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Biomedical subjects

B Leipert

Publications and source records attributed to B Leipert.

10 recordsLinked to original sources
PubMed1999

Women's health and the practice of public health nurses in northern British Columbia.

This study explored women's health and the practice of public health nurses in northern British Columbia using a phenomenological methodology. Ten public health nurses in northern British Columbia were interviewed to determine their perspectives on their practice in the area of women's health. Findings reveal three central themes: women's health, public health nursing practice, and rural context. Several subthemes elaborate on the central themes. Women's health is described in terms of women's health needs, how women stay healthy in northern communities, and conditions that affect women's health. Public health nursing practice is described in terms of activities, strengths, conditions, and ways to strengthen practice. Definitions of rural context are provided and some of the benefits and challenges of living and working in northern communities are presented. Health promotion and illness and injury prevention needs of women are clearly evident in the findings. Public health nurses are well placed in the North to help women meet their health care needs. However, further attention to women's health needs and the expansion of public health nursing services would facilitate improved health for women who live in isolated northern settings. In addition, further research is needed to explicate women's health and public health nursing practice in isolated northern settings in Canada.

Adult↗
PubMed1998

The use of professional nursing practice standards in nursing labour arbitrations in British Columbia, 1987-1994.

This study examined the use of nursing practice standards in British Columbia in labour arbitrations related to patient care for the years 1987-1994. Retrospective secondary content analysis was the method used to analyse the cases. Although practice standards were referred to in some of the cases, the nature and clarity of these standards were not always evident. In addition, corporate and industrial precedents, rather than health care precedents, formed the basis for much of the arbitration deliberations. The perspectives of nurses, patients, and families were not significantly represented. Many of the arbitration hearings did not get beyond procedural matters, and so did not address substantive patient care situations. Clearly, the visibility and importance of nursing standards need to be raised among nurses and non-nurses alike. Implications and recommendations for nursing practice, administration, education and research, as well as for nursing professional associations and unions are discussed. Research questions for the future are suggested.

British Columbia↗
PubMed1998

Issues for nurses in rural and remote Canada.

Canada is a vast country with great diversity in its landscape, industry, culture and communities. The healthcare issues and concerns of people living in rural and remote areas are as fully diverse as the people and the landscape. This article describes the context of rural and remote nursing practice in Canada and discusses issues of health status and the social determinants of health, geographical isolation, professional isolation and cultural safety. It concludes with current initiatives in practice, education, research and policy. Particular issues facing nurses in rural and remote First Nations communities are highlighted.

Canada↗
PubMed1992

Different endothelial mechanisms involved in coronary responses to known vasodilators.

The role of the endothelium in mediating flow responses to acetylcholine (ACh), bradykinin (BK), adenosine (Ado), and the poorly hydrolyzable ATP-derivative beta,gamma-methylene-ATP (MeATP) was evaluated in the intact coronary system of the isolated perfused guinea pig heart. In the presence of superoxide anions, known to inactivate the endothelium-derived relaxing factor nitric oxide (NO), only steady-state dilatation induced by ACh (1 microM) was fully inhibited and that of BK (0.1 nM) attenuated. Similar effects were obtained with methylene blue and N omega-nitro-L-arginine; however, the latter also reduced the actions of Ado (0.1 microM) and MeATP (0.5 microM). Conversely, perfusion with the NO precursor L-arginine (10 microM) resulted in a potentiated relaxation by ACh, whereas steady-state responses to BK and Ado remained unchanged. Pretreatment of hearts with hydroxyl radicals (.OH) elevated vascular permeability. Under this condition, flow increases induced by ACh, BK, and Ado were enhanced by 130, 89, and 47%, respectively, whereas the effect of MeATP (0.5 microM) was reduced by 45%. Preexposure of hearts to the oxidant hypochlorous acid (HOCl) prevented dilatations by ACh, BK, MeATP and Ado (0.1 microM), and the response to Ado (5 microM) was reduced by 68%; postischemic hyperemia was attenuated. Glyburide, an inhibitor of ATP-sensitive K+ channels, halved the flow response to infused Ado (0.1 and 5 microM), inhibited MeATP, and abolished reactive hyperemia. We conclude that in the guinea pig coronary system ACh, BK, MeATP, and Ado (0.1 microM) induce endothelium-dependent vasodilatation, some step(s) of the signal transmission being vulnerable to oxidative attack by HOCl.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

[Are the radical scavenging properties of ACE inhibitors with sulfhydryl groups in therapeutically effective concentrations of quantitative significance?].

The chemiluminescence reaction elicited from luminol in the presence of hydroxyl radicals was concentration-dependently suppressed by captopril, indicating efficacious radical scavenging. As to be expected, ACE inhibitors lacking free sulfhydryl groups (ramipril, enalapril) were inactive. However, the endogenous scavenger and anti-oxidant uric acid proved to be far superior to captopril, when concentrations of both were compared that are realized in vivo. A substantial augmentation of endogenous scavenging ability during therapy with captopril thus seems unlikely. In a model of standardized myocardial hypoxia (isolated working heart of the guinea pig with 30 min low flow perfusion) captopril, ramiprilat and uric acid equally improved post-hypoxic heart function. There was no cardioprotective action of captopril in excess of that accountable for by inhibition of ACE. It seems possible that ACE (kininase II) inhibitors exert cardioprotection via elevated tissue levels of kinins: bradykinin also improved heart performance after low flow perfusion and bradykinin-induced coronary dilatation was markedly enhanced in the presence of ramiprilate, reflecting attenuated degradation by endothelial kininase II.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1989

Uric acid as radical scavenger and antioxidant in the heart.

Uric acid (UA) is released from the heart of many species, including man, and its site of formation has been shown to be the microvascular endothelium. Since UA reacts with oxygen radicals in vitro, experiments were conducted on guinea pig hearts perfused with Krebs-Henseleit buffer (KHB) to evaluate whether the formation of UA could afford protection from damage by radicals and oxidants. The following results were obtained: (1) Upon addition of the hydroxyl radical scavenger DMSO to the perfusate, the coronary rate of release of endogenous uric acid was increased relative to the precursor purines. (2) UA was degraded during passage through the coronary system and also in KHB in vitro after addition of substances generating hydroxyl radicals or hypochlorite. Superoxide (O2-) radicals did not seem to react directly with UA, though UA concentration-dependently quenched the chemiluminescence generated from luminol in the presence of O2- and OH radicals. (3) Coronary dilation by acetylcholine (Ach) and sub-microM concentrations of adenosine, induced by both via endothelial mechanisms, was attenuated after prolonged inhibition of endothelial UA formation by allopurinol. Furthermore, the effect of Ach but not of adenosine proved acutely sensitive to methylene blue and O2-, substances known to inactivate EDRF. This finding suggests involvement of EDRF in Ach-mediated, but not in adenosine-induced dilatation of the intact coronary system. Exogenously applied UA prevented the impairment of vascular responses to Ach and adenosine caused by allopurinol, and to Ach upon generation of O2-. (4) Hearts performed more pressure-volume work and exhibited greater functional stability when perfused with KHB supplemented with UA in a physiological concentration.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMedDate not supplied

Postischemic dysfunction of the heart induced by small numbers of neutrophils via formation of hypochlorous acid.

The role of polymorphonuclear neutrophils (PMN) in the injury of the heart following ischemia and reperfusion is still controversial. The aim of this study was to investigate whether small numbers of PMN may cause myocardial dysfunction in an isolated system, how the resulting loss of function can be characterized and whether the formation of hypochlorous acid (HOCl) can be responsible for the PMN-mediated effect. Isolated working guinea pig hearts were subjected to a 90% reduction of coronary flow for 30 min, with or without intracoronary infusion of homologous PMN (approximately 1-2 x 10(5) cells/min, i.e. about 5-10% of normal blood count). This ischemia was followed by a 15 min reflow period in a non-working ("Langendorff") mode before work was resumed. In hearts perfused only with buffer, post-hypoxic heart function recovered to 75-80% of the initial value. Inclusion of unstimulated PMN did not further attenuate cardiac function. However, cardiac output was decreased to 42% of the initial value, provided thrombin (0.3 U/ml) and H2O2 (10(-5) M) were also present, and the retained PMN (about 10% of those infused) were additionally stimulated during reflow by application of FMLP (10(-6) M for 1 min). In these instances, coronary flow at any time of the experiment and release of lactate or purines during ischemia and reflow did not differ significantly between hearts perfused with or without PMN. There was no substantial release of myoglobin in controls and in PMN-treated hearts. Inotropic stimulation of the hearts with noradrenaline or exogenous Ca2+ caused a sustained increase in contractile force. However, the response was significantly reduced in PMN-perfused hearts in comparison to control hearts. The myocardial contents of high-energy phosphates with and without inotropic stimulation proved to be identical irrespective of whether experiments had been performed in the absence or presence of PMN. A similar loss of myocardial function as mediated by PMN could be produced by infusing chemically generated hypochlorous acid (HOCl, 5 x 10(-7) M for 10 min). Strikingly, that portion of the infused HOCl which actually reacted with cardiac tissue was comparable to the amount shown to be generated by stimulating 10(6) PMN retained in the coronary system (about 7 nmoles). Supplementing the perfusate with the scavengers L-methionine (10(-4) M) or uric acid (5 x 10(-4) M) prevented the attenuation of heart function provoked by PMN. The results indicate that small numbers of PMN, sufficiently activated, can depress cardiac function after 30 min of ischemia.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMedDate not supplied

Women's health and community health nursing practice in geographically isolated settings: a Canadian perspective.

In this article we examine the literature on women's health and community health nursing practice in geographically isolated settings from a Canadian perspective. An extensive review of journal literature, Canadian government documents and reports, and reports by women's organizations forms the basis of this examination. Following a brief introduction to the concept of geographical isolation, literature relating to women's health issues in rural and northern settings is described. This is followed by a discussion of community health nursing practice and women's health in rural and northern settings. The discussion section identifies major gaps in the literature and suggests implications for community health nursing practice and research, as well as strategies for policy and programming to improve women's health and community health nursing practice in geographically isolated settings in Canada.

Canada↗