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Biomedical subjects

R Kearns

Publications and source records attributed to R Kearns.

9 recordsLinked to original sources
PubMed2001

Making space for the 'intellectual' in geographies of disability.

There is a growing body of work on geographies of deinstitutionalisation and its consequences, but the weight of this scholarship has focussed on people with mental health problems and physically disabled people. With only few exceptions, the 'post asylum geographies' of intellectually disabled people remain neglected by geographers. We advocate a redressing of this imbalance. First, we assess reasons for the relative absence of 'intellectual' considerations in geographies of disability. We then consider ways in which the full spectrum of those with mental differences might be included in geographical research. We conclude that Wolpert's call 25 years ago to 'open closed spaces' is just as applicable to our efforts to conceptually link health, place, and disability, as it is to the material welfare of vulnerable groups in society.

Deinstitutionalization↗
PubMed2001

The impacts of a school closure on neighbourhood social cohesion: narratives from Invercargill, New Zealand.

We propose that, beyond their educational function, schools can serve as catalysts for community participation, social cohesion and the vitality of neighbourhoods. The paper explores the impacts of a school closure on families in an urban neighbourhood in Invercargill, New Zealand. The highest urban depopulation rate in the country has had implications for the viability of Invercargill schools. We present a qualitative study of narratives gathered during an interview-based study of the closure of Surrey Park School. Our analysis highlights the impact of school closure for low-income families and more generally reflects on the place of schools in contributing to social cohesion and the broadly defined health of a community.

Adolescent↗
PubMed1999

Whole body hyperthermia: effects upon canine immune and hemostatic functions.

In this study, the effects of induced whole body hyperthermia (WBH; 42.3 degrees C for 90 min) on peripheral blood mononuclear cell (PBMC) phenotype distribution, in vitro blastogenic responsiveness and selected parameters of hemostasis were determined in dogs. Hyperthermia was induced by heating venous blood during extracorporeal circulation (EC); induction of WBH by peritoneal lavage (PL) and perfusion without heating (i.e. euthermic EC and euthermic PL) were used as controls. Whole body hyperthermia was associated with lymphopenia and thrombocytopenia that persisted throughout the eight-day post-treatment observation interval. The lymphopenia was selective in that CD5-positive T lymphocytes were more sensitive than were sIg-positive B cells and, within the T-cell compartment, suppressor (CD8-positive) cells were more sensitive to hyperthermic stress than helper (CD4 positive) lymphocytes. Lymphopenia was also observed in EC and PL euthermic controls, although that lymphopenia was transient and nonselective. Persistent suppression of T-cell phytomitogen-induced blastogenesis was induced by WBH in contrast to transient suppression in euthermic controls. For all treatment groups, lymphopenia and suppressed blastogenesis were correlated to elevated plasma cortisol levels. Induction of WBH by EC resulted in coagulopathy characterized by thrombocytopenia, increased plasma fibrin degradation products, prolonged clotting times, and evidence of spontaneous bleeding. These hemostatic alterations were correlated temporally to increased serum levels of liver enzymes. However, there was no evidence of hepatic injury when WBH was induced by PL, where transient thrombocytopenia was the only significant hemostatic alteration. These results indicate that 42.3 degrees C whole body hyperthermia can be well-tolerated and, although associated with suppression of general indexes of immunocompetence, is not associated with opportunistic infections.

Animals↗
PubMed1995

Management of hypertension and the core services guidelines: results from interviews with 100 Auckland general practitioners.

AIM: To determine if the management of a hypothetical case of essential hypertension by general practitioners conforms with the Report to the National Advisory Committee on Core Health and Disability Services guidelines on the Management of Raised Blood Pressure in New Zealand (Core Services Report on Hypertension) sent to all general practitioners in November 1992. METHOD: A cross-sectional survey of a random sample of 100 Auckland general practitioners using a standard case of a 60 year old man with essential hypertension. Seventy interviews were conducted by a face-to-face interview and 30 by telephone interview. The main outcome measures were. Initial choice of medication and levels at which blood pressure would require treatment. RESULTS: Forty one percent of the interviewed doctors had read the Core Services report on hypertension. Fifty percent of the doctors indicated they would use the recommended first line antihypertensive medication (ie, diuretic or beta blocker). Doctors who prescribed beta blockers had been graduated a significantly longer time than those who did not. The majority of doctors indicated that they would initiate pharmacological treatment at lower blood pressures in younger patients than older patients contrary to the recommendation of the report. CONCLUSIONS: Current reported practice is only partially consistent with that suggested by the Core Services report on hypertension. Approximately half of the doctors interviewed were prescribing the recommended first line medication. Treatment was more likely to be initiated at lower levels in younger patients than in older patients in spite of the higher absolute risk and potential absolute benefit in the latter group. Adherence to the guidelines could see a shift from overtreatment of younger patients to an increase in treatment for older patients who are at higher risk of blood pressure related disease. More specific graduate educational measures will be needed if the Core Services report on hypertension are to be implemented.

Adult↗
PubMed1991

Acquired factor VIII inhibitor.

Development of a circulating inhibitor of the coagulant activity of factor VIII is a rare event producing a clinical picture similar to that of classic hemophilia. A case of autoimmune factor VIII inhibitor has been presented. Although a hemostatic response was rapidly achieved with the infusion of factor IX concentrates, immunosuppressive therapy was initiated. The inhibitor disappeared in less than 20 days from the initiation of therapy.

Autoantibodies↗
PubMed1984

Effects of a contusion injury on spinal cord blood flow in the sheep.

The effect of experimental trauma on the blood flow in the central (essentially gray matter) and peripheral (essentially white matter) regions of the sheep's spinal cord was studied using a radioactive microsphere technique. In seven out of eight animals, a progressive fall in blood flow occurred in both the peripheral and central regions of the cord within 2 hours following injury and remained reduced over the period of recording (up to 12 hours). Changes in local vascular resistance indicated that in approximately 60% of our animals, changes in arterial pressure alone contributed highly significantly to the decreased spinal blood flow. There remains the possibility that early therapeutic intervention could sustain neuronal function where local blood flow would otherwise be inadequate in the damaged spinal cord.

Animals↗
PubMed1981

Effects of anesthesia and laminectomy on regional spinal cord blood flow in conscious sheep.

Blood flow for the whole spinal cord (SCBF), central cord (largely gray matter), and peripheral cord (largely white matter) has been measured at all segmental levels using radioactive microspheres in conscious sheep. Whole SCBF was greatest in the lower cervical and lumbar enlargements and least in the upper cervical and thoracic regions. This was attributable partly to regional variations in gray-matter blood flow but principally to regional variations in the proportion of gray and white matter present. Whole SCBF for the total cord was 14.5 +/- 0.8 ml/100 gm/min, central cord flow was 40.6 +/- 3.5 ml/100 gm/min, and peripheral cord flow was 9.7 +/- 1.9 ml/100 gm/min. Blood flow was not affected by sodium pentobarbital provided the level of anesthesia, arterial pressure, and blood gases was carefully regulated. Laminectomy usually resulted in a marked increase in central cord blood flow at the site of cord exposure, lasting about 90 minutes; this increase was not necessarily reflected in whole SCBF because of the absence of any change in blood flow in the relatively large proportion of peripheral cord. This effect of laminectomy could adversely influence results obtained from studies using invasive techniques to measure SCBF.

Anesthesia, Intravenous↗