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C Hunt

Publications and source records attributed to C Hunt.

107 records · Page 6Linked to original sources

Comorbidity in the anxiety disorders: the use of a life-chart approach.

Findings of comorbidity across the anxiety and depressive disorders have implications for aetiology, diagnosis and treatment. This paper describes a method to assess one aspect of the relationship between comorbid disorders: the degree to which one illness experience is believed to be caused by the earlier experience of a different illness. The life-chart method involves the use of a semi-structured interview to document the lifetime course of disorders. The method was reliable in a sample of patients treated at a specialized treatment unit for anxiety disorders. Patients fell into three major groupings: those with one disorder only (19%); those who fulfilled criteria for two or more disorders, but with one disorder primary and other disorders secondary to it (55%); and those who fulfilled criteria for two or more independent disorders (26%).

Adult↗

Selective attentional biases for physical threat in physical anxiety sensitivity.

Anxiety sensitivity is a trait susceptibility associated with the fear of anxiety-related sensations. One reason why such fears exist may be because those high in anxiety sensitivity selectively attend towards such sensations. However, few studies have actually investigated these cognitive biases in high anxiety sensitive individuals. The current study, therefore, sought to investigate selective attentional biases using the visual dot-probe paradigm. Since recent research suggests that at least one component of anxiety sensitivity is linked to the fear of physical sensations, individual were selected on the basis as to whether they were high or low in their anxious concern for physical sensations. In order to determine whether a general or specific attentional bias exists, the emotionality of material presented to participants was varied in terms of whether it was physically threat-related, socially threat-related, or positive. Consistent with predictions, those high in physical anxiety sensitivity were found to exhibit a selective attentional bias in favour of the location of physically threatening material. Furthermore, those low in anxiety sensitivity were found to avoid such material. Interestingly, a similar attentional bias was not found for either socially threatening or positive material. If anything, those high in physical anxiety sensitivity avoided positive material. These findings are discussed in light of current theories of anxiety sensitivity and future research.

Adolescent↗

Long-term outcome of panic disorder and social phobia.

The question is addressed as to whether cognitive-behavior treatment delivered as a routine service in a specialist clinic is effective in the long term. Of 124 consecutive patients completing treatment for panic disorder or social phobia, 93 were assessed an average of 2 years following treatment. The treatment produced significant improvement in measures of symptoms, avoidance, and disablement during treatment and further significant improvement during the follow-up. A quarter of participants no longer met diagnostic criteria, had not sought further treatment, and their anxiety had not troubled them since treatment. These findings, although not showing the large treatment effects reported from controlled outcome research, support the effectiveness of cognitive-behavioral interventions in routine care.

Adult↗

Health care reform.

Explore the source record for details and available documents.

Delivery of Health Care↗

Exploring decision-making for environmental health services: perspectives from four cities.

Increasing resources are being allocated to environmental health monitoring, especially for developing methods and collecting data to construct environmental health indicators (EHIs). Yet, little research has focused on understanding how communities and service providers make decisions with regard to environmental health priorities and the role of indicators in this process. This paper presents insights regarding local decision-making that arose from a project to test the feasibility of using community-based EHIs to facilitate communication between the providers and the recipients of environmental services in four developing-country cities. The results of the study indicate that decision-making for environmental health services is complex and iterative rather than rational and linear. Contextual and process factors play an important role. These factors include the morale of service providers, the extent of collaboration between service agencies, the priorities of different community groups and relations between service providers and communities. Scientific information, in the form of EHIs, did not appear to be a key element of decision-making in the settings studied. As tools, EHIs are unlikely to become part of the decision-making process unless they are integrated with local agendas and backed by strong local representation.

Cities↗

Characterization of human liver cytochromes P-450 involved in theophylline metabolism.

Theophylline is metabolized in the liver by one or more cytochrome P-450 enzymes. To assess the amounts and types of these human cytochromes P-450, we incubated theophylline with microsomes prepared from 22 different human livers in the presence of NADPH, and measured simultaneous rates of 1- and 3-N-demethylations to 3-methylxanthine (3-MX) and 1-methylxanthine (1-MX), respectively; and 8-hydroxylation to 1,3-dimethyluric acid (1,3-DMU). Under optimal conditions, 3-MX, 1-MX, and 1,3-DMU formation proceeded with mean Km values of 2.05, 1.93, and 5.34 mM and Vmax values of 2.28, 2.48, and 23.4 pmol/mg/min, respectively. Formation of 3-MX and 1-MX correlated best with amounts of the immunoreactive protein HLd (P-450IA2) (p less than 0.05), whereas formation of 1,3-DMU correlated with the microsomal content of HLp (P-450IIIA3) and HLj (P-450IIE1). In immunoinhibition experiments, incubations conducted with a polyclonal anti-rat P-450c/d antibody, the formation of all the three theophylline metabolites (p less than 0.05) was significantly inhibited. However, addition of isoform-specific anti-rat-P-450d antibodies to the microsomal mixture significantly inhibited 1-N-demethylation, selectively, with little (if any) inhibition of 3-N-demethylation or 8-hydroxylation. Nonspecific cytochrome P-450 inhibition was ruled out by showing that erythromycin N-demethylation, an activity catalyzed by HLp, was unaffected by either anti-P-450c/d (P-450IA1/IA2) or anti-P-450d. Anti-rat-P-450p antibodies failed to block formation of theophylline metabolism, but did inhibit erythromycin N-demethylase.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Home care clients, providers and costs.

The goals of the study were to describe the clients of home care and their care providers; to determine the competencies required to provide their care; to determine the costs of the formal care providers per client diagnoses; and to determine the burden of care for a randomly selected sample of informal care providers. Forty-nine percent of the 773 clients who participated in the study were age 70 and older and 63% were female. Forty-one percent of clients lived with a spouse but 24% lived alone. The most frequent primary diagnoses (reason for admission to program) were arthritis, stroke, fractures and sepsis. Discipline experts determined the competencies required to provide the care. Variations in costs across the same diagnosis were related to the category of providers assigned and to the frequency of provision of care strategies. The constant dependency of the client was perceived as the greatest stressor for informal providers.

Adolescent↗