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Biomedical subjects

S M Hunt

Publications and source records attributed to S M Hunt.

At least 37 records · Page 2Linked to original sources

The QLDS: a scale for the measurement of quality of life in depression.

It has been apparent for some time that utilisation of health services is more influenced by how people feel than by their 'objective' symptoms. Research has also shown that compliance with treatment regimens is dependent on the impact of that treatment on the patient's well-being. Such findings highlight the need to assess the patient's view of his or her progress through the health care system. This has led to a growing interest in quality of life assessment and, in particular, to the impact of illness and its treatment on the quality of life of the patient. Perhaps surprisingly, interest in quality of life measures for outcome assessment in Psychiatry has been slower to develop than in other specialties. While a number of clinician- and patient-completed measures of the severity of depressive symptoms exist, no measure of the quality of life of depressed patients is available. This paper describes the development and testing of the Quality of Life in Depression Scale (QLDS), a new measure designed to fill this gap. The theoretical basis for the instrument is that life gains its quality from the ability and capacity of the individual to satisfy his or her needs. The items included in the QLDS were derived from 30 qualitative interviews with depressed or recently recovered patients. Further interviews were held with depressed patients to establish the face and content validity of the instrument. Respondents had little trouble completing the questionnaire and found the content to be relevant to their experience of depression. The QLDS represents an important advance in our ability to understand the impact of depression on quality of life.

Depression↗

A new measure of quality of life in depression: testing the reliability and construct validity of the QLDS.

Our previous paper described the development of a new quality of life scale for use with people suffering from depression; the Quality of Life in Depression Scale (QLDS). This paper reports on the testing of the scale for reliability and construct validity. Reliability was assessed by giving the questionnaire to the same set of patients on two occasions 2 weeks apart. This test-retest technique yielded a correlation of 0.94, with high internal consistency at both time 1 and time 2. A test of split-half reliability also indicated very high reliability. Construct validity was measured by comparing scores on the QLDS with those on an established scale of well-being from the same group of patients. The results gave a correlation between the two measures of 0.79, giving a satisfactory validity. It is concluded that the QLDS is a reliable and valid measure which is easy to use and acceptable to patients. Further tests of discriminative, concurrent and criterion validity are planned.

Depression↗

Induced expression of a Drosophila hsp70 promoter-fusion transgene is reduced after repeated heat shocks.

Levels of transcripts produced by a heat shock protein 70 (hsp70)-antisense white transgene in Drosophila were measured after single and multiple heat shocks to determine whether the hsp70 promoter could produce sustained high levels of transgene transcripts. A single heat shock resulted in typical highly inducible levels of RNA, but the amount of antisense RNA was substantially reduced after multiple heat shocks. Endogenous hsp70 mRNA levels were also less abundant after multiple heat shocks as compared to a single heat shock. The hsp70 promoter is unsuitable for use in fusion gene constructs for long term expression studies where repeated heat shocks are required.

Animals↗

Cross-cultural adaptation of health measures. European Group for Health Management and Quality of Life Assessment.

There is increasing interest throughout Europe in measuring health needs in the general population and in the 'quality of life' of patients. This has led to a demand for questionnaires capable of measuring health status in a reliable and valid manner. Most existing measures have, however, been standardised only in the U.S.A. and, to a lesser extent, in the U.K. The issue of translation and retesting of questionnaires prepared in the English language for use in other countries has received surprisingly little attention. This paper describes some of the technical, linguistic and conceptual issues raised by translation and the processes involved in producing acceptable country-specific versions of the Nottingham Health Profile according to a systematic method.

Cross-Cultural Comparison↗

Health-related behaviour in a small Scottish community.

A survey of health-related behaviours was carried out in a small Scottish town. A random sample stratified by age and sex was drawn from the records of the sole local health centre. A previously validated questionnaire was sent by post with a covering letter from the general practitioners and a reply paid envelope. An overall response rate of 71.3% was achieved. The results indicated very high rates of smoking for women with manual jobs, but differences between men in manual & non manual groups were not significant. Younger women reported higher alcohol consumption than older women, but there were no significant differences between occupational groups or employed and unemployed men. Only a minority of respondents reported regular consumption of high fibre products, low fat milk and polyunsaturated margarine and few claimed to undertake vigorous exercise. In general health-related behaviours showed little association with self-rated health. Whilst the data confirm the importance of socio-demographic factors in certain behaviours they also indicate that these are inadequate to predict the pattern of such behaviours within a community.

Adolescent↗

The incidence and correlates of health-related behavioural change in a small Scottish community.

This paper reports on a survey of health related behavioural change in a small Scottish town. Four types of behaviour were surveyed; smoking, alcohol use, dietary habits and exercise. The results indicate that for both smoking exercise behavioural change is very unstable. Cutting down or giving up alcohol was significantly associated with cessation of smoking in women but not in men. All dietary changes were strongly inter-related. Giving up smoking, taking exercise and eating more fibre were significantly associated with very good reported health. Sex, age and social class patterns in health-related changes were evident.

Adolescent↗

Health related behaviour in hypertension.

Three groups of patients matched for age and sex were drawn from general practitioner records. One group had been diagnosed as mild hypertensives and were not on any medication, the second group consisted of moderate to severe hypertensives on medication and the third was a quasi-control group consisting of normotensives with no diagnosed medical problem. These three groups were compared with respect to individual behaviours which may affect blood pressure levels. Patients in both hypertensive groups were less likely to be current smokers. They were also more likely to be controlling their weight than people in the control group: well over 50% of men and women in both hypertensive groups as compared with about one-third in the control group. There were no differences between the three groups with respect to reported frequency or amount of alcohol use, frequency of exercise or strategies for coping with stress, although men in the control group were significantly less likely to describe themselves as not very active. We suggest that more advice is needed for hypertensive patients concerning the adverse effects of alcohol, the benefits of exercise and successful methods of weight control. However, the greater propensity of normotensives to smoke may put them more at risk of cardiovascular disease than the hypertensive individuals.

Adaptation, Psychological↗

Damp housing, mould growth, and symptomatic health state.

OBJECTIVE: To examine the relation between damp and mould growth and symptomatic ill health. DESIGN: Cross-sectional study of random sample of households containing children; separate and independent assessments of housing conditions (by surveyor) and health (structured interview by trained researcher). SETTING: Subjects' homes (in selected areas of public housing in Glasgow, Edinburgh, and London). SUBJECTS: Adult respondents (94% women) and 1169 children living in 597 households. END POINTS: Specific health symptoms and general evaluation of health among respondents and children over two weeks before interview; and score on general health questionnaire (only respondents). MEASUREMENTS AND MAIN RESULTS: Damp was found in 184 (30.8%) dwellings and actual mould growth in 274 (45.9%). Adult respondents living in damp and mouldy dwellings were likely to report more symptoms overall, including nausea and vomiting, blocked nose, breathlessness, backache, fainting, and bad nerves, than respondents in dry dwellings. Children living in damp and mouldy dwellings had a greater prevalence of respiratory symptoms (wheeze, sore throat, runny nose) and headaches and fever compared with those living in dry dwellings. The mean number of symptoms was higher in damp and mouldy houses and positively associated with increasing severity of dampness and mould (dose response relation). All these differences persisted after controlling for possible confounding factors such as household income, cigarette smoking, unemployment, and overcrowding. Other possible sources of bias that might invalidate the assumption of a causal link between housing conditions and ill health--namely, investigator bias, respondent bias, and selection bias--were also considered and ruled out. CONCLUSION: Damp and mouldy living conditions have an adverse effect on symptomatic health, particularly among children.

Adolescent↗

Self-assessed disability in patients with arthrosis of the hip joint. Reliability of the Swedish version of the Nottingham Health Profile.

The study aimed to describe self-assessed disability, using the Nottingham Health Profile (NHP), in patients with arthrosis of the hip joint, to test the reliability of the Swedish version of the NHP, and to compare disability perceived by the patient with the Charnley/d'Aubignet score. The NHP was administered twice to 73 patients, waiting for total hip replacement. Pain, energy, sleep, and mobility were severely affected. The correlations between subjective and objective scores were, apart from pain, moderate. The two test administrations correlated highly. In conclusion, the NHP is a reliable instrument, which may provide valuable supplementary information in the assessment of disability.

Activities of Daily Living↗

The human pyruvate dehydrogenase complex. Isolation of cDNA clones for the E1 alpha subunit, sequence analysis, and characterization of the mRNA.

cDNA clones corresponding to the entire length of mRNA for the alpha subunit of human pyruvate dehydrogenase (EC 1.2.4.1), the E1 component of the pyruvate dehydrogenase complex, have been isolated from liver cDNA libraries. Two classes of cDNA clones were obtained and these correspond to two forms of pyruvate dehydrogenase E1 alpha mRNA. Both mRNA species have been demonstrated in a variety of human tissues and cultured fibroblasts. The cDNA sequence has been determined and, from it, the protein sequence of the human E1 alpha subunit was deduced. The protein is synthesized with a typical mitochondrial import leader sequence and the peptide bond at which this sequence is cleaved after transport into the mitochondrion has been determined by direct amino acid sequencing of the mature E1 alpha subunit. The human pyruvate dehydrogenase E1 alpha subunit contains identical phosphorylation sites to those found in the corresponding porcine protein. Preliminary studies of pyruvate dehydrogenase E1 alpha mRNA in cultured fibroblasts from patients with severe pyruvate dehydrogenase deficiency have revealed considerable heterogeneity as would be expected from protein studies.

Amino Acid Sequence↗

Housing conditions and ill health.

Lack of empirical evidence that living in damp houses has detrimental effects on health may partly be due to inadequate research. A preliminary study was therefore carried out of a random sample of council owned residences in a deprived area of Edinburgh, a respondent from consenting households being interviewed to obtain a profile of the physical and mental health of all adults and children. In addition, information was gathered about other factors that might be important, particularly smoking and selective bias in the allocation of tenants to houses. Independent measures of dampness were made by environmental health officers. No conclusive effects of damp on the health of adults were identified. Nevertheless, children living in damp houses, especially where fungal mould was present, had higher rates of respiratory symptoms, which were unrelated to smoking in the household, and higher rates of symptoms of infection and stress. Housing should remain an important public health issue, and the effects of damp warrant further investigation.

Disease↗

Profound neurological illness, relieved by protein restriction, in a baby with a transient disturbance in the metabolism of ingested isoleucine.

An 8-month-old infant presented because of poor development followed by the acute onset of cortical blindness and a severe seizure disorder at the time of changing from breast to formula feeding. Metabolic investigations revealed an increased urinary excretion of 2-methyl-3-hydroxybutyric, methylmalonic and 2-ethylhydracrylic acids. The concentration of these compounds in urine was augmented by oral protein (5 g/kg per day) and isoleucine loading. A low protein diet (1.5 g/kg per day) produced a dramatic response with complete cessation of seizures and a marked improvement in vision and general development. After many months of low protein diet, the biochemical abnormalities were no longer detectable, even after protein loading. Extensive investigations have failed to reveal an intrinsic enzyme defect which would account for these clinical and biochemical findings. A toxic effect of a bacterial metabolite of isoleucine is proposed.

Amino Acid Metabolism, Inborn Errors↗