Nursing home care: exploring the role of religiousness in the mental health, quality of life and stress of formal caregivers.

Despite the high number of studies on family caregivers, there is little research on the impact of religiosity on formal caregiving (paid providers). We examine the role of religiousness in the mental health, quality of life and stress of nurse aides (NA) who provide care for patients in a nursing home. NA in a Brazilian nursing home were invited to participate. Because of its coping function, we hypothesized that religiousness was related to better mental health and quality of life. Linear regression was used to test this hypothesis and control for confounders. Compared with the Brazilian general population, NA scored higher on measures of religious involvement. Intrinsic religiosity was associated with better mental health and quality of life. Organizational religiosity was associated with better social functioning, better general mental health and fewer anxiety symptoms. Non-organizational religiosity (prayer), however, was associated with negative outcomes, such as higher stress, poorer general health perceptions and more anxiety symptoms. Most NA indicated that they had prayed for and with their patients. In conclusion, paid caregivers (NA) have a strong sense of religiousness, which plays an important role in many ways, including the type of care they provide, their mental health and their quality of life.

[Autoregulation of renal blood flow and blood pressure variability in the conscious rat]. / Autorégulation du débit sanguin rénal et variabilité tensionnelle chez le rat éveillé.

It is often proposed that autoregulatory mechanisms prevent acute changes in systemic blood pressure (BP) from being transmitted to the glomerular capillary circulation. However, it is not known whether renal blood flow (RBF) is still autoregulated when the kidney is exposed to exaggerated BP fluctuations, in particular hypertensive episodes. The aim of the present study was therefore to evaluate the efficacy of renal autoregulatory responses in an animal model of BP lability, the sinoaortic denervated (SAD) rat. BP and RBF were simultaneously recorded in 8 SAD (2 wks before study) and 8 baroreceptor intact (INT) Sprague-Dawley rats during approximately 3 h of spontaneous activity. The left kidney used for RBF recordings was denervated to prevent the interference of changes in renal sympathetic tone with autoregulatory responses. The SAD procedure modified neither the mean BP nor the mean RBF levels (111 +/- 1 mmHg and 11.3 +/- 1.3 mL/min in INT rats: 113 +/- 6 mmHg and 11.1 +/- 0.9 mL/min in SAD rats). However, SAD strongly increased the BP variability (coefficient of variation: 5.9 +/- 0.2% and 18.2 +/- 1.1% in INT and SAD rats, respectively). In spite of this marked BP lability, RBF variability was not significantly affected by the SAD procedure (9.1 +/- 0.8% and 12.4 +/- 1.6% in INT and SAD rats, respectively). In SAD rats, spontaneous hypertensive episodes (top 1% of BP values: 174 +/- 10 mmHg) did not induce increases in RBF (10.5 +/- 1.0 ml/min). Fast Fourier transform analysis revealed that in SAD rats, autoregulatory mechanisms attenuated approximately 80% of BP fluctuations in the 0.0015-0.01 Hz frequency range, suggesting a major involvement of the tubuloglomerular feedback. In conclusion, autoregulatory mechanisms have an ample capacity to protect the kidney against spontaneous BP fluctuations in the conscious rat. Consequently, BP variability per se is probably not detrimental to the kidney, as long as autoregulatory mechanisms are normally functioning.

Renal blood flow dynamics and arterial pressure lability in the conscious rat.

It is not known whether renal blood flow (RBF) is still autoregulated when the kidney is exposed to large transient blood pressure (BP) fluctuations such as those occurring spontaneously in conscious sinoaortic baroreceptor-denervated (SAD) rats. In this study, BP and RBF were simultaneously recorded in 8 SAD rats (2 weeks before study) and 8 baroreceptor-intact rats during approximately 3 hours of spontaneous activity. The kidney used for RBF recordings was denervated to prevent the interference of changes in renal sympathetic tone with autoregulatory mechanisms. In intact rats, RBF variability (coefficient of variation 9.1+/-0.8%) was larger (P<0.02) than BP variability (5.9+/-0.2%). This was mainly because of slow changes in RBF that were unrelated to BP and also to a prominent oscillation of RBF of approximately 0.25-Hz frequency. Autoregulatory patterns were identified at frequencies <0.1 Hz and provided a modest attenuation of BP fluctuations. In SAD rats, RBF variability (12.4+/-1.6%) was lower (P<0.02) than BP variability (18.2+/-1.1%). Autoregulation powerfully attenuated BP changes <0.1 Hz (normalized transfer gain 0.21+/-0.02 in the 0.0015- to 0.01-Hz frequency range) but at the expense of an oscillation located at approximately 0.05 Hz that possibly reflected the operation of the tubuloglomerular feedback. Large transient hypertensive episodes were not translated into RBF changes in SAD rats. We conclude that autoregulatory mechanisms have an ample capacity to protect the kidney against spontaneous BP fluctuations in the conscious rat. This capacity is not fully used under normal conditions of low BP variability.

Endothelium-derived nitric oxide is involved in the hypotensive and vasorelaxant responses induced by the aqueous fraction of the ethanolic extract of the leaves of Albizia inopinata (Harms) G. P. Lewis in rats.

The acute cardiovascular effects of an aqueous fraction of the ethanolic extract of the leaves (AFL) of Albizia inopinata (Harms) G. P. Lewis (Leguminosae) were studied in rats using a combined in vivo and in vitro approach. In conscious, unrestrained rats, AFL (5, 10 and 20 mg/kg(-1) body wt. i.v., randomly) produced a significant and dose-dependent hypotension associated with increases in heart rate and cardiac output, and with a strong reduction in total peripheral resistances. The hypotensive response to AFL (20 mg/kg(-1) body wt.) was attenuated significantly after nitric oxide (NO) synthase blockade (L-NAME, 20 mg/kg(-1) body wt. i.v.). Furthermore, under these conditions, the associated tachycardia was inhibited completely. In isolated rat aortic rings, increasing concentrations of AFL (10, 20, 40 and 80 microg/ml(-1)) were able to antagonize the effects of phenylephrine- (1 microM) and KCl- (80 mM) induced contractions (IC50 value 65 +/- 4 and 54 +/- 6 microg/ml(-1), respectively). The smooth muscle-relaxant activity of AFL was inhibited similarly either removal of the vascular endothelium or by L-NAME (10 and 100 microM), but was not affected significantly by atropine (1 microM) or indomethacin (10 microM). In isolated rat atrial preparations, AFL (30, 100, 300 and 500 microg/ml(-1)) produced concentration-related negative inotropic and chronotropic effects (IC50 value = 274 +/- 53 and 335 +/- 23 microg/ml(-1), respectively). These results suggest that in rats, the hypotensive effect of AFL is due to a peripheral vasodilation, at least partly secondary to the release of NO by the vascular endothelium. The direct cardio-depressant actions of AFL are of little importance in the systemic effects of the extract.

Cardiovascular effects of an aqueous fraction of the ethanol extract of the leaves of Cissampelos Eichl. in the rat.

The cardiovascular effects of the aqueous fraction of the ethanol extract of the leaves (AFL) of Cissampelos sympodialis Eichl. were evaluated in this work. In conscious freely moving rats, AFL (0.5, 1, 2, 4 and 8 mg/kg, i.v.) increased the mean arterial pressure (MAP) by 7 ± 2,16 ± 5, 33 ± 5, 43 ± 3 and 38 ± 4 mmHg, respectively, followed by a significant decrease in heart rate. After cardiac autonomic blockade (atenolol + atropine, 2 mg/kg, i.v., each), the hypertensive effects produced by AFL (2 and 4 mg/kg) were potentiated. However, AFL was ineffective in producing bradycardia. In anesthetized rats, AFL (4 mg/kg) induced similar increases in MAP (34 ± 4 mmHg) and bradycardia (-160 ± 24 bpm). Further, it induced a third-degree atrioventricular (AV) blockade. Nevertheless, both bradycardia and AV-blockade were completely abolished after atropine. While the AFL failed to induce bradycardia directly in the isolated perfused rat heart, in isolated right and left rat atria, it produced positive chronotropic and inotropic effects. The results demonstrate that the AFL markedly increases blood pressure in conscious unrestrained and anesthetized rats and improves heart rate and contractility in isolated perfused atrial preparations. Furthermore, the results suggest that the bradycardia associated with increase in blood pressure is reflex in origin.