality articles were included, the results were maintained. Conclusion: A moderate positive correlation was found between S/R and resilience.

Internato médico rural na Serra Gaúcha: a experiência da Universidade de Caxias do Sul / Rural medical internship in Serra Gaúcha: the experience of the Universidade de Caxias do Sul

Um dos desafios das comunidades rurais e remotas é a dificuldade no recrutamento e a retenção de recursos humanos em saúde. A educação médica em áreas rurais é uma das estratégias para enfrentar tal deficiência. No Brasil, há relativamente poucos relatos de experiências de educação médica em áreas rurais, especialmente de duração prolongada, e há necessidade de se avaliar as existentes para contribuir com a formulação de políticas públicas. Este trabalho descreve o estágio rural do internato médico em Medicina de Família e Comunidade (MFC) da Universidade de Caxias do Sul (UCS). Até agora, durante os treze anos desde seu início, mais de 550 estagiários passaram pelas unidades de saúde de quatro municípios da Serra Gaúcha. Reflexões sobre a experiência para a formação médica e para as políticas de recursos humanos são apresentadas. O estágio rural tem sido importante espaço de diversificação de cenário para educação, reforçando o papel da Atenção Primária à Saúde e da MFC, além de possibilitar a aproximação da Universidade com a comunidade, confirmando sua responsabilidade social. Os resultados contribuem para as estratégias de formação médica e para as políticas de recrutamento e retenção de recursos humanos na saúde para áreas rurais e remotas.(AU)

One of the challenges of rural and remote communities is the difficulty in recruiting and retaining human resources in health. Medical education in rural areas is one of the strategies to tackle this deficiency. In Brazil, there are relatively few reports of medical education experiences in rural areas, especially of long duration, and there is a need to evaluate the existing ones to generate useful reflections for the formulation of public policies. This work describes the medical internship in Family Medicine (FM) at the Universidade de Caxias do Sul (UCS). To date, during the thirteen years since its inception, more than 550 medical students have passed through four municipalities in the Serra Gaúcha. Reflections on the experience about medical training and human resources policies for rural health are presented. The rural internship has been an important space for diversifying the scenario for medical education, reinforcing the role of Primary Health Care and of FM, in addition to making it possible to bring the University closer to the community, confirming its social responsibility. The results of this report contribute to medical training strategies and policies for the recruitment and retention of human resources in health for rural and remote areas.(AU)

Impacto da mudança climática sobre a atenção primária à saúde: uma revisão sistemática

Este trabalho tem por finalidade consolidar informações sobre o efeito da mudança climática quanto às alterações no perfil de demanda, no volume da demanda, na composição e capacitação das equipes e no orçamento para atenção primária à saúde.

Guanosine enhances glutamate transport capacity in brain cortical slices.

1. The effect of guanosine on L-[3H] glutamate uptake was investigated in brain cortical slices within physio-pathological range of glutamate(1-1000 microM). In these conditions, glutamate uptake was significantly enhanced in slices treated with 100 microM guanosine only at 100 and 300 microM glutamate (44 and 52%, respectively). 2. Evaluation of kinetic parameters showed that guanosine affected significantly only uptake Vmax (23%). 3. The guanosine withdrawal did not abolish its significant effect on glutamate uptake when 100 or 300 microM glutamate were used (an increase of 66 and 35%, respectively). 4. These results support the hypothesis of a protective role for guanosine during excitotoxic conditions when glutamate levels are enhanced (e.g. brain ischemia and seizures), possibly by activating glutamate uptake. Moreover, our results may contribute to understand the antiexcitotoxic mechanism of guanosine on glutamate transport, giving new information concerning its mechanism of action.

Effects of chronic administered guanosine on behavioral parameters and brain glutamate uptake in rats.

Oral and intraperitoneal administration of the nucleoside guanosine have been shown to prevent quinolinic acid- (QA) and alpha-dendrotoxin-induced seizures, impair memory, and impair anxiety in rats and mice. We investigated the effect of 2-weeks ad lib orally administered guanosine (0.5 mg/ml) on seizures induced by QA, inhibitory avoidance memory, and locomotor performance in rats. We also studied the mechanism of action of guanosine through the measurement of its concentration in the cerebrospinal fluid (CSF) and its effect on glutamate uptake in cortical slices of rats. QA produced seizures in 85% of rats, an effect partially prevented by guanosine (53% of seizures; P = 0.0208). Guanosine also impaired retention on the inhibitory avoidance task (P = 0.0278) and decreased locomotor activity on the open field test (P = 0.0101). The CSF guanosine concentration increased twofold in the treated group compared to that in the vehicle group (P = 0.0178). Additionally, QA promoted a 30% decrease in glutamate uptake as compared to that with intracerebroventricular saline administration, an effect prevented by guanosine in animals protected against QA-induced seizures. Altogether, these findings suggest a potential role of guanosine for treating diseases involving glutamatergic excitotoxicity such as epilepsy. These effects seem to be related to modulation of glutamate uptake.

Mitochondrial permeability transition in neuronal damage promoted by Ca2+ and respiratory chain complex II inhibition.

Changes in mitochondrial integrity, reactive oxygen species release and Ca2+ handling are proposed to be involved in the pathogenesis of many neurological disorders including methylmalonic acidaemia and Huntington's disease, which exhibit partial mitochondrial respiratory inhibition. In this report, we studied the mechanisms by which the respiratory chain complex II inhibitors malonate, methylmalonate and 3-nitropropionate affect rat brain mitochondrial function and neuronal survival. All three compounds, at concentrations which inhibit respiration by 50%, induced mitochondrial inner membrane permeabilization when in the presence of micromolar Ca2+ concentrations. ADP, cyclosporin A and catalase prevented or delayed this effect, indicating it is mediated by reactive oxygen species and mitochondrial permeability transition (PT). PT induced by malonate was also present in mitochondria isolated from liver and kidney, but required more significant respiratory inhibition. In brain, PT promoted by complex II inhibition was stimulated by increasing Ca2+ cycling and absent when mitochondria were pre-loaded with Ca2+ or when Ca2+ uptake was prevented. In addition to isolated mitochondria, we determined the effect of methylmalonate on cultured PC12 cells and freshly prepared rat brain slices. Methylmalonate promoted cell death in striatal slices and PC12 cells, in a manner attenuated by cyclosporin A and bongkrekate, and unrelated to impairment of energy metabolism. We propose that under conditions in which mitochondrial complex II is partially inhibited in the CNS, neuronal cell death involves the induction of PT.

Ontogenetic profile of glutamate uptake in brain structures slices from rats: sensitivity to guanosine.

The excitotoxicity of the neurotransmitter glutamate has been shown to be connected with many acute and chronic diseases of the CNS. High affinity sodium-dependent glutamate transporters play a key role in maintaining adequate levels of extracellular glutamate. In the present study, we used slices of striatum, hippocampus and cortex from rat brain to describe the in vitro profile of glutamate uptake during development and ageing, and its sensitivity to guanosine. In all structures, glutamate uptake was higher in immature animals. There was a maximum decrease in glutamate uptake in striatum and hippocampus in 15-month-old rats, which later increased, while in cortex there was a significant decrease in rats aged 60 days old. The effect of guanosine seems to be age and structure dependent since the increase in basal glutamate uptake was only seen in slices of cortex from 10-day-old animals.

Ebselen protects against methylmercury-induced inhibition of glutamate uptake by cortical slices from adult mice.

Methylmercury (MeHg) is a highly neurotoxic compound and the inhibition of glutamate uptake by astrocytes has been pointed as an important mechanism involved in MeHg-induced glutamate excitotoxicity. We examined the effect of oral exposure to MeHg (10 and 40 mg/l in drinking water) on glutamate uptake by brain cortical slices of adult mice. Moreover, the possible protective role of ebselen (20 mg/kg, subcutaneously) against MeHg effect was also examined. In addition, it was measured the glutathione peroxidase and catalase activities in mice brain. Our results demonstrated, for the first time, that in vivo exposure to MeHg causes a dose-dependent decrease in glutamate uptake and that ebselen, which did not affect the uptake per se, reverted this effect. MeHg decreased glutathione peroxidase activity and increased catalase activity, effects which were also prevented by ebselen. These results may indirectly indicate that: (i) the in vivo inhibitory effect of MeHg on glutamate uptake could be probably related to overproduction of H(2)O(2); (ii) the protective effect of ebselen on MeHg-induced inhibition of glutamate uptake could be related to its ability to detoxify H(2)O(2).